Near-infrared spectroscopy and plasma homovanillic acid levels in bipolar disorder: a case report.
Misdiagnosis of bipolar disorder is a serious, but not unusual problem for patients. Nevertheless, there are few biomarkers for distinguishing unipolar and bipolar disorder. Near-infrared spectroscopy (NIRS) is a noninvasive and useful method for the measurement of hemoglobin concentration changes in the cortical surface area, which enables the assessment of brain function. We measured NIRS and plasma monoamine metabolite levels in a patient with bipolar disorder. A 22-year-old man was admitted due to major depression. At admission, NIRS findings showed oxygenated hemoglobin reincrease in the posttask period, which is characteristic of schizophrenia. After treatment with paroxetine, he became manic with psychotic symptoms. His plasma level of homovanillic acid just before the manic switch was ten times higher than that just after paroxetine initiation. Treatment with lithium and antipsychotics was successful, and plasma homovanillic acid decreased after treatment. In this case, the NIRS findings may predict a possible risk of a manic switch, which is likely induced by paroxetine. NIRS may be able to help distinguish unipolar and bipolar disorder in clinical settings.
Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan ; Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
Itaru
I
Miura
Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Soichi
S
Kono
Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Sachie
S
Oshima
Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Keiko
K
Kanno-Nozaki
Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Hirobumi
H
Mashiko
Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Shin-Ichi
S
Niwa
Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Hirooki
H
Yabe
biomarker; bipolar disorder; diagnosis; homovanillic acid; near-infrared spectroscopy