Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH.
Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX.
Bipolar Disord. 2019 Jun;21(4):330-341. doi: 10.1111/bdi.12770. Epub 2019 Mar 28.
To investigate neurochemical abnormalities in the left and right ventrolateral prefrontal cortex (VLPFC) and anterior cingulate cortex (ACC) of youth at risk for bipolar disorder using proton magnetic resonance spectroscopy before and after their first mood episode.
Children and adolescents offspring of parents with bipolar I disorder (at-risk group, n = 117) and matched healthy controls (HC group, n = 61) were recruited at the University of Cincinnati. At-risk subjects had no lifetime major mood and psychotic disorders at baseline, and were followed up every 4 months to monitor for development of a major depressive, manic, hypomanic, or mixed mood episode. Levels of N-acetyl-aspartate (NAA), phosphocreatine plus creatine (PCr + Cr), choline-containing compounds, myo-inositol, and glutamate were determined using LCModel and corrected for partial volume effects.
There were no baseline differences in metabolite levels for any of the brain regions between at-risk and HC youth. Nineteen at-risk subjects developed a first mood episode during follow-up. Survival analyses showed that baseline PCr + Cr levels in the left VLPFC significantly predicted a mood episode during follow-up in the at-risk group (HR: 0.47, 95% CI: 0.27-0.82, P = 0.008). There were no longitudinal changes in metabolites levels in the VLPFC and ACC before and after a mood episode in at-risk subjects.
We found no evidence for abnormal proton spectroscopy metabolite levels in the VLPFC and ACC of at-risk youth, prior and after the development of their first mood episode. Preliminary findings of association between baseline PCr + Cr levels in the left VLPFC and risk to develop a mood episode warrant further investigation.
使用质子磁共振波谱法，在首次情绪发作前后，研究双相障碍风险青年的左侧和右侧腹外侧前额叶皮层（VLPFC）和前扣带皮层（ACC）的神经化学异常。
在辛辛那提大学招募了父母患有双相 I 型障碍的儿童和青少年（风险组，n=117）和匹配的健康对照（HC 组，n=61）。在基线时，风险组的受试者没有终生的主要情绪和精神病障碍，并且每 4 个月随访一次，以监测是否发生重大抑郁、躁狂、轻躁狂或混合情绪发作。使用 LCModel 确定 N-乙酰天冬氨酸（NAA）、磷酸肌酸加肌酸（PCr+Cr）、含胆碱化合物、肌醇和谷氨酸的水平，并校正部分容积效应。
在基线时，风险组和 HC 组之间任何脑区的代谢物水平均无差异。19 名风险组受试者在随访期间出现首次情绪发作。生存分析显示，左侧 VLPFC 的基线 PCr+Cr 水平显著预测风险组随访期间的情绪发作（HR：0.47，95%CI：0.27-0.82，P=0.008）。在风险组中，情绪发作前后 VLPFC 和 ACC 的代谢物水平没有纵向变化。
我们没有发现风险青年 VLPFC 和 ACC 质子波谱代谢物水平异常的证据，无论是在首次情绪发作之前还是之后。在左侧 VLPFC 中发现基线 PCr+Cr 水平与发生情绪发作的风险之间存在关联的初步发现值得进一步研究。
