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Background  Alcohol dependence (AD) patients have a high prevalence of aggressive behavior (AB). The frontal cortex and amygdala contains various neurotransmitter systems and plays an important role in AB, which is also associated with cognitive deficits. However, to date, no study has addressed the association of metabolites in the frontal cortex and amygdala with cognitive deficits in Chinese aggressive behavior-alcohol dependent patients(AB-ADs).    Methods  We recruited 80 male AD and 40 male healthy controls (HCs), who completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Modified Overt Aggression Scale (MOAS), and the proton magnetic resonance spectroscopy (¹H MRS) scan using 3.0T Siemens. The ¹H MRS data were automatically fitted with a linear combination model for quantification of metabolite levels of n-acetyl-aspartate (NAA), glutamate (Glu), Choline (Cho) and creatine (Cr). Metabolite levels were reported as ratios to Cr.    Results  The AB-ADs group scored significantly lower than the non-aggression-alcohol dependent patients (NA-ADs) on these two RBANS subscales (immediate memory and attention function indices). The AB-ADs group showed a significant reduction in NAA/CR ratio in the left frontal cortex and Cho/Cr ratio in the left amygdala, and elevation in Glu/Cr ratio in the bilateral amygdala, compared with the NA-ADs group. The NAA/Cr ratio in the left frontal cortex was positively associated with immediate memory (r=0.60, P<0.05), and the Glu/Cr ratio in the right amygdala was negatively associated with delayed memory (r=-0.44,P<0.05) in AB-ADs group.    Conclusions  Metabolite alterations in the frontal cortex and amygdala may be involved in the pathophysiology of AB in AD and its associated cognitive impairment, especially immediate memory and delayed memory.

frontiers in psychiatry

Alterations of Metabolites in the Frontal Cortex and Amygdala Are Associated With Cognitive Impairment in Alcohol Dependent Patients With Aggressive Behavior