Machado-Vieira Rodrigo, Gattaz Wagner F, Zanetti Marcus V, De Sousa Rafael T, Carvalho Andre F, Soeiro-de-Souza Marcio G, Leite Claudia C, Otaduy Maria C
Laboratory of Neuroscience, LIM- 27, Institute and Department of Psychiatry, University of Sao Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo, Brazil; Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, NIH, Bethesda, MD, United States.
Laboratory of Neuroscience, LIM- 27, Institute and Department of Psychiatry, University of Sao Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo, Brazil.
Eur Neuropsychopharmacol. 2015 Dec;25(12):2311-7. doi: 10.1016/j.euroneuro.2015.08.023. Epub 2015 Sep 25.
The anterior cingulate cortex (ACC) is a key area in mood regulation. To date, no longitudinal study has specifically evaluated lithium׳s effects on ACC metabolites using (1)H-MRS, as well as its association with clinical improvement in bipolar depression. This (1)H-MRS (TE=35ms) study evaluated 24 drug-free BD patients during depressive episodes and after lithium treatment at therapeutic levels. Brain metabolite levels (N-acetyl aspartate (NAA), creatine (tCr), choline, myo-inositol, and glutamate levels) were measured in the ACC at baseline (week 0) and after lithium monotherapy (week 6). The present investigation showed that ACC glutamate (Glu/tCr) and glutamate+glutamine (Glx/tCr) significantly increased after six weeks of lithium therapy. Regarding the association with clinical improvement, remitters showed an increase in myoinositol levels (mI/tCr) after lithium treatment compared to non-remitters. The present findings reinforce a role for ACC glutamate-glutamine cycling and myoinositol pathway as key targets for lithium׳s therapeutic effects in BD.
前扣带回皮质（ACC）是情绪调节的关键区域。迄今为止，尚无纵向研究使用氢质子磁共振波谱（¹H-MRS）专门评估锂对ACC代谢物的影响，以及其与双相抑郁临床改善的关联。这项¹H-MRS（TE=35ms）研究评估了24例在抑郁发作期间及接受治疗剂量锂治疗后的未用药双相障碍患者。在基线（第0周）和锂单药治疗后（第6周）测量ACC中的脑代谢物水平（N-乙酰天门冬氨酸（NAA）、肌酸（tCr）、胆碱、肌醇和谷氨酸水平）。本研究表明，锂治疗六周后，ACC中的谷氨酸（Glu/tCr）和谷氨酸+谷氨酰胺（Glx/tCr）显著增加。关于与临床改善的关联，与未缓解者相比，缓解者在锂治疗后肌醇水平（mI/tCr）有所增加。本研究结果强化了ACC谷氨酸-谷氨酰胺循环和肌醇途径作为锂在双相障碍中治疗作用关键靶点的作用。
