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Biol. Psychiatry, Available online 15 December 2015 | doi:10.1016/j.biopsych.2015.11.027 Effects of creatine monohydrate augmentation on brain metabolic and network outcome measures in women with major depressive disorder

Abstract

Sujung Yoon^{a, 1}, Jieun E Kim^{a, 1}, Jaeuk Hwang^b, Tae-Suk Kim^c, Hee Jin Kang^a, Eun Namgung^a, Soonhyun Ban^a, Subin Oh^a, Jeongwon Yang^a, Perry F. Renshaw^d, In Kyoon Lyoo^{a, d}

^a Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea

^b Department of Psychiatry, Soonchunhyang University College of Medicine, Seoul, South Korea

^c Department of Psychiatry, the Catholic University of Korea College of Medicine

^d The Brain Institute and Department of Psychiatry, The University of Utah, SLC, Utah, USA

Address for correspondence to In Kyoon Lyoo, M.D., Ph.D., M.M.S., Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha W. University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, South Korea.

¹ These authors have equally contributed to the paper.

Abstract

Background

Creatine monohydrate (creatine) augmentation has the potential to accelerate the clinical responses and to enhance the overall efficacy of selective serotonin reuptake inhibitor (SSRI) treatment in women with major depressive disorder (MDD). Although it has been suggested that creatine augmentation may involve the restoration of brain energy metabolism, the mechanisms underlying its antidepressant efficacy remain unknown.

Methods

In a randomized, double-blind, placebo-controlled trial, 52 women with MDD were assigned to receive either creatine augmentation or placebo augmentation of escitalopram, and 34 participated in multimodal neuroimaging assessments at baseline and week 8. Age-matched healthy women (n=39) were also assessed twice at the same intervals. Metabolic and network outcomes were measured for changes in prefrontal n-acetyl aspartate (NAA) and those in rich club hub connections of the structural brain network, using proton magnetic resonance spectroscopy and diffusion tensor imaging, respectively.

Results

We found MDD-related metabolic and network dysfunction at baseline. Improvement in depressive symptoms was greater in patients receiving creatine augmentation relative to placebo augmentation. Following 8 weeks of treatment, prefrontal NAA levels increased significantly in the creatine augmentation group as compared to the placebo augmentation group. Increment in rich club hub connections was also greater in the creatine augmentation group than in the placebo augmentation group.

Conclusions

NAA levels and rich club connection increased after creatine augmentation of SSRI treatment. Effects of creatine administration on brain energy metabolism and network organization may partly underlie its efficacy in women with MDD.

Key Words : Major depressive disorder; Creatine monohydrate; Antidepressant; Brain bioenergetics; Network organization; Selective serotonin reuptake inhibitor

논문정보

형식Research article
게재일2015년 12월 (BRIC 등록일 2015-12-22)
연구진국내(교신)+국외 연구진
분야 생명과학 > 신경생물학

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