Neurochemical and metabolic imaging in bipolar disorder

Abstract

Abstract Bipolar disorder is a chronic psychiatric disorder characterized by alternating mood states of mania, hypomania, and depression, accompanied by changes in behavior, energy, activity levels, and the ability to function. Although there is converging evidence supporting the notion that bipolar disorder has neurobiological underpinnings, the underlying pathophysiology still remains unknown. Magnetic resonance spectroscopy studies in the field of bipolar disorder have produced data that suggests that cellular bioenergetics might be impaired in those with bipolar disorder. Consistent with this, the concentrations of certain metabolites representing mitochondrial function, neural metabolism, and intracellular energy cycles were found to be altered in specific brain regions. Decreased levels of N-acetyl aspartate and phosphocreatine and increased Glx (the combination of glutamate and glutamine) and lactate seem to be the most replicated findings in the literature. Prefrontal and anterior cingulate cortices are the regions where the neurochemical abnormalities have most consistently been reported. This chapter aims to review and interpret the results of magnetic resonance spectroscopy findings in bipolar disorder.