Forester Brent P, Finn Chelsea T, Berlow Yosef A, Wardrop Megan, Renshaw Perry F, Moore Constance M
Geriatric Psychiatry Research Program, McLean Hospital, Belmont, MA 02478, USA.
Bipolar Disord. 2008 Sep;10(6):691-700. doi: 10.1111/j.1399-5618.2008.00627.x.
We investigated the relationship between brain lithium levels and the metabolites N-acetyl aspartate (NAA) and myo-inositol (myo-Ino) in the anterior cingulate cortex of a group of older adults with bipolar disorder (BD).
This cross-sectional assessment included nine subjects (six males and three females) with bipolar I disorder and currently treated with lithium, who were examined at McLean Hospital's Geriatric Psychiatry Research Program and Brain Imaging Center. The subjects' ages ranged from 56 to 85 years (66.0 +/- 9.7 years) and all subjects had measurements of serum and brain lithium levels. Brain lithium levels were assessed using lithium magnetic resonance spectroscopy. All subjects also had proton magnetic resonance spectroscopy to obtain measurements of NAA and myo-Ino.
Brain lithium levels were associated with higher NAA levels [df = (1, 8), Beta = 12.53, t = 4.09, p < 0.005] and higher myo-Ino levels [df = (1, 7), F = 16.81, p < 0.006]. There were no significant effects of serum lithium levels on any of the metabolites.
Our findings of a relationship between higher brain lithium levels and elevated NAA levels in older adult subjects with BD may support previous evidence of lithium's neuroprotective, neurotrophic, and mitochondrial function-enhancing effects. Elevated myo-Ino related to elevated brain lithium levels may reflect increased inositol monophosphatase (IMPase) activity, which would lead to an increase in myo-Ino levels. This is the first study to demonstrate alterations in NAA and myo-Ino in a sample of older adults with BD treated with lithium.
我们研究了一组老年双相情感障碍（BD）患者前扣带回皮质中脑锂水平与代谢产物N - 乙酰天门冬氨酸（NAA）和肌醇（myo - Ino）之间的关系。
这项横断面评估纳入了9名患有双相I型障碍且目前正在接受锂治疗的受试者（6名男性和3名女性），他们在麦克莱恩医院老年精神病学研究项目和脑成像中心接受了检查。受试者年龄在56岁至85岁之间（66.0±9.7岁），所有受试者均进行了血清和脑锂水平测量。采用锂磁共振波谱法评估脑锂水平。所有受试者还接受了质子磁共振波谱检查以获取NAA和myo - Ino的测量值。
脑锂水平与较高的NAA水平相关[自由度 = (1, 8)，β = 12.53，t = 4.09，p < 0.005]，也与较高的myo - Ino水平相关[自由度 = (1, 7)，F = 16.81，p < 0.006]。血清锂水平对任何一种代谢产物均无显著影响。
我们在老年BD患者中发现脑锂水平升高与NAA水平升高之间存在关联，这可能支持了先前关于锂具有神经保护、神经营养和增强线粒体功能作用的证据。与脑锂水平升高相关的myo - Ino升高可能反映了肌醇单磷酸酶（IMPase）活性增加，这会导致myo - Ino水平升高。这是第一项证明在用锂治疗的老年BD患者样本中NAA和myo - Ino发生改变的研究。
