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World J Biol Psychiatry. 2009;10(4):285-94. doi: 10.3109/15622970701472086.

Cortical neurochemistry in euthymic patients with bipolar I disorder.

Author information

  • 1Department of Psychiatry and Psychotherapy, Georg-August-University Goettingen, 37075 Goettingen, Germany. hscherk@uni-goettingen.de



Prefrontal and anterior cingulate cortical regions are assumed to be involved in the pathophysiology of mood regulation. Reduced prefrontal and anterior cingulate function indicated by decreased N-acetyl-aspartate (NAA) levels in patients with bipolar disorder has been reported inconsistently. A positive correlation between lithium serum level and NAA concentrations has been found previously. The aim of this study was to re-investigate prefrontal and anterior cingulate neurochemistry in a sample of euthymic patients with bipolar I disorder.


NAA, choline (Cho), creatine (Cr) and myo-inositol (Ins) in left dorsolateral prefrontal cortex and left anterior cingulate cortex were measured in 33 euthymic patients with bipolar I disorder and 29 healthy comparison subjects by using proton magnetic resonance spectroscopy ([(1)H]MRS).


Metabolic ratios did not differ between patients with bipolar I disorder and comparison subjects in prefrontal and anterior cingulate cortex neither in the total sample nor in the pairwise matched sub-sample. We could not observe an association between lithium level and NAA ratios. Lithium treated patients demonstrated unchanged NAA or myo-inositol ratios compared to alternatively treated patients.


In contrast to prior findings, we could not observe any metabolic alterations in euthymic patients with bipolar disorder.

[PubMed - indexed for MEDLINE]
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