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. 2023;82(4):203-209.
doi: 10.1159/000530312. Epub 2023 Jun 15.

Effects of Psychotherapy on Glutamatergic Neurotransmission

Laura Wade-Bohleber  1   2 , Niklaus Zoelch  1   3 , Mick Lehmann  1 , Jutta Ernst  1 , André Richter  4 , Erich Seifritz  1 , Heinz Boeker  1 , Simone Grimm  1   5   6
Affiliations

Effects of Psychotherapy on Glutamatergic Neurotransmission

Laura Wade-Bohleber et al. Neuropsychobiology. 2023.

Abstract

Introduction: Psychodynamic psychotherapy is an effective and widely used treatment for major depressive disorder (MDD); however, little is known about neurobiological changes associated with induced symptom improvement.

Methods: Proton magnetic resonance spectroscopy with a two-dimensional J-resolved sequence served to test the relationship between glutamate (Glu) and glutamine (Gln) levels, measured separately in pregenual anterior cingulate cortex (pgACC) and the anterior midcingulate cortex (aMCC) as a control region, with change in depression symptoms after 6 months of weekly psychodynamic psychotherapy sessions in MDD patients. Depressed (N = 45) and healthy (N = 30) subjects participated in a baseline proton magnetic resonance spectroscopy measurement and a subgroup of MDD subjects (N = 21) then received once-a-week psychodynamic psychotherapy and participated in a second proton magnetic resonance spectroscopy measurement after 6 months. Change in depression symptoms was assessed using the Hamilton Depression Rating Scale (HAMD).

Results: Higher pretreatment pgACC Gln concentrations in MDD patients compared to healthy controls were associated with symptom severity. Patients and controls did not differ regarding Gln levels in aMCC nor regarding Glu levels in both regions. The association of pgACC Gln concentration and severity of depressive symptoms was reversed after 6 months of psychotherapy in MDD subjects. Regarding Gln in aMCC as well as Glu in both regions, there were no significant associations with improvement of depressive symptoms in the course of psychotherapy.

Discussion: Findings indicate specific regional effects of psychodynamic psychotherapy on glutamatergic neurotransmission and thereby highlight the key role of the pgACC in both depression pathophysiology and recovery.

Keywords: Depression; Glutamate; Glutamine; Proton magnetic resonance spectroscopy; Psychotherapy.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
a Two-dimensional JPRESS spectrum with the measured spectrum on top, the fitted spectrum in the middle, and the residuals (measured spectrum – fitted spectrum) at the bottom. Yellow circles indicate regions of Gln peaks, and white circles indicate regions of Glu peaks. b Cross-sectional view of the two-dimensional JPRESS spectrum along F1 = 0. The measured spectrum (black), the fit (red), and the residuals (gray) on top are plotted. In addition, the contributions from Gln (blue) and Glu (orange) are shown. c. Voxel placement in the pgACC (red) and aMCC (blue).
Fig. 2.
Fig. 2.
a Group difference in Gln in pgACC between depressed and healthy subjects. b Association of Gln and HAMD in pgACC pre- and posttreatment in depressed subjects. Green: pretreatment, orange: posttreatment.
See this image and copyright information in PMC

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