title: Neurochemical deficits in the cerebellar vermis in child offspring of parents with bipolar disorder.
abstract: OBJECTIVE
  We aimed to compare concentrations of N-acetyl aspartate, myo-inositol, and other neurometabolites in the cerebellar vermis of offspring at risk for bipolar disorder (BD) and healthy controls to examine whether changes in these neuronal metabolite concentrations occur in at-risk offspring prior to the onset of mania.
  
  
  METHODS
  A total of 22 children and adolescents aged 9-17 years with a familial risk for bipolar I or II disorder [at-risk offspring with non-bipolar I disorder mood symptoms (AR)], and 25 healthy controls (HC) were examined using proton magnetic resonance spectroscopy at 3T to study metabolite concentrations in an 8-cc voxel in the cerebellar vermis.
  
  
  RESULTS
  Decreased myo-inositol and choline concentrations in the vermis were seen in the AR group compared to HC (p<0.01).
  
  
  CONCLUSIONS
  Decreased cellular metabolism and interference with second messenger pathways may be present in the cerebellar vermis in youth at risk for BD as evident by decreased myo-inositol and choline concentrations in this region. These results may be limited by a cross-sectional design, co-occurring diagnoses, and medication exposure. Longitudinal studies are necessary to determine whether early neurochemical changes can predict the development of mania. Improved methods for identifying children with certain neurochemical vulnerabilities may inform preventive and early intervention strategies prior to the onset of mania.
authors: Pediatric Bipolar Disorders Research Program, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA. mksingh@stanford.edu
authors: Manpreet K
authors: MK
authors: Singh
authors: Daniel
authors: D
authors: Spielman
authors: Allison
authors: A
authors: Libby
authors: Elizabeth
authors: E
authors: Adams
authors: Tenah
authors: T
authors: Acquaye
authors: Meghan
authors: M
authors: Howe
authors: Ryan
authors: R
authors: Kelley
authors: Allan
authors: A
authors: Reiss
authors: Kiki D
authors: KD
authors: Chang
mesh_terms: D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001714:Bipolar Disorder / Q000473:pathology*; D001923:Brain Chemistry / Q000502:physiology*; D002531:Cerebellum / Q000378:metabolism*; D002648:Child; D002794:Choline / Q000378:metabolism; D005260:Female; D006801:Humans; D007294:Inositol / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D011522:Protons; D011569:Psychiatric Status Rating Scales
chemical_list: D011522:Protons; D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D002794:Choline