Lithium-associated anterior cingulate neurometabolic profile in euthymic Bipolar I disorder: A H-1-MRS study

Author(s)

Soeiro-de-Souza, Marcio Gerhardt ^{[1, 2]} ; Garcia Otaduy, Maria Concepcion ^[3] ; Machado-Vieira, Rodrigo ^[4] ; Moreno, Ricardo Alberto ^[1] ; Nery, Fabiano G. ^[5] ; Leite, Claudia ^[3] ; Lafer, Beny ^[6]

Affiliation

^[1] Univ Sao Paulo, Dept & Inst Psychiat, Mood Disorders Unit GRUDA, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Dept & Inst Psychiat, Genet & Pharmacogenet Unit PROGENE, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo InRad FMUSP, Dept & Inst Radiol, Lab Magnet Resonance LIM44, Sao Paulo, SP - Brazil

^[4] Univ Texas Houston, Houston, TX - USA

^[5] Univ Cincinnati, Dept Psychiat & Behav Neurosci, Coll Med, Cincinnati, OH 45221 - USA

^[6] Univ Sao Paulo, Dept & Inst Psychiat, Bipolar Disorders Program PROMAN, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: Journal of Affective Disorders; v. 241, p. 192-199, DEC 1 2018.
• Web of Science Citations: 1

Abstract

Objective: In the treatment of Bipolar disorder (BD), achieving euthymia is highly complex and usually requires a combination of mood stabilizers. The mechanism of action in stabilizing mood has not been fully elucidated, but alterations in N-Acetylaspartate (NAA), Myo-Inositol (mI) and Choline (Cho) have been implicated. Proton magnetic resonance spectroscopy (H-1-MRS) is the gold standard technique for measuring brain NAA, Cho and mI in vivo. The objective of this study was to investigate the association of lithium use in BD type I and brain levels of NAA, mI and Cho in the (anterior cingulate cortex) ACC. Methods: 129 BD type I subjects and 79 healthy controls (HC) were submitted to a 3-Tesla brain magnetic resonance imaging scan (H-1-MRS) using a PRESS ACC single voxel (8cm(3)) sequence. Results: BD patients exhibited higher NAA and Cho levels compared to HC. Lithium prescription was associated with lower mI (combination + monotherapy) and higher NAA levels (monotherapy). Conclusion: The results observed add to the knowledge about the mechanisms of action of mood stabilizers on brain metabolites during euthymia. Additionally, the observed decrease in mI levels associated with lithium monotherapy is an in vivo finding that supports the inositol-depletion hypothesis of lithium pharmacodynamics. (AU)

• FAPESP's process: 12/23796-2 - "Genetic association study between cognitive performance, polymorphisms of GAD1/Reelin and 3T magnetic ressonance spectroscopy of GABA/glutamate in bipolar I disorder and healthy controls"
• Grantee: Márcio Gerhardt Soeiro-de-Souza
• Support Opportunities: Scholarships in Brazil - Post-Doctoral