Original Investigation

Psychopharmacology

, Volume 168, Issue 3, pp 344-346

First online:

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

  • Nikolaus MichaelAffiliated withUniversity of MuensterDepartment of Psychiatry, University of Muenster Email author 
  • , Andreas ErfurthAffiliated withUniversity of MuensterDepartment of Psychiatry, University of Muenster
  • , Patricia OhrmannAffiliated withUniversity of MuensterDepartment of Psychiatry, University of Muenster
  • , Michael GösslingAffiliated withUniversity of MuensterDepartment of Psychiatry, University of MuensterDepartment of Clinical Radiology, University of Muenster
  • , Volker AroltAffiliated withUniversity of MuensterDepartment of Psychiatry, University of Muenster
  • , Walter HeindelAffiliated withUniversity of MuensterDepartment of Clinical Radiology, University of Muenster
  • , Bettina PfleidererAffiliated withUniversity of MuensterDepartment of Clinical Radiology, University of Muenster

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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.

Keywords

Acute mania Bipolar disorder Glutamate Glutamine Proton magnetic resonance spectroscopy