Mania, glutamate/glutamine and risperidone in pediatric bipolar disorder: A proton magnetic resonance spectroscopy study of the anterior cingulate cortex

Abstract

Background-The purpose of this study was to investigate the anterior cingulate cortex (ACC) Glutamate/Glutamine (Glx) to creatine ratio (Glx/Cr) in two groups of children with bipolar disorder (BPD): those exhibiting manic symptoms requiring treatment and those being stably treated with the atypical antipsychotic risperidone. Atypical antipsychotics have been shown to increase serum glutamate levels and ACC Glx/Cr in subjects with schizophrenia. In this study, we hypothesized that the children with BPD in need of treatment would have lower Glx/Cr compared with the children with BPD being stably treated with risperidone.

Neurochemical Alterations in Adolescent Bipolar Depression: A Proton Magnetic Resonance Spectroscopy Pilot Study of the Prefrontal Cortex

“…Because adolescents are closer to their illness onset compared with adults, 1 H MRS investigations of adolescents with bipolar disorder are typically free of confounding variables often seen in adults, such as illness duration and repeated affective episodes (DelBello et al 2006a), and this may allow for a better understanding of the developmental neurophysiology of bipolar disorder. Several studies have characterized neurochemical abnormalities in youths with mania (Davanzo et al 2001;Davanzo et al 2003;DelBello et al 2006b;Moore et al 2007), but to our knowledge, there are no published 1 H MRS studies exclusively studying youths with bipolar depression. Understanding neurochemical alterations in this phase of the illness may provide the identification of biomarkers specific for bipolar depression, thereby helping to clarify whether such abnormalities correspond with specific symptom clusters (state-dependent), or with an underlying disease process (trait-dependent).…”

Evidence for Increased Glutamatergic Cortical Facilitation in Children and Adolescents With Major Depressive Disorder

“…[16][17][18] However, little is known about the role of this ubiquitous neurotransmitter in child and adolescent depression. 19,20 Conversely, GABA is the brain's principal inhibitory neurotransmitter. 21 Research demonstrates that deficient GABA (GABA ionotropic receptor family A [GABA A ] and GABA metabotropic receptor family B [GABA B ]) neurotransmission plays a critical role in the pathophysiology of MDD in adults, [22][23][24] but there is little similar information about child and adolescent depression.…”

Focus on HTR2C: A possible suggestion for genetic studies of complex disorders

“…Intriguingly, the ACC may represent the biological relay whose disruption provides the basis for the auditory hallucinations [Hunter et al, 2006], and consistently, the verbal fluently of schizophrenic patients seems to be impaired due also to the disorganization of this part of the brain [Fu et al, 2005;Schaufelberger et al, 2005]. The evidence of the unbalanced ACC activity in mood disorders is extremely wide, for any interest, reader's attention is readdressed to some interesting works [Cotter t al., 2001;Mirza et al, 2004;Thomas et al, 2004;Fornito et al, 2007;Moore et al, 2007;Weis et al, 2007; Bhagwagar et al, 2008; Boes et al, 2008]. Drug abuse disorders [Bouras et al, 2001;Fishbein et al, 2005;Hao et al, 2005;Mohila and Onn, 2005], eating disorders [Naruo et al, 2001;Muhlau et al, 2007;Penas-Lledo et al, 2007], personality disorders [Degos et al, 1993;Takahashi et al, 2002;Haas et al, 2007], and anxiety disorders [Paulus et al, 2004;Butler et al, 2005;Phan et al, 2005;Milad et al, 2007;Bryant et al, 2008;Yucel et al, 2008] have also been associated with disruptions in the ACC.…”