title: Neurochemical alterations in adolescent bipolar depression: a proton magnetic resonance spectroscopy pilot study of the prefrontal cortex.
abstract: OBJECTIVE
  Identifying neurochemical alterations in adolescent bipolar depression may enhance our understanding of the neurophysiology of bipolar disorder across the age spectrum. The objective of this study was to compare in vivo neurometabolite concentrations in bipolar adolescents with a depressed episode and healthy adolescents using proton magnetic resonance spectroscopy ((1)H MRS).
  
  
  METHODS
  Bipolar adolescents with a depressed episode (n = 28) and healthy adolescents (n = 10) underwent a (1)H MRS scan. Anterior cingulate (ACC) and left and right ventral lateral prefrontal (LVLPFC, RVLPFC) metabolite concentrations were calculated and compared between groups using analysis of covariance (ANCOVA).
  
  
  RESULTS
  ANCOVA showed significant group differences in ACC N-acetyl-aspartate (NAA) (F(1,33) = 17.8, p = 0.0002), LVLPFC choline (Cho) (F(1,32) = 13.1, p = 0.001), creatine/phosphocreatine (Cr) (F(1,32) = 18.5, p = 0.0002), and NAA (F(1,32) = 13.6, p = 0.0008), and RVLPFC Cr (F(1,32) = 9.6, p = 0.004), mI (F(1,32) = 11.1, p = 0.002), and NAA (F(1,32) = 11.4, p = 0.002) concentrations. In general, the bipolar depressed group had higher neurometabolite concentrations than the healthy group.
  
  
  CONCLUSIONS
  There may be localized alterations in brain neurometabolites in adolescents with bipolar depression. Limitations include lack of bipolar adolescents in other mood states and potential confounding effects of prior psychotropic medication use. Confirmatory (1)H MRS studies in larger samples of youths with bipolar depression are needed.
authors.affiliation: LifeSynch, Fort Worth, Texas 76102, USA. npatel@lifesynch.com
authors.forename: Nick C
authors.initials: NC
authors.lastname: Patel
authors.forename: Kim M
authors.initials: KM
authors.lastname: Cecil
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Strakowski
authors.forename: Caleb M
authors.initials: CM
authors.lastname: Adler
authors.forename: Melissa P
authors.initials: MP
authors.lastname: DelBello
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001714:Bipolar Disorder / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology*; D001923:Brain Chemistry / Q000502:physiology*; D002648:Child; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D007294:Inositol / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D010865:Pilot Projects; D017397:Prefrontal Cortex / Q000503:physiopathology*; D005680:gamma-Aminobutyric Acid / Q000378:metabolism
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; D007294:Inositol; D005680:gamma-Aminobutyric Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline