title: Tissue-dependent cerebral energy metabolism in adolescents with bipolar disorder.
abstract: OBJECTIVE
  To investigate tissue-dependent cerebral energy metabolism by measuring high energy phosphate levels in unmedicated adolescents diagnosed with bipolar I disorder.
  
  
  METHODS
  Phosphorus-31 magnetic resonance spectroscopic imaging data were acquired over the entire brain of 24 adolescents with bipolar I disorder and 19 demographically matched healthy comparison adolescents. Estimates of phosphocreatine (PCr) and adenosine triphosphate (ATP, determined from the γ-resonance) in homogeneous gray and white matter in the right and left hemispheres of the cerebrum of each subject were obtained by extrapolation of linear regression analyses of metabolite concentrations vs. voxel gray matter fractions.
  
  
  RESULTS
  Multivariate analyses of variance showed a significant effect of group on high energy phosphate concentrations in the right cerebrum (p=0.0002) but not in the left (p=0.17). Post-hoc testing in the right cerebrum revealed significantly reduced concentrations of PCr in gray matter and ATP in white matter in both manic (p=0.002 and 0.0001, respectively) and euthymic (p=0.004 and 0.002, respectively) bipolar I disorder subjects relative to healthy comparisons.
  
  
  CONCLUSIONS
  The small sample sizes yield relatively low statistical power between manic and euthymic groups; cross-sectional observations limit the ability to determine if these findings are truly independent of mood state.
  
  
  CONCLUSIONS
  Our results suggest bioenergetic impairment - consistent with downregulation of creatine kinase - is an early pathophysiological feature of bipolar I disorder.
authors.affiliation: Center for Imaging Research, University of Cincinnati, USA. Electronic address: dudleyjd@ucmail.uc.edu.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dudley
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, USA.
authors.forename: Melissa P
authors.initials: MP
authors.lastname: DelBello
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, USA.
authors.forename: Wade A
authors.initials: WA
authors.lastname: Weber
authors.affiliation: Center for Imaging Research, University of Cincinnati, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, USA.
authors.forename: Caleb M
authors.initials: CM
authors.lastname: Adler
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, USA; Department of Biomedical, Chemical, and Environmental Engineering, University of Cincinnati College of Engineering and Applied Science, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Strakowski
authors.affiliation: Center for Imaging Research, University of Cincinnati, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, USA; Department of Biomedical, Chemical, and Environmental Engineering, University of Cincinnati College of Engineering and Applied Science, USA.
authors.forename: Jing-Huei
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism*; D000293:Adolescent; D000339:Affect; D015415:Biomarkers / Q000378:metabolism; D001714:Bipolar Disorder / Q000378:metabolism*; D001921:Brain / Q000378:metabolism; D016022:Case-Control Studies; D054022:Cerebrum / Q000378:metabolism*; D002648:Child; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D066128:Gray Matter / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D010725:Phosphocreatine / Q000378:metabolism*; D010759:Phosphorus Isotopes; D066127:White Matter / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010759:Phosphorus Isotopes; D010725:Phosphocreatine; D000255:Adenosine Triphosphate
keywords: (31)P MRS; Adolescent; Bioenergetics; Bipolar disorder