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Choline, myo‐inositol and mood in bipolar disorder: a proton magnetic resonance spectroscopic imaging study of the anterior cingulate cortex
Author(s) -
Moore Constance M,
Breeze Janis L,
Gruber Staci A,
Babb Suzann M,
DeB Frederick Blaise,
Villafuerte Rosemond A,
Stoll Andrew L,
Hennen John,
YurgelunTodd Deborah A,
Cohen Bruce M,
Renshaw Perry F
Publication year - 2000
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1034/j.1399-5618.2000.20302.x
Subject(s) - mania , bipolar disorder , anterior cingulate cortex , choline , psychology , inositol , cingulate cortex , medicine , lithium (medication) , endocrinology , magnetic resonance spectroscopic imaging , neuroscience , psychiatry , magnetic resonance imaging , central nervous system , cognition , receptor , radiology
Objectives:Alterations in choline and myo‐inositol metabolism have been noted in bipolar disorder, and the therapeutic efficacy of lithium in mania may be related to these effects. We wished to determine the relationship between anterior cingulate cortex choline and myo‐inositol levels, assessed using proton magnetic resonance spectroscopic imaging (MRSI), and mood state in subjects with bipolar disorder.
Methods: Serial assessments of anterior cingulate cortex choline and myo‐inositol metabolism were performed in nine subjects with bipolar disorder, taking either lithium or valproate, and 14 controls. Each bipolar subject was examined between one and four times (3.1±1.3). On the occasion of each examination, standardized ratings of both depression and mania were recorded.
Results: In the left cingulate cortex, the bipolar subjects’ depression ratings correlated positively with MRSI measures of Cho/Cr‐PCr. In the right cingulate cortex, the Cho/Cr‐PCr ratio was significantly higher in subjects with bipolar disorder compared with control subjects. In addition, bipolar subjects not taking antidepressants had a significantly higher right cingulate cortex Cho/Cr‐PCr ratio compared with patients taking antidepressants or controls. No clinical or drug‐related changes were observed for the Ino/Cr‐PCr ratio.
Conclusions: The results of this study suggest that bipolar disorder is associated with alterations in the metabolism of cytosolic, choline‐containing compounds in the anterior cingulate cortex. As this resonance arises primarily from phosphocholine and glycerophosphocholine, both of which are metabolites of phosphatidylcholine, these results are consistent with impaired intraneuronal signaling mechanisms.