Mania, glutamate/glutamine and risperidone in pediatric bipolar disorder: A proton magnetic resonance spectroscopy study of the anterior cingulate cortex

Constance M. Moore, Joseph Biederman, Janet Wozniak, Eric Mick, Megan Aleardi, Megan Wardrop, Meghan Dougherty, Terri Harpold, Paul Hammerness, Edin Randall, In Kyoon Lyoo, Perry F. Renshaw

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Background: The purpose of this study was to investigate the anterior cingulate cortex (ACC) glutamate/glutamine (Glx) to creatine ratio (Glx/Cr) in two groups of children with Bipolar Disorder (BPD): those exhibiting manic symptoms requiring treatment and those being stably treated with the atypical antipsychotic risperidone. Atypical antipsychotics have been shown to increase serum glutamate levels and ACC Glx/Cr in subjects with schizophrenia. In this study, we hypothesized that the children with BPD in need of treatment would have lower Glx/Cr compared with the children with BPD being stably treated with risperidone. Methods: Proton MR spectra were acquired, at 1.5 T, from the ACC of eighteen subjects with a DSM-IV diagnosis of BPD: ten (11.10 ± 3.48 years; five female) were manic and not medicated with any antipsychotic and eight (10.88 ± 2.99 years; one female) were medicated with the atypical antipsychotic risperidone. Results: Children with BPD exhibiting manic symptoms requiring treatment had lower Glx/Cr than children with BPD being stably treated with the atypical antipsychotic risperidone. The children treated with risperidone also had significantly lower YMRS and CGI-Mania scores than the children not treated with risperidone. Both YMRS and CGI-Mania scores correlated negatively with ACC Glx/Cr levels. Limitations: The cross-sectional design, small sample size, the use of Glx rather than glutamate or glutamine and the use of Cr ratios rather than absolute concentrations are limitations of this study. Conclusions: Children with mania have lower Glx/Cr levels than children with BPD being stably treated with the atypical antipsychotic risperidone. Mania may be associated with reduced glutamate/glutamine levels in the ACC: other imaging studies have shown mania associated with hypometabolism in the ACC. These reductions in glutamate/glutamine may be increased following successful treatment with glutamatergic agents.

Original languageEnglish
Pages (from-to)19-25
Number of pages7
JournalJournal of Affective Disorders
Volume99
Issue number1-3
DOIs
StatePublished - Apr 2007

Keywords

  • Anterior cingulate cortex
  • Bipolar disorder
  • Glutamate/glutamine
  • Mania
  • Proton magnetic resonance spectroscopy

Fingerprint

Dive into the research topics of 'Mania, glutamate/glutamine and risperidone in pediatric bipolar disorder: A proton magnetic resonance spectroscopy study of the anterior cingulate cortex'. Together they form a unique fingerprint.

Cite this