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It is important to note, since Glx/tNAA indexes the cortical glutamate + glutamine pool rather than synaptic glutamate release alone, the attenuation we observed may reflect metabolic changes as well as altered neurotransmitter cycling, consistent with C-MRS evidence that prefrontal tricarboxylic (TCA)-cycle activity can fall without a corresponding change in glutamate and glutamine cycling in depression 36

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Alcohol withdrawal When an individual with habitual alcohol ingestion suddenly stops alcohol use, the CNS experiences glutamate excitation without alcohol-induced inhibition, causing an imbalance in CNS homeostasis

Borchardt, T

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