title: Elevated midbrain serotonin transporter availability in mixed mania: a case report.
abstract: BACKGROUND
  Results obtained from brain imaging studies indicate that serotonin transporter (SERT) and dopamine transporter (DAT) densities are altered in major depression. However, no such studies have been published on current mania or hypomania.
  
  
  METHODS
  In this single photon emission computed tomography (SPECT) study with [123I]nor-beta-CIT we present a case with simultaneous symptoms of major depression and hypomania. She had an elevated serotonin transporter availability (SERT) in the midbrain and elevated dopamine transporter availability (DAT) in the striatum, which normalised in a one-year follow-up period during which she received eight months of psychodynamic psychotherapy.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report on SERT and DAT associated with mania. In our case the availability of both SERT in the midbrain and DAT in the striatum were elevated at baseline and declined during psychotherapy, while the SERT and DAT of the depressed controls increased during psychotherapy. Symptoms of hypomania in the case were alleviated during psychotherapy. Clinical recovery was also reflected in the Hamilton Depression Rating Scale (HDRS) scores.
authors.affiliation: Department of Psychiatry, Kuopio University Hospital, 70210 Kuopio, Finland. tommi.tolmunen@kuh.fi.
authors.forename: Tommi
authors.initials: T
authors.lastname: Tolmunen
authors.forename: Mikko
authors.initials: M
authors.lastname: Joensuu
authors.forename: Pirjo Irmeli
authors.initials: PI
authors.lastname: Saarinen
authors.forename: Hanna
authors.initials: H
authors.lastname: Mussalo
authors.forename: Pasi
authors.initials: P
authors.lastname: Ahola
authors.forename: Ritva
authors.initials: R
authors.lastname: Vanninen
authors.forename: Jyrki
authors.initials: J
authors.lastname: Kuikka
authors.forename: Jari
authors.initials: J
authors.lastname: Tiihonen
authors.forename: Johannes
authors.initials: J
authors.lastname: Lehtonen
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism*; D003042:Cocaine / Q000031:analogs & derivatives*; D003342:Corpus Striatum / Q000737:chemistry / Q000000981:diagnostic imaging / Q000378:metabolism; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D050483:Dopamine Plasma Membrane Transport Proteins; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008562:Membrane Glycoproteins / Q000032:analysis / Q000378:metabolism*; D026901:Membrane Transport Proteins / Q000032:analysis / Q000378:metabolism*; D008636:Mesencephalon / Q000737:chemistry / Q000000981:diagnostic imaging / Q000378:metabolism*; D009419:Nerve Tissue Proteins / Q000032:analysis / Q000378:metabolism*; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D050486:Serotonin Plasma Membrane Transport Proteins; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D007457:Iodine Radioisotopes; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D009419:Nerve Tissue Proteins; C493214:SLC6A3 protein, human; C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; C086915:N-nor-3-(4'-iodophenyl)tropane-2-carboxylic acid methyl ester; D003042:Cocaine