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Published in: Systematic Reviews 1/2018

Open Access 01-12-2018 | Protocol

A comprehensive regional neurochemical theory in depression: a protocol for the systematic review and meta-analysis of 1H-MRS studies in major depressive disorder

Authors: Thomas Drago, Patrick W O’Regan, Ivan Welaratne, Shane Rooney, Aoife O’Callaghan, Marissa Malkit, Elena Roman, Kirk J Levins, Lauren Alexander, Denis Barry, Erik O’Hanlon, Veronica O’Keane, Darren William Roddy

Published in: Systematic Reviews | Issue 1/2018

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Abstract

Background

Magnetic resonance spectroscopy (MRS) is a non-invasive analytical technique that investigates the presence and concentrations of brain metabolites. In the context of major depressive disorder (MDD), MRS has revealed regional biochemical changes in GABA, glutamate, and choline across different brain compartments. Technical and methodological advances in MRS data acquisition, in particular proton-based 1H-MRS, have resulted in a significant increase in the incidence of reports utilizing the technique for psychiatric disorder research and diagnosis. The most recent comprehensive meta-analysis reviewing MRS in MDD stems from 2006. Using contemporary systemic reviews and meta-analysis, the aim is to first test a neurochemical circuit-based theory of depression and then to determine if clinical scores relate to metabolite concentrations before and during treatment.

Methods

Region-specific metabolite changes in MDD will be assessed by systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Inclusion criteria will include participant age (18 to 65), English language studies, known regions of interest, and detailed documentation of 1H-MRS procedures. Reported brain regions will be standardized according neuroanatomical expertise allowing increased power of the meta-analysis. Regions of interest will initially include the hippocampus, thalamus, prefrontal cortex, anterior and posterior cingulate gyri, parietal lobe, and basal ganglia. Exclusion criteria will include comorbid psychiatric illness and drug use. Two independent reviewers will undertake all data extraction, while a third reviewer will check for reviewer discrepancies. Statistical analysis will be performed using STATA supplemented by Metan software and SPSS.

Discussion

This data will shed new light on the biochemical basis of depression in different brain regions, thereby highlighting the potential of MRS in identifying biomarkers and generating models of MDD and treatment response.

Systematic review registration

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Metadata
Title
A comprehensive regional neurochemical theory in depression: a protocol for the systematic review and meta-analysis of 1H-MRS studies in major depressive disorder
Authors
Thomas Drago
Patrick W O’Regan
Ivan Welaratne
Shane Rooney
Aoife O’Callaghan
Marissa Malkit
Elena Roman
Kirk J Levins
Lauren Alexander
Denis Barry
Erik O’Hanlon
Veronica O’Keane
Darren William Roddy
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2018
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0830-6

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