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A non-invasive imaging technique, 1H-MRS, can detect chemicals in different parts of the brain. Choline is represented by “Cho” in the above graph. Credit: UC Regents<\/p>\n
People with anxiety disorders have lower levels of choline in their brains, according to research from UC Davis Health.<\/p>\n
The study<\/a>, published in the journal Molecular Psychiatry, analyzed data from 25 studies. The researchers compared the levels of neurometabolites\u2014chemicals produced during brain metabolism<\/a>\u2014in 370 people with anxiety disorders<\/a> to 342 people without anxiety.<\/p>\n They found the level of choline\u2014an essential nutrient\u2014was about 8% lower in those with anxiety disorders. The evidence for low choline was especially consistent in the prefrontal cortex, the part of the brain that helps control thinking, emotions and behavior.<\/p>\n “This is the first meta-analysis to show a chemical pattern in the brain in anxiety disorders,” said Jason Smucny, co-author and an assistant professor in the Department of Psychiatry and Behavioral Sciences. “It suggests nutritional approaches\u2014like appropriate choline supplementation\u2014may help restore brain chemistry and improve outcomes for patients.”<\/p>\n Choline (pronounced KOE lean) is vital for cell membranes and brain functions like memory, mood regulation and muscle control. The body makes a small amount, but most must come from food.<\/p>\n Anxiety disorders affect about 30% of adults<\/p>\n Richard Maddock, senior author of the study, is a psychiatrist and research professor in the Department of Psychiatry and Behavioral Sciences. He is also a researcher at the UC Davis Imaging Research Center, which uses magnetic resonance imaging (MRI) techniques to study brain health.<\/p>\n Maddock spent decades in clinical practice treating patients with anxiety disorders and conducting research on these conditions.<\/p>\n “Anxiety disorders are the most common mental illness in the United States, affecting about 30% of adults. They can be debilitating for people, and many people do not receive adequate treatment,” Maddock said.<\/p>\n Anxiety disorders include:<\/p>\n Brain interactions affect anxiety<\/p>\n Anxiety disorders are linked to how different parts of the brain\u2014like the amygdala, which influences our sense of safety or danger, and the prefrontal cortex<\/a>, which is involved in planning and decision-making\u2014respond to stress or potential threats.<\/p>\n Anxiety disorders are also linked to imbalances in neurotransmitters. For example, norepinephrine\u2014part of the body’s “fight-or-flight” response\u2014is often elevated in anxiety disorders.<\/p>\n Normally, the brain can tell the difference between potential threats that are manageable and those that are not. In anxiety disorders, manageable threats can seem overwhelming. For example, with generalized anxiety disorder, people worry excessively about everyday things and have trouble controlling their worries or feelings of nervousness.<\/p>\n Noninvasive technique identifies chemical levels in the brain<\/p>\n Maddock and Smucny have spent years studying brain chemistry and its association with mental illness using a noninvasive medical imaging technique known as proton magnetic resonance spectroscopy, or 1H-MRS.<\/p>\n The measurements are made using an MRI machine. 1H-MRS uses the magnetic fields and radio waves of an MRI to analyze the body. However, instead of creating an image of the body, it provides data about the chemicals that are present in the tissue.<\/p>\n Maddock had noticed low levels of choline in his earlier studies<\/a> of patients with panic disorder. He decided to conduct a meta-analysis with Smucny. And even though they thought they would find low choline, he was still surprised by the results.<\/p>\n “An 8% lower amount doesn’t sound like that much, but in the brain it’s significant,” Maddock said.<\/p>\n Most Americans don’t get enough choline<\/p>\n The researchers think the high fight-or-flight activity experienced in anxiety disorders may increase choline demand, lowering its levels.<\/p>\n “We don’t know yet if increasing choline in the diet will help reduce anxiety. More research will be needed,” Maddock said. He cautions that people with anxiety should not self-medicate with excessive choline supplements.<\/p>\n But he notes a healthy diet<\/a> is essential for all aspects of health, including mental health.<\/p>\n “Someone with an anxiety disorder might want to look at their diet and see whether they are getting the recommended daily amount of choline. Previous research<\/a> has shown that most people in the U.S., including children, don’t get the recommended daily amount,” Maddock said. “Some forms of omega-3 fatty acids<\/a>, like those found in salmon, may be especially good sources for supplying choline to the brain.”<\/p>\n Other foods rich in choline<\/a> include beef liver, eggs (particularly the yolk), beef, chicken, fish, soybeans and milk, among others.<\/p>\n More information:<\/strong>\n
\n Richard J. Maddock et al, Transdiagnostic reduction in cortical choline-containing compounds in anxiety disorders: a 1H-magnetic resonance spectroscopy meta-analysis, Molecular Psychiatry (2025). DOI: 10.1038\/s41380-025-03206-7<\/a>\n<\/p>\n