Acute mania is accompanied by elevated glutamate/glutamine levels within the left dorsolateral prefrontal cortex
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The dorsolateral prefrontal cortex (DLPFC) participates in the pathophysiology of mania. In particular, left-sided structural and metabolic abnormalities have been described.
Clinical symptoms may be due to hyperactivity of cortical glutamatergic neurons, resulting in increased excitatory neurotransmitter flux and thus enhanced Glx levels.
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.
Manic patients had significantly elevated Glx levels (t-test; t=–3.1, P=0.008) within the left DLPFC.
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.
KeywordsAcute mania Bipolar disorder Glutamate Glutamine Proton magnetic resonance spectroscopy
This work was supported by an "innovative medical research" grant (IMF) from the University of Münster, FRG (ER 219918). We wish to thank Professor Martin Fiebich, Department of Biomedical Engineering, University of Applied Sciences, Giessen, Germany, for providing the semiautomatic interactive algorithm to perform segmentation of our voxels.
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