Hamakawa H, Kato T, Shioiri T, Inubushi T, Kato N
Department of Psychiatry and Molecular Neurobiology Research Center, Shiga University of Medical Science, Otsu, Japan.
Psychol Med. 1999 May;29(3):639-44. doi: 10.1017/s0033291799008442.
Using 31P and 1H magnetic resonance spectroscopy (MRS) we previously reported that phosphocreatine was decreased in the left frontal lobe and choline-containing compounds were increased in the basal ganglia in the depressive state in patients with bipolar disorder. We applied quantitative 1H-MRS for further characterization of biochemical alteration in the frontal lobes of bipolar patients.
Twenty-three bipolar patients and 20 normal controls were examined by 1H-MRS with a 1.5T MR system. All patients were examined in the euthymic state, and eight patients were also examined in the depressive state. Volumes of interest of 2.5 x 2.5 x 2.5 cm were selected in the left and right frontal lobes. Absolute concentrations of N-acetyl-1-aspartate, creatine plus phosphocreatine, and choline-containing compounds were calculated from each metabolite peak.
Creatine concentration in the left frontal lobe in bipolar patients in the depressive state was significantly lower than that in the euthymic state. Creatine concentration in the right frontal lobe in the male patients was significantly higher than that in the female patients and a similar trend was also found in the control subjects.
We found a state-dependent change of creatine metabolism in the left frontal lobe of bipolar patients. The present results are compatible with our previous report of decreased phosphocreatine measured by 31P-MRS in the left frontal lobe in bipolar disorder. We also found an effect of gender on the creatine concentration. There may be a gender difference in creatine transport function into the brain.
我们之前利用31P和1H磁共振波谱（MRS）报告称，双相情感障碍患者处于抑郁状态时，左额叶中的磷酸肌酸减少，基底节中含胆碱化合物增加。我们应用定量1H-MRS进一步表征双相情感障碍患者额叶中的生化改变。
使用1.5T磁共振系统通过1H-MRS对23名双相情感障碍患者和20名正常对照者进行检查。所有患者均在心境正常状态下接受检查，8名患者还在抑郁状态下接受了检查。在左右额叶中选择2.5×2.5×2.5 cm的感兴趣区。根据每个代谢物峰计算N-乙酰天门冬氨酸、肌酸加磷酸肌酸以及含胆碱化合物的绝对浓度。
处于抑郁状态的双相情感障碍患者左额叶中的肌酸浓度显著低于心境正常状态。男性患者右额叶中的肌酸浓度显著高于女性患者，在对照者中也发现了类似趋势。
我们发现双相情感障碍患者左额叶中存在肌酸代谢的状态依赖性变化。目前的结果与我们之前关于双相情感障碍患者左额叶中通过31P-MRS测得的磷酸肌酸减少的报告一致。我们还发现了性别对肌酸浓度的影响。肌酸向脑内的转运功能可能存在性别差异。
