title: PET study of [(18)F]6-fluoro-L-dopa uptake in neuroleptic- and mood-stabilizer-naive first-episode nonpsychotic mania: effects of treatment with divalproex sodium.
abstract: OBJECTIVE
  Although dopaminergic hyperactivity has been implicated in mania, the precise location in the brain of the abnormality is unclear. This study assessed presynaptic dopamine function in neuroleptic- and mood-stabilizer-naive nonpsychotic first-episode manic patients before and after treatment with divalproex sodium by measuring [(18)F]6-fluoro-L-dopa ([(18)F]DOPA) uptake in the striatum with positron emission tomography (PET).
  
  
  METHODS
  Thirteen patients with DSM-IV bipolar I disorder, manic episode, and 13 healthy comparison subjects underwent [(18)F]DOPA PET scans. Ten of the 13 patients had repeat PET scans 2-6 weeks after beginning treatment with divalproex sodium monotherapy. [(18)F]DOPA uptake rate constants (K(i) values) in the striatum were calculated by using graphical analysis with activity from the occipital cortex as the input function.
  
  
  RESULTS
  No significant differences in [(18)F]DOPA uptake rate constants in the striatum were found between the manic patients and the comparison subjects. After treatment with divalproex sodium, [(18)F]DOPA rate constants were significantly reduced in the patients and were lower in the patients than in the comparison subjects.
  
  
  CONCLUSIONS
  Although presynaptic dopamine function as reflected by [(18)F]DOPA uptake is not altered in mania, presynaptic dopamine function in manic patients was lower after treatment with divalproex sodium.
authors: Department of Psychiatry, University of British Columbia, Vancouver, Canada. yatham@unixg.ubc.ca
authors: Lakshmi N
authors: LN
authors: Yatham
authors: Peter F
authors: PF
authors: Liddle
authors: I-Shin
authors: IS
authors: Shiah
authors: Raymond W
authors: RW
authors: Lam
authors: Elton
authors: E
authors: Ngan
authors: Gayle
authors: G
authors: Scarrow
authors: Miguel
authors: M
authors: Imperial
authors: Jon
authors: J
authors: Stoessl
authors: Vesna
authors: V
authors: Sossi
authors: Thomas J
authors: TJ
authors: Ruth
mesh_terms: D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents; D001714:Bipolar Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism*; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism*; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D004298:Dopamine / Q000378:metabolism*; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed / Q000706:statistics & numerical data; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D005462:Fluorine Radioisotopes; C043437:fluorodopa F 18; D014635:Valproic Acid; D004295:Dihydroxyphenylalanine; D004298:Dopamine