Acute mania is accompanied by elevated glutamate/glutamine levels within the left dorsolateral prefrontal cortex.
BACKGROUND
The dorsolateral prefrontal cortex (DLPFC) participates in the pathophysiology of mania. In particular, left-sided structural and metabolic abnormalities have been described.


OBJECTIVE
Clinical symptoms may be due to hyperactivity of cortical glutamatergic neurons, resulting in increased excitatory neurotransmitter flux and thus enhanced Glx levels.


METHODS
Glutamate/glutamine (Glx) levels were assessed by proton magnetic resonance spectroscopy ((1)H-MRS) in eight acute manic patients compared with age- and gender-matched controls.


RESULTS
Manic patients had significantly elevated Glx levels ( t-test; t=-3.1, P=0.008) within the left DLPFC.


CONCLUSIONS
Our results indicate that the prefrontal cortical glutamatergic system is involved in the pathophysiology of acute mania. This may have implications for the treatment of mania.
Michael
Nikolaus
N
University of Muenster, 48129 Münster, Germany. nikmich@uni-muenster.de
Erfurth
Andreas
A
Ohrmann
Patricia
P
Gössling
Michael
M
Arolt
Volker
V
Heindel
Walter
W
Pfleiderer
Bettina
B
D000208:Acute Disease; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001714:Bipolar Disorder / Q000378:metabolism*; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism*; D005973:Glutamine / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D017397:Prefrontal Cortex / Q000378:metabolism*; D017470:Receptors, Glutamate
D017470:Receptors, Glutamate; D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline