Magnetic resonance spectroscopy biomarkers of anti-inflammatory interventions in mood disorders: A systematic review of clinical trials☆

Abstract

Background: Mood disorders are linked to inflammation, suggesting anti-inflammatory treatments may influence mood regulation. Magnetic Resonance Spectroscopy (MRS) is effective in monitoring neurochemical changes associated with neuroinflammation and tracking the neurophysiological effects of anti-inflammatory agents. This systematic review summarizes clinical trials investigating the effects of anti-inflammatory agents on brain MRS measures in individuals with, or at risk for, mood disorders. Methods: We conducted a systematic review following PRISMA 2020 guidelines in PubMed, Scopus, Embase, and Web of Science to identify relevant studies published before April 2024. Clinical trials evaluating the effects of anti-inflammatory agents on MRS measures in mood disorders were included. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the Effective Public Health Practice Project tool. Results: Ten studies were included. Omega-3 increased N-acetyl aspartate (NAA) in the corpus callosum in bipolar disorder (BD) and reduced choline (Cho) and creatine (Cr) in the anterior cingulate cortex (ACC) in offspring of BD patients. N-acetylcysteine was associated with higher NAA, glutamate, and glutamine (Glx) and lower myoinositol levels in the ACC in major depressive disorder (MDD). Ebselen reduced inositol and Glx concentrations in the ACC in MDD. Infliximab reduced Glx in the prefrontal cortex in BD, and lovastatin increased NAA in the ACC and decreased the Cho/Cr ratio in the left basal ganglia in manic BD. Conclusion: Anti-inflammatory agents induce neurochemical changes in mood disorders that can be measured with MRS. These shifts may relate to symptom improvement. Further research is needed to elucidate the mechanisms underlying these effects.