1H magnetic resonance spectroscopy investigation of the dorsolateral prefrontal cortex in bipolar disorder patients
1H magnetic resonance spectroscopy investigation of the dorsolateral prefrontal cortex in bipolar disorder patients
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DOI：
10.1016/j.jad.2004.12.008
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发表时间：
2005-05-01
影响因子：
6.6
通讯作者：
Soares, JC
中科院分区：
文献类型：
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作者：
Brambilla, P;Stanley, JA;Soares, JC
背景资料：磁共振波谱研究（MRS）报告了成人双相情感障碍患者的背外侧前额叶皮层（DLPFC）中N-乙酰天冬氨酸（NAA，神经元完整性的标志物）水平异常低，表明可能存在神经元功能障碍。此外，最近的MRS报告表明，在双相情感障碍患者中，锂可能诱导NAA水平升高。我们采用活体H-1磁共振波谱分析技术（H-1 MRS）对10例双相情感障碍患者的DLPFC进行了NAA水平的检测。（6例锂治疗，4例无药物）和32例健康对照者接受了短回波时间H-1 MRS会话，使用STEAM序列在左侧DLPFC中定位8 cm（3）单体素。两组间NAA、含胆碱分子（GPC+PC）或磷酸肌酸加肌酸（PCr+Cr）无显著差异（Student t检验，p > 0.05）。尽管如此，与未用药患者和健康对照组相比，锂治疗的双相情感障碍患者的NAA/PCr+Cr比值显著增加（Mann-Whitney U检验，p < 0.05）。局限性：相对较小的样本量可能降低了我们分析的统计功效，并且利用单体素方法不允许检查其他皮质脑区域。这项研究没有发现在成人双相情感障碍患者的左侧DLPFC中NAA水平异常降低，在大多数药物治疗的患者样本中。然而，在锂治疗的双相患者中，NAA/PCr+Cr比值升高。纵向H-1 MRS研究应进一步检查情绪稳定治疗前后未经治疗的双相情感障碍患者前额叶皮层区域的NAA水平。(c)2005 Elsevier B. V.保留所有权利。
Background: Magnetic resonance spectroscopy studies (MRS) reported abnormally low levels of N-acetylaspartate (NAA, a marker of neuronal integrity) in dorsolateral prefrontal cortex (DLPFC) of adult bipolar patients, suggesting possible neuronal dysfunction. Furthermore, recent MRS reports suggested possible lithium-induced increase in NAA levels in bipolar patients. We examined with in vivo H-1 MRS NAA levels in the DLPFC of adult bipolar patients.Methods: Ten DSM-IV bipolar disorder patients (6 lithium-treated, 4 drug-free) and 32 healthy controls underwent a short echo-time H-1 MRS session, which localized an 8 cm(3) single-voxel in the left DLPFC using a STEAM sequence.Results: No significant differences between the two groups were found for NAA, choline-containing molecules (GPC+PC), or phosphocreatine plus creatine (PCr+Cr) (Student t-test, p > 0.05). Nonetheless, NAA/PCr+Cr ratios were significantly increased in lithium-treated bipolar subjects compared to unmedicated patients and healthy controls (Mann-Whitney U-test, p < 0.05).Limitations: Relatively small sample size may have reduced the statistical power of our analyses and the utilization of a single-voxel approach did not allow for the examination of other cortical brain areas.Conclusions: This study did not find abnormally reduced levels of NAA in left DLPFC of adult bipolar patients, in a sample of patients who were mostly on medications. However, elevated NAA/PCr+Cr ratios were shown in lithium-treated bipolar patients. Longitudinal H-1 MRS studies should further examine NAA levels in prefrontal cortex regions in untreated bipolar patients before and after mood stabilizing treatment. (c) 2005 Elsevier B.V. All rights reserved.