Department of Psychiatry, Medical University of Warsaw, Pruszkow, Poland.
Department of Psychiatry, Medical University of Warsaw, Pruszkow, Poland.
Psychiatry Res Neuroimaging. 2018 Mar 30;273:1-8. doi: 10.1016/j.pscychresns.2018.01.001. Epub 2018 Jan 17.
1H MRS is widely used in the research of mental disorders. It enables evaluation of concentration or ratios of several metabolites, which play important roles in brain metabolism: N-acetylaspartate (NAA), choline containing compounds, myo-inositol and glutamate, glutamine and GABA (together as Glx complex or separately). Specifically in bipolar disorder brain metabolite abnormalities include mostly NAA reduces and Glx increases in different brain regions. Bipolar disorder is associated with impairment in neurotrophic and cellular plasticity, resilience pathways and in neuroprotective processes. Lithium, which is commonly used in BD treatment, modulates neurotransmitter release, reduces oxidative stress and apoptosis, induces angiogenesis, neurogenesis and neurotrophic response. Thus brain metabolite abnormalities may elucidate the mechanisms of this processes. In the present article we systematically reviewed 26 studies - the majority of them investigated bipolar disorder ( 7 follow-up and all 11 cross-sectional studies). Moreover we dispute whether the influence of lithium on brain metabolites in bipolar disorder could explain the background of its potential neuroprotective action. The results of our literature review do not equivocally confirm Lithium's influence the metabolite changes in the brain. The majority of the follow-up studies do not support the initially assumed influence of Lithium on the increase of NAA level in various brain structures. The results of studies are inconclusive with regard to levels of Glx or Glu and Lithium intake, rather point a lack of relationship. The above results were reviewed according to the most recent theories in the field accounting for the impact of lithium (1)HMRS measures.
1H MRS 广泛应用于精神障碍的研究。它可以评估几种代谢物的浓度或比率，这些代谢物在大脑代谢中起着重要作用：N-乙酰天冬氨酸（NAA）、含有胆碱的化合物、肌醇和谷氨酸、谷氨酰胺和 GABA（统称为 Glx 复合物或单独）。具体来说，在双相情感障碍的大脑代谢物异常中，包括大多数 NAA 减少和不同脑区的 Glx 增加。双相情感障碍与神经营养和细胞可塑性、适应能力途径以及神经保护过程受损有关。锂是一种常用于 BD 治疗的药物，它可以调节神经递质的释放，减少氧化应激和细胞凋亡，诱导血管生成、神经发生和神经营养反应。因此，大脑代谢物异常可能阐明了这些过程的机制。在本文中，我们系统地综述了 26 项研究-其中大多数研究了双相情感障碍（7 项随访和 11 项横断面研究）。此外，我们还质疑锂对双相情感障碍患者大脑代谢物的影响是否可以解释其潜在神经保护作用的机制。我们文献综述的结果并没有明确证实锂对大脑代谢物变化的影响。大多数随访研究并不支持锂对各种大脑结构中 NAA 水平升高的最初假设影响。关于 Glx 或 Glu 水平和锂摄入量的研究结果尚无定论，而是表明缺乏相关性。根据该领域的最新理论，对上述结果进行了回顾，这些理论考虑了锂（1）HMRS 测量的影响。
