The Relationship Between Aberrant Neuronal Activation in the Pregenual Anterior Cingulate, Altered Glutamatergic Metabolism, and Anhedonia in Major Depression
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CONTEXT: Major depressive disorder (MDD) is characterized by diverse metabolic and functional abnormalities that occur in, among other regions, the pregenual anterior cingulate cortex (pgACC), a cortical region linked to anhedonia. OBJECTIVES: To contextualize metabolic, functional, and clinical parameters and thus to reveal cellular mechanisms related to anhedonia. DESIGN: The pgACC was investigated using a combined functional magnetic resonance imaging and magnetic resonance spectroscopic approach. Negative blood oxygenation level-dependent (BOLD) activations in the pgACC were assessed during emotional stimulation. Quantitative J-resolved magnetic resonance spectroscopy in the pgACC enabled simultaneous determination of glutamine, glutamate, N-acetylaspartate, glucose, and gamma-aminobutyric acid concentrations. Subjective emotional intensity ratings as well as various clinical parameters were determined. SETTING: The patients were recruited and evaluated in the Department of Psychiatry, University of Zurich, while the measurements were performed in the Institute of Biomedical Engineering, University of Zurich and the Technical University Zurich. PARTICIPANTS: Nineteen unmedicated patients with MDD and 24 healthy subjects. MAIN OUTCOME MEASURES: Reduced glutamine levels and lower functional responses in pgACC in anhedonic depressed patients were expected to be the predominant effect of abnormal glutamatergic transmission. It was further tested if, among patients, the ratings of emotional intensity on visual stimulation predicted the amount of metabolic and functional alterations in terms of reduced relative metabolite concentrations and BOLD changes. RESULTS: Patients with highly anhedonic MDD show decreased glutamine but normal glutamate and gamma-aminobutyric acid concentrations, with glutamine concentrations being dissociated from glucose concentrations. Glutamate and N-acetylaspartate concentrations in pgACC correlate with negative BOLD responses induced by emotional stimulation in MDD; whereas in healthy subjects, negative BOLD responses correlate with gamma-aminobutyric acid instead. Negative BOLD responses as well as glutamate and N-acetylaspartate concentrations correlate with emotional intensity ratings, an anhedonia surrogate, in those with MDD but not in healthy subjects. CONCLUSION: Aberrant neuronal activation patterns of the pgACC in anhedonic depression are related to deficits of glutamatergic metabolism.
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Pregenual anterior cingulate cortex has been shown to be hypoactivated in major depressive disorder.
“Pregenual anterior cingulate cortex (pgACC) has been shown to be hypoactivated in MDD [25].”
From State and training effects of mindfulness meditation on brain networks reflect neuronal mechanisms of its antidepressant effect (2016) · cites this paper as [25]
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Self-citationSelf-referential processing influences functional activation during cognitive control: An fMRI study
Wagner, G., Koch, K., Schachtzabel, C., Peikert, G., Schultz, C. C., Reichenbach, J. R., Sauer, H., & Schlösser, R. G. (2013) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nss074 · Cited by 47 · see citing works
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- Authors
- Walter, M., Henning, A., Grimm, S., Schulte, R. F., Beck, J., Dydak, U., Schnepf, B., Boeker, H., Boesiger, P., & Northoff, G.
- Affiliations
- Otto-von-Guericke-Universität Magdeburg (DE)
- University of Zurich (CH)
- General Electric (United States) (US)
- University of Basel (CH)
- Indiana University Bloomington (US)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2009-05-01
- Volume
- 66
- Issue
- 5
- Pages
- 478
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W1996941358
- Cited by
- 306
- References
- 50
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 10 · 2023: 8 · 2022: 17 · 2021: 14 · 2020: 26 · 2019: 12 · 2018: 20 · 2017: 19 · 2016: 21 · 2015: 28 · 2014: 21 · 2013: 28 · 2012: 33
- FWCI
- 17.55
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Max Planck Digital Library (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- major depressive disorder, anhedonia, pregenual anterior cingulate cortex, glutamine, glutamate, N-acetylaspartate, GABA, glucose metabolism, negative BOLD response, emotional intensity, neuronal activation, untreated depression
- MeSH terms
- Adult, Arousal, Aspartic Acid, Blood Glucose, Corpus Callosum, Depressive Disorder, Major, Major Depressive Disorder, Dominance, Cerebral, Emotions, Energy Metabolism, Female, gamma-Aminobutyric Acid, Glutamine, Gyrus Cinguli, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Synaptic Transmission, Neurons, Magnetic Resonance Spectroscopy, Oxygen Consumption, Glutamic Acid
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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