Choline
Choline featured article
Choline is an essential nutrient critical for various bodily functions, including brain development, liver health, and muscle function. It acts as a precursor to acetylcholine, a neurotransmitter involved in memory, attention, and muscle control. Choline also contributes to the synthesis of phospholipid membranes and serves as a source of methyl groups necessary for metabolic processes. While the body can produce small amounts of choline, most of it must come from the diet to meet physiological needs.
The benefits of choline are wide-ranging. During pregnancy, adequate choline intake supports fetal brain development and may enhance memory, attention, and visual-spatial learning in children. It also plays a role in cardiovascular health by reducing the risk of heart disease and stroke. Additionally, sufficient choline levels have been linked to improved cognitive function and may lower the risk of cognitive decline and dementia. For athletes, choline is vital for muscle...
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Anxiety disorders are common and often difficult to treat, yet a clear picture of their brain neurometabolic abnormalities to guide new therapies is still lacking. In a new study, researchers pooled the results of existing studies to test whether any brain metabolites consistently differ between patients with social anxiety disorder, generalized anxiety disorder, or panic disorder and healthy volunteers.
The meta analysis integrated 25 human datasets covering 370 patients and 342 healthy controls, all scanned with proton magnetic resonance spectroscopy, an imaging technique that can measure brain metabolites. The investigators focused on eight commonly reported brain chemicals: total choline containing compounds, N-acetylaspartate, total creatine, myo-inositol, glutamate, glutamate plus glutamine, gamma-aminobutyric acid (GABA), and lactate.
The analysis revealed a characteristic pattern of brain chemistry in anxiety disorders compared with controls:
Choline levels were consistently lower in the brain's outer regions (the cortex) in people with anxiety disorders. Across studies, this drop was about seven to eight percent, making it the strongest and most reliable finding.
NAA also showed slightly lower levels in anxiety disorders, but this pattern was weaker and less consistent than the choline finding.
Deeper brain regions (subcortical areas) such as the basal ganglia and hippocampus did not show clear differences in choline or NAA. A possible drop in creatine levels appeared only in studies of unmedicated participants, not overall.
The other measured brain chemicals did not show reliable differences between people with anxiety and healthy volunteers.
The size of the choline reduction was similar in generalized anxiety disorder, panic disorder, and social anxiety disorder, pointing to a shared pattern across these diagnoses.
The brain relies heavily on choline that enters from the bloodstream, and its available supply can drop if demand rises faster than uptake. Anxiety disorders are marked by persistent overactivation of arousal-related systems, including the noradrenergic stress network. This kind of long-term arousal can increase the brain's need for choline, for example to support myelination, the process of building and maintaining the myelin sheath that insulates nerve fibers and helps them transmit signals efficiently.
The pattern for NAA fits into this broader picture. In other psychiatric conditions, larger drops in NAA tend to appear together with actual thinning of cortical tissue. This combination has not been observed in anxiety disorders, but the small and inconsistent NAA reduction seen in this analysis may point to a subtle metabolic strain on neurons.
The study is limited by the modest number of datasets, incomplete reporting on measurement quality, and its correlational design, which cannot establish causality. Even so, it highlights reduced cortical choline as a consistent pattern across anxiety disorders and a promising target for future mechanistic and supplementation trials. In Aliquot #67, I talk about the role of choline in metabolic and brain health.