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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Bimodal Effect of Lithium Plasma Levels on Hippocampal Glutamate Concentrations in Bipolar II Depression: A Pilot Study

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Author(s):
Zanetti, Marcus V. [1, 2, 3] ; Otaduy, Maria C. [4] ; de Sousa, Rafael T. [3] ; Gattaz, Wagner F. [1, 3] ; Busatto, Geraldo F. [1, 2] ; Leite, Claudia C. [4] ; Machado-Vieira, Rodrigo [1, 5, 3]
Total Authors: 7
Affiliation:
[1] Univ Sao Paulo, Ctr Interdisciplinary Res Appl Neurosci NAPNA, BR-05508 Sao Paulo - Brazil
[2] Univ Sao Paulo, Dept & Inst Psychiat, Lab Psychiat Neuroimaging, LIM 21, BR-05508 Sao Paulo - Brazil
[3] Univ Sao Paulo, Dept & Inst Psychiat, Lab Neurosci LIM 27, Mood Disorders Program, BR-05508 Sao Paulo - Brazil
[4] Univ Sao Paulo, Dept Radiol, BR-05508 Sao Paulo - Brazil
[5] NIMH, ETPB, NIH, Bethesda, MD 20892 - USA
Total Affiliations: 5
Document type: Journal article
Source: INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY; v. 18, n. 6 APR 2015.
Web of Science Citations: 12
Abstract

Background: The hippocampus has been highly implicated in the pathophysiology of bipolar disorder (BD). Nevertheless, no study has longitudinally evaluated hippocampal metabolite levels in bipolar depression under treatment with lithium. Methods: Nineteen medication-free BD patients (78.9% treatment-naive and 73.7% with BD type II) presenting an acute depressive episode and 17 healthy controls were studied. Patients were treated for 6 weeks with lithium in an open-label trial. N-acetyl aspartate (NAA), creatine, choline, myo-Inositol, and glutamate levels were assessed in the left hippocampus before (week 0) and after (week 6) lithium treatment using 3T proton magnetic resonance spectroscopy (1H-MRS). The metabolite concentrations were estimated using internal water as reference and voxel segmentation for partial volume correction. Results: At baseline, acutely depressed BD patients and healthy controls exhibited similar hippocampal metabolites concentrations, with no changes after 6 weeks of lithium monotherapy. A significant correlation between antidepressant efficacy and increases in NAA concentration over time was observed. Also, there was a significant positive correlation between the changes in glutamate concentrations over follow-up and plasma lithium levels at endpoint. Mixed effects model analysis revealed a bimodal effect of lithium plasma levels in hippocampal glutamate concentrations: levels of 0.2 to 0.49 mmol/L (n=9) were associated with a decrease in glutamate concentrations, whereas the subgroup of BD subjects with ``standard{''} lithium levels (>= 0.50 mmol/L; n = 10) showed an overall increase in glutamate concentrations over time. Conclusions: These preliminary results suggest that lithium has a bimodal action in hippocampal glutamate concentration depending on the plasma levels. (AU)

FAPESP's process: 13/03905-4 - NEUROBIOLOGICAL DIFFERENCES BETWEEN TREATMENT-NAIVE PATIENTS WITH BIPOLAR DISORDER SUBTYPES I AND II
Grantee:Marcus Vinicius Zanetti
Support Opportunities: Scholarships in Brazil - Post-Doctoral
FAPESP's process: 09/14891-9 - Longitudinal study on the neuroprotective and neurotrophic effects of lithium in bipolar disorder: identification of cellular and molecular targets clinically relevant
Grantee:Rodrigo Machado-Vieira
Support Opportunities: Research Grants - Young Investigators Grants