, Volume 168, Issue 3, pp 344-346
Date: 09 Apr 2003

Acute mania is accompanied by elevated glutamate/glutamine levels within the left dorsolateral prefrontal cortex

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Abstract

Rationale

The dorsolateral prefrontal cortex (DLPFC) participates in the pathophysiology of mania. In particular, left-sided structural and metabolic abnormalities have been described.

Objectives

Clinical symptoms may be due to hyperactivity of cortical glutamatergic neurons, resulting in increased excitatory neurotransmitter flux and thus enhanced Glx levels.

Methods

Glutamate/glutamine (Glx) levels were assessed by proton magnetic resonance spectroscopy (1H-MRS) in eight acute manic patients compared with age- and gender-matched controls.

Results

Manic patients had significantly elevated Glx levels (t-test; t=–3.1, P=0.008) within the left DLPFC.

Conclusions

Our results indicate that the prefrontal cortical glutamatergic system is involved in the pathophysiology of acute mania. This may have implications for the treatment of mania.