title: Glutamine and glutamate levels in children and adolescents with bipolar disorder: a 4.0-T proton magnetic resonance spectroscopy study of the anterior cingulate cortex.
abstract: OBJECTIVE
  The purpose of this study was to use proton magnetic resonance spectroscopy, at 4.0 T, to explore the glutamine and glutamate levels in the anterior cingulate cortex of children and adolescents with bipolar disorder (BPD; medicated and unmedicated) and healthy comparison subjects (HCSs). We hypothesized that unmedicated children with BPD would have reduced glutamine and glutamate levels compared with HCSs and medicated children with BPD.
  
  
  METHODS
  Spectra were acquired from the anterior cingulate cortex in 22 children and adolescents with DSM-IV-TR BPD, type 1 (13 female: age 12.6 +/- 4.4 years: 7 of the subjects with BPD were unmedicated at the time of the scan) and 10 HCSs (7 female: age 12.3 +/- 2.5 years).
  
  
  RESULTS
  Unmedicated subjects with BPD had significantly lower glutamine levels than HCSs or medicated subjects with BPD. There were no differences in glutamate levels between the three groups.
  
  
  CONCLUSIONS
  These results are consistent with there being an abnormality in anterior cingulate cortex glia in untreated children and adolescents with BPD. The results of this pilot study may be important in helping us better understand the pathophysiology of child and adolescent BPD. In addition, this observation may help to develop better and more targeted treatments, in particular those affecting the metabolism of glutamine, perhaps by regulation of glutamine synthetase activity.
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: Jean A
authors.initials: JA
authors.lastname: Frazier
authors.forename: Carol A
authors.initials: CA
authors.lastname: Glod
authors.forename: Janis L
authors.initials: JL
authors.lastname: Breeze
authors.forename: Megan
authors.initials: M
authors.lastname: Dieterich
authors.forename: Chelsea T
authors.initials: CT
authors.lastname: Finn
authors.forename: Blaise deB
authors.initials: Bd
authors.lastname: Frederick
authors.forename: Perry F
authors.initials: PF
authors.lastname: Renshaw
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000188:drug therapy / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism*; D005973:Glutamine / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009457:Neuroglia / Q000473:pathology; D009778:Occipital Lobe / Q000473:pathology*; D011522:Protons; D011619:Psychotropic Drugs / Q000627:therapeutic use
chemical_list: D011522:Protons; D011619:Psychotropic Drugs; D005973:Glutamine; D018698:Glutamic Acid