title: A review of MR spectroscopy studies of pediatric bipolar disorder.
abstract: Pediatric bipolar disorder is a severe mental illness whose pathophysiology is poorly understood and for which there is an urgent need for improved diagnosis and treatment. MR spectroscopy is a neuroimaging method capable of in vivo measurement of neurochemicals relevant to bipolar disorder neurobiology. MR spectroscopy studies of adult bipolar disorder provide consistent evidence for alterations in the glutamate system and mitochondrial function. In bipolar disorder, these 2 phenomena may be linked because 85% of glucose in the brain is consumed by glutamatergic neurotransmission and the conversion of glutamate to glutamine. The purpose of this article is to review the MR spectroscopic imaging literature in pediatric bipolar disorder, at-risk samples, and severe mood dysregulation, with a focus on the published findings that are relevant to glutamatergic and mitochondrial functioning. Potential directions for future MR spectroscopy studies of the glutamate system and mitochondrial dysfunction in pediatric bipolar disorder are discussed.
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.) doug.kondo@hsc.utah.edu.
authors.forename: D G
authors.initials: DG
authors.lastname: Kondo
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, Utah.
authors.forename: T L
authors.initials: TL
authors.lastname: Hellem
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.).
authors.forename: X-F
authors.initials: XF
authors.lastname: Shi
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.).
authors.forename: Y H
authors.initials: YH
authors.lastname: Sung
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahRadiology (A.P.P.), University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: A P
authors.initials: AP
authors.lastname: Prescot
authors.affiliation: and Department of Psychiatry (T.S.K.), Catholic University of Korea Graduate School of Medicine, Seoul, Republic of Korea.
authors.forename: T S
authors.initials: TS
authors.lastname: Kim
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, Utah.
authors.forename: R S
authors.initials: RS
authors.lastname: Huber
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, Utah.
authors.forename: L N
authors.initials: LN
authors.lastname: Forrest
authors.affiliation: From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.)Veterans Integrated Service Network 19 Mental Illness Research (P.F.R.), Education and Clinical Center, VA Salt Lake City Health Care System, Salt Lake City, Utah.
authors.forename: P F
authors.initials: PF
authors.lastname: Renshaw
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis* / Q000378:metabolism*; D001921:Brain / Q000378:metabolism*; D002648:Child; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D010372:Pediatrics