Choline Compounds of the Frontal Lobe and Temporal Glutamatergic System in Bipolar and Schizophrenia Proton Magnetic Resonance Spectroscopy Study

Abstract

Purpose Modern neuroimaging techniques allow investigating brain structures and substances involved in the pathophysiology of mental disorders, trying to find new markers of these disorders. To better understanding of the pathophysiology and differential diagnosis of schizophrenia and bipolar disorder, this study was conducted to assess the neurochemical alterations in the frontal and temporal lobes in hospitalized patients with schizophrenia and bipolar disorder. Methods Twenty-one subjects with schizophrenia (paranoid and differentiated types), 16 subjects with bipolar I disorder (manic, depressive, and mixed episode), and 20 healthy subjects were studied. Magnetic resonance (MR) imaging and proton resonance magnetic spectroscopy (1H MRS) were performed on a 1.5 T scanner. Voxels of 8 cm3 were positioned in the left frontal and left temporal lobes. Results Glx/H2O (GABA, glutamine, and glutamate/nonsuppressed water signal) ratios were significantly increased in the left temporal lobe in schizophrenia, but not in bipolar disorder, compared with controls. Cho/H2O (choline/nonsuppressed water signal) ratios in the left frontal lobe had a tendency to increase in bipolar disorder and schizophrenia, relative to controls. A lower temporal lobe NAA/H2O ratio in mixed than in manic and depressive episode of bipolar patients was also found. No other significant differences were found among three studied groups as regards NAA, Cr, and mI ratios. Conclusions Our results partially confirm the role of a glutamatergic system in schizophrenia, however, only in a temporal lobe. We also point to the importance of the choline-containing compounds (marker of cellular density) in the frontal lobe of patients suffering from bipolar disorder and schizophrenia. We also found the deleterious effect of mixed bipolar episode on the integrity and functioning of the temporal lobe. Glutamatergic left temporal spectroscopic changes may potentially help in differential diagnosis of schizophrenia from bipolar disorder.

Depth‐dependent abnormal cortical myelination in first‐episode treatment‐naïve schizophrenia

“…Structural and functional abnormalities in STG were related to verbal hallucination in SZ (Kose, Jessen, Ebdrup, & Nielsen, ; Kunzelmann et al, ). Level of gamma‐aminobutyric acid (GABA) was found increased in temporal gyrus in SZ patients, which may suggest that hypermyelination in the STG could relate to GABAergic pathway disruption in the disease (Galinska‐Skok et al, ).…”

Pre- and Post-treatment Levels of Plasma Metabolites in Patients With Bipolar Depression

“…Effective drug therapy could improve biological function by increasing blood choline levels. Previous studies have found abnormal levels of choline in BD (27). Therefore, serum choline level is expected to be a biomarker for the diagnosis and the evaluation of drug treatment effectiveness of bipolar depression.…”

Deletion of Crtc1 leads to hippocampal neuroenergetic impairments associated with depressive-like behavior

“…Importantly, tCho concentration and tissue volume in PFC was able to differentiate Crtc1 -/from wild-type mice (AUC: 82%), suggesting a potential use for clinical diagnosis or predicting treatment-compatibility. Interestingly, several MRS studies have reported elevated tCho levels in the anterior cingulate cortex of patients with bipolar disorders [78][79][80][81] and these metabolites have been previously used as a MRS biomarker, such as for diagnostic of neoplastic tumor lesions in the brain [82][83][84][85] . Future research should address whether our observations in the DH and PFC could serve, respectively, as potential 'diagnostic' and 'predictive' clinical biomarkers for mood disorders.…”