title: Differences in brain chemistry in children and adolescents with attention deficit hyperactivity disorder with and without comorbid bipolar disorder: a proton magnetic resonance spectroscopy study.
abstract: OBJECTIVE
  The authors' goal was to investigate phosphatidylinositol and glutamatergic metabolism in the anterior cingulate cortex of children and adolescents with attention deficit hyperactivity disorder (ADHD) alone, children with ADHD plus bipolar disorder, and children with no axis I diagnosis.
  
  
  METHODS
  Proton spectra were acquired from a 4.8-ml voxel placed in the anterior cingulate cortex of 30 subjects who were 6 to 13 years old. Fifteen subjects had ADHD and no comorbid disorder, eight had ADHD plus bipolar disorder, and seven were healthy comparison subjects.
  
  
  RESULTS
  Children with ADHD had a significantly higher ratio of glutamate plus glutamine to myo-inositol-containing compounds than children with ADHD plus bipolar disorder and healthy children.
  
  
  CONCLUSIONS
  myo-Inositol-containing compounds may provide information on the action of antimanic treatments such as lithium, valproate, and carbamazepine. Glutamate and glutamine are measures of glutamatergic neurotransmission and thus may also reflect changes in serotonin and dopamine pathways.
authors.affiliation: Brain Imaging Center, McLean Hospital, Belmont, MA 02478, USA. const@mclean.harvard.edu.
authors.forename: Constance M
authors.initials: CM
authors.lastname: Moore
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Janet
authors.initials: J
authors.lastname: Wozniak
authors.forename: Eric
authors.initials: E
authors.lastname: Mick
authors.forename: Megan
authors.initials: M
authors.lastname: Aleardi
authors.forename: Megan
authors.initials: M
authors.lastname: Wardrop
authors.forename: Meghan
authors.initials: M
authors.lastname: Dougherty
authors.forename: Terri
authors.initials: T
authors.lastname: Harpold
authors.forename: Paul
authors.initials: P
authors.lastname: Hammerness
authors.forename: Edin
authors.initials: E
authors.lastname: Randall
authors.forename: Perry F
authors.initials: PF
authors.lastname: Renshaw
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D001923:Brain Chemistry; D002648:Child; D015897:Comorbidity; D003401:Creatine / Q000378:metabolism; D004298:Dopamine / Q000378:metabolism / Q000502:physiology; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006179:Gyrus Cinguli / Q000378:metabolism*; D006801:Humans; D007294:Inositol / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000706:statistics & numerical data; D010725:Phosphocreatine / Q000378:metabolism; D011522:Protons; D012701:Serotonin / Q000378:metabolism / Q000502:physiology; D014018:Tissue Distribution
chemical_list: D011522:Protons; D010725:Phosphocreatine; D005973:Glutamine; D012701:Serotonin; D018698:Glutamic Acid; D007294:Inositol; D003401:Creatine; D004298:Dopamine