Measurement of Post-Treatment Changes in Brain Metabolites in Patients with Generalized Anxiety Disorder using Magnetic Resonance Spectroscopy

Background: From previous studies, we know the correlations of some brain metabolites with a generalized anxiety disorder (GAD) and its symptoms. The response of GAD patients to various treatments is not the same and finding the best treatment option for each patient takes a long period of time. Objective: In this study, we try to examine if there is any relationship between a special treatment option and GAD patients’ response and brain metabolite correlation with anxiety level change.Material and Methods: This study is a clinical trial type of studies. We have used proton MRS (۱H-MRS) with field strength of ۳ Tesla to assess whether a different treatment option makes different responses based on metabolite changes. We chose ۱۶ patients based on Hamilton’s anxiety rate and a psychiatrist diagnosis. Patients were divided into two groups randomly. Each group took different treatments. Before treatment started, patients underwent MRS imaging and ۸ weeks after treatment as well. Our study lacked a control group, and the results were analyzed by comparing the measured values of metabolites and clinical scores before and after treatment. Results: The NAA and Cho concentration increased after treatments and Cr concentration remained constant in both groups. Both groups showed improvements in their symptoms of anxiety and also in their clinical score rates. Sertraline group showed a more increase in NAA concentration than CBT and also a more decrease in HAMA and HAMD-۱۷ scores. Conclusion: A simultaneously increase in NAA and Cho in both groups and a decrease in clinical anxiety levels demonstrate that NAA and Cho concentration are associated negatively with anxiety levels. In addition, both CBT and sertraline are effective in the improvement of anxiety symptoms.

Keywords:

Magnetic resonance spectroscopy , Generalized Anxiety Disorder , Sertraline , Cognitive behavior therapy , Dorsolateral Prefrontal Cortex , Brain Metabolites