Abstract
Background
The brain regions involved in the pathophysiology of bipolar disorder have not been
definitively determined. Previous studies have suggested possible involvement of the
hippocampus and of prefrontal regions. Proton magnetic resonance spectroscopic imaging
(1H-MRSI) allows measurement of N-acetylaspartate (NAA, marker of neuronal integrity),
choline-containing compounds (CHO), and creatine+phosphocreatine (CRE) in multiple
brain regions. The objective of this study was to assess possible NAA reductions in
hippocampus and prefrontal regions in patients with bipolar disorder.
Methods
We studied 17 patients with bipolar disorder and 17 age- and gender-matched healthy
subjects on a 1.5-T nuclear magnetic resonance (NMR) machine. With 1H-MRSI we measured ratios of areas under the metabolite peaks of the proton spectra
(i.e., NAA/CRE, NAA/CHO, CHO/CRE) for multiple cortical and subcortical regions.
Results
Patients showed significant reductions of NAA/CRE bilaterally in the hippocampus.
There were no significant changes in CHO/CRE or in NAA ratios in any other area sampled.
Conclusions
This study shows that patients with bipolar disorder have a regional reduction of
NAA relative signals, suggesting neuronal damage or malfunction of the hippocampus.
As suggested by other studies, neuronal pathology in the hippocampus may be involved
in the pathophysiology of bipolar disorder and in susceptibility to psychosis.
Keywords
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Article info
Publication history
Accepted:
November 19,
2002
Received in revised form:
November 13,
2002
Received:
May 24,
2002
Identification
Copyright
© 2003 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
