title: Acute mania is accompanied by elevated glutamate/glutamine levels within the left dorsolateral prefrontal cortex.
abstract: 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.
authors.affiliation: University of Muenster, 48129 Münster, Germany. nikmich@uni-muenster.de
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Michael
authors.forename: Andreas
authors.initials: A
authors.lastname: Erfurth
authors.forename: Patricia
authors.initials: P
authors.lastname: Ohrmann
authors.forename: Michael
authors.initials: M
authors.lastname: Gössling
authors.forename: Volker
authors.initials: V
authors.lastname: Arolt
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
authors.forename: Bettina
authors.initials: B
authors.lastname: Pfleiderer
mesh_terms: 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
chemical_list: D017470:Receptors, Glutamate; D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline