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The levels of glutamate were found to be elevated among ES patients (n\u2009=\u200930, 16 females) compared with controls (n\u2009=\u200931, 15 females). Notably, this increase was detected only in the anterior cingulate and mesial prefrontal cortex (ACC\/mPFC), and the glutamate levels were linearly correlated with the degree of perceived stress. Furthermore, there was a sex by group interaction, as the glutamate elevation was present only in female patients. Female but not male ES patients also showed an increase in N-acetyl aspartate (NAA) levels in the amygdala. No group differences were detected in glutamine concentration (also measured). These data show the key role of glutamate in stress-related neuronal signaling and the specific roles of the amygdala and ACC\/mPFC. The data extend previous reports about the neurochemical basis of stress and identify a potential neural marker and mediator of ES due to occupational stress. The observation of specific sex differences provides a tentative explanation to the well-known female predominance in stress-related psychopathology.<\/jats:p>","DOI":"10.1093\/cercor\/bhz340","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T20:16:52Z","timestamp":1582748212000},"page":"3759-3770","source":"Crossref","is-referenced-by-count":10,"title":["MRS Shows Regionally Increased Glutamate Levels among Patients with Exhaustion Syndrome Due to Occupational Stress"],"prefix":"10.1093","volume":"30","author":[{"given":"Ivanka","family":"Savic","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden"},{"name":"Department of Neurology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden"},{"name":"Department of Neurology, UCLA, Los Angeles, CA 90095-1769, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"issue":"1","key":"2020051808283490900_ref1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00127-005-0011-5","article-title":"Burnout in the general population. 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