Elevated Choline-Containing Compound Levels in Rapid Cycling Bipolar Disorder

Abstract

Previous studies have found increased levels of choline-containing compounds (ie, glycerophosphocholine plus phosphocholine (GPC+PC)) in bipolar disorder using in vivo proton magnetic resonance spectroscopy (H MRS), especially in bipolar I disorder (BD-I). Increased levels of GPC+PC suggest alterations in the membrane phospholipids metabolism in bipolar disorder. Rapid cycling (RC) bipolar disorder is considered as a severe course of bipolar disorder, but it is unclear whether rapid cycling bipolar disorder is linked to highly altered membrane phospholipid metabolism. The purpose of this study was to investigate whether the regional extent of elevated GPC+PC were greater in BD-I patients with rapid cycling compared to BD-I patients without rapid cycling and healthy controls. Using a multi-voxel H MRS approach at 3 Tesla with high spatial resolution and absolute quantification, GPC+PC levels from the anterior cingulate cortex (ACC), caudate and putamen of 16 RC BD-I, 34 non-RC BD-I and 44 healthy controls were assessed. We found significantly elevated GPC+PC levels in ACC, putamen and caudate of RC BD-I patients compared to healthy controls (P<0.005) and in ACC compared to non-RC BD-I patients (P<0.05). These results suggest greater alteration of membrane phospholipid metabolisms in rapid cycling BD-I compared to non-rapid-cycling BD-I.

Metabolomic Identification of Serum Exosome-Derived Biomarkers for Bipolar Disorder

“…For example, arachadonic and docosahexaenoic acid were found to be reduced in red blood cell membranes of BD patients in a manic phase [ 22 ]. Another study used in vivo proton magnetic resonance spectroscopy and found increased glycerophosphocholine plus phosphocholine levels in the basal ganglia and anterior cingulate cortex of patients with BD, which are brain regions that are important for mood regulation [ 23 ]. Moreover, Knowles et al recruited a sample of 558 individuals from 38 extended pedigrees and analyzed 13 serum-based phospholipid concentrations; they concluded that serum-based phosphatidylinositol had a significant association with BD risk [ 24 ].…”

Meta-analysis and Open-source Database for In Vivo Brain Magnetic Resonance Spectroscopy in Health and Disease

“…Studies that investigated clinical groups and included a healthy control group were included in the clinical population analysis. There were 180 publications [141,142,157,305,306,308,310–312,317,321,322,328,160,329–333,335,337,339–341,161,342,345,350–354,359–361,162,362,364,365,368–374,163,377,378,380–387,165,388–397,166,398–407,167,408–414,169,171,143,174,175,178,179,181,183–185,187,188,144,190,192,193,195–201,145,203,204,207–211,213–215,146,217,219,220,223,227,229–231,233,235,150,237,238,240,243,247,249,250,253,254,256,151,…”

Magnetic Resonance Spectroscopy and Bipolar Disorder: How Feasible Is This Pairing?

“…First, they mark a point in favor of the pathophysiological process mentioned above; indeed, each molecule analyzed in these studies has a pathophysiological correlation with BD. As mentioned before, there is a process of neuronal damage in BD; thus, molecules such as n-acetyl-aspartate (NAA) and choline (Cho) translate a neurodegenerative process [ 21 ] and impaired repair of neuronal membranes, respectively [ 22 ]. Consequently, in BD there is a decrease in NAA, reflecting a loss of neuronal integrity [ 23 ], and an increase in Cho, which translates into cell membrane damage and altered metabolism of neuronal membranes [ 24 ].…”