First time in vivo assessment of sigma-1 receptor binding (Sig-1R) in the brain of unmedicated acute major depressive disorder (MDD) using the novel Sig-1R-specific radioligand (-)-[F-18]Fluspidine and PET

Ziel/Aim:

The Sig-1R is a chaperone protein localized at the endoplasmatic reticulum (ER) that can translocate under ER stress, a mechanism which is critically involved in the pathophysiology of MDD. In order to investigate the pathophysiology of Sig-1R regulation in MDD, for the first time we quantitatively assessed Sig-1R binding in the brain of unmedicated, acute MDD and compared it with healthy controls (HC) using the novel radioligand (-)-[F-18]Fluspidine and PET.
Methodik/Methods:
Unmedicated, moderate to severe, acute MDD (n=12; 33±13ys; 6 males: HAMD: 19.0±4.3; MDD+ with family histora [n=6] and MDD- without family history of depression [n=6]), were investigated using(-)-[F-18]Fluspidine PET (300 MBq, ECAT Exact HR+) and compared with age-/sex-matched healthy controls (HC; n=9; 37±16ys [n.s.]; 4 males [n.s]). Distribution volume parameters (V_T) were determined using full pharmacokinetic modelling (2TCM, metabolite correction). Regional VOI-analyses were carried out.
Ergebnisse/Results:
Compared with HC, in MDD, V_T was significantly higher within the ncl. caudatus, ncl. accumbens, fronto-temporo-parieto-occipital and cingulate cortices, insula, amygdala, thalamus and midbrain/raphe (+15 to +24%, P<0.05). Compared with MDD-, in MDD+, V_T was higher in the fronto -temporo and cingulate cortices, insula, hippocampus, putamen, thalamus (P<0.05). There was an inverted U-relationship between the severity of MDD (HAMD) and V_T in the fronto-temporo-parietal and posterior cingulate cortices and thalamus (P<0.05).
Schlussfolgerungen/Conclusions:
Using (-)-[F-18]Fluspidine PET, we demonstrate for the first time higher Sig-1R binding in meso-striato-cortico-limbic and paralimbic brain regions of unmedicated, acute MDD. Higher Sig-1R binding in MDD+, compared with MDD-, may express different subtypes of depression. Increased Sig-1Rs in acute MDD and the inverted U-relationship between severity and Sig-1R may reflect neuroadaptive uptregulation of Sig-1R counteracting ER stress that is exhausted in the severest stages of MDD leading to apoptosis.