锂相关的双相情感障碍 I 型患者静息态扣带回神经代谢特征：一项质子磁共振波谱研究。
Lithium-associated anterior cingulate neurometabolic profile in euthymic Bipolar I disorder: A H-MRS study.
机构信息
Mood Disorders Unit (GRUDA), Department and Institute of Psychiatry, University of Sao Paulo, Brazil; Genetics and Pharmacogenetics Unit (PROGENE), Department and Institute of Psychiatry, University of Sao Paulo, Brazil.
Laboratory of Magnetic Resonance LIM44, Department and Institute of Radiology, University of São Paulo (InRad-FMUSP), Brazil.
出版信息
J Affect Disord. 2018 Dec 1;241:192-199. doi: 10.1016/j.jad.2018.08.039. Epub 2018 Aug 10.
OBJECTIVE
In the treatment of Bipolar disorder (BD), achieving euthymia is highly complex and usually requires a combination of mood stabilizers. The mechanism of action in stabilizing mood has not been fully elucidated, but alterations in N-Acetylaspartate (NAA), Myo-Inositol (mI) and Choline (Cho) have been implicated. Proton magnetic resonance spectroscopy (H-MRS) is the gold standard technique for measuring brain NAA, Cho and mI in vivo. The objective of this study was to investigate the association of lithium use in BD type I and brain levels of NAA, mI and Cho in the (anterior cingulate cortex) ACC.
METHODS
129 BD type I subjects and 79 healthy controls (HC) were submitted to a 3-Tesla brain magnetic resonance imaging scan (H-MRS) using a PRESS ACC single voxel (8cm) sequence.
RESULTS
BD patients exhibited higher NAA and Cho levels compared to HC. Lithium prescription was associated with lower mI (combination + monotherapy) and higher NAA levels (monotherapy).
CONCLUSION
The results observed add to the knowledge about the mechanisms of action of mood stabilizers on brain metabolites during euthymia. Additionally, the observed decrease in mI levels associated with lithium monotherapy is an in vivo finding that supports the inositol-depletion hypothesis of lithium pharmacodynamics.
目的
在双相情感障碍（BD）的治疗中，达到病情稳定状态非常复杂，通常需要联合使用情绪稳定剂。稳定情绪的作用机制尚未完全阐明，但 N-乙酰天门冬氨酸（NAA）、肌醇（mI）和胆碱（Cho）的变化与该病相关。质子磁共振波谱（H-MRS）是测量脑内 NAA、Cho 和 mI 的金标准技术。本研究的目的是探讨 I 型双相情感障碍患者使用锂盐与大脑前扣带回（ACC）中 NAA、mI 和 Cho 水平的相关性。
方法
129 名 I 型双相情感障碍患者和 79 名健康对照者（HC）接受了 3T 脑部磁共振成像扫描（H-MRS），使用 PRESS ACC 单体素（8cm）序列。
结果
与 HC 相比，BD 患者的 NAA 和 Cho 水平更高。锂盐处方与 mI 降低（联合+单药治疗）和 NAA 水平升高（单药治疗）相关。
结论
观察到的结果增加了关于心境稳定剂在病情稳定状态下对脑代谢物作用机制的知识。此外，与锂盐单药治疗相关的 mI 水平下降是一种体内发现，支持锂盐药效学的肌醇耗竭假说。
Zotero 插件