Brain choline concentrations may not be altered in euthymic bipolar disorder patients chronically treated with either lithium or sodium valproate

BACKGROUND: It has been suggested that lithium increases choline concentrations, although previous human studies examining this possibility using (1)H magnetic resonance spectroscopy ((1)H MRS) have had mixed results: some found increases while most found no differences. METHODS: The present study utilized (1)H MRS, in a 3 T scanner to examine the effects of both lithium and sodium valproate upon choline concentrations in treated euthymic bipolar patients utilizing two different methodologies. In the first part of the study healthy controls (n = 18) were compared with euthymic Bipolar Disorder patients (Type I and Type II) who were taking either lithium (n = 14) or sodium valproate (n = 11), and temporal lobe choline/creatine (Cho/Cr) ratios were determined. In the second part we examined a separate group of euthymic Bipolar Disorder Type I patients taking sodium valproate (n = 9) and compared these to controls (n = 11). Here we measured the absolute concentrations of choline in both temporal and frontal lobes. RESULTS: The results from the first part of the study showed that bipolar patients chronically treated with both lithium and sodium valproate had significantly reduced temporal lobe Cho/Cr ratios. In contrast, in the second part of the study, there were no effects of sodium valproate on either absolute choline concentrations or on Cho/Cr ratios in either temporal or frontal lobes. CONCLUSIONS: These findings suggest that measuring Cho/Cr ratios may not accurately reflect brain choline concentrations. In addition, the results do not support previous suggestions that either lithium or valproate increases choline concentrations in bipolar patients

Illness versus substance use effects on the frontal white matter in early phase schizophrenia: A 4 Tesla \u3csup\u3e1\u3c/sup\u3eH-MRS study

Objective Young adults with early phase schizophrenia often report a past or current pattern of illicit substance use and/or alcohol misuse. Still, little is known about the cumulative and separate effects of each stressor on white matter tissue, at this vulnerable period of brain development. Methods Participants involved 24 healthy controls with a past or current history of sustained illicit drug use and/or alcohol misuse (users), 23 healthy controls without such history (normative data), and 27 users with early phase schizophrenia. 1H-MRS data were acquired from a large frontal volume encompassing 95% of white matter, using a 4 Tesla scanner (LASER sequence, TR/TE 3200/46 ms). Results Reduced levels of choline-containing compounds (Cho) were specific to the effect of illness (Cohen\u27s d = 0.68), with 22% of the variance in Cho levels accounted for by duration of illness. Reduced levels of myoInositol (d = 1.10) and creatine plus phosphocreatine (d = 1.07) were specific to the effects of illness plus substance use. Effect of substance use on its own was revealed by reductions in levels of glutamate plus glutamine (d = 0.83) in control users relative to normative data. Conclusions The specific effect of illness on white matter might indicate a decreased synthesis of membrane phospholipids or alternatively, reduced membrane cellular density. In terms of limitations, this study did not include patients without a lifetime history of substance use (non-users), and the specific effect of each substance used could not be studied separately

Illness Versus Substance Use Effects on The Frontal White Matter in Early Schizophrenia: A 4Tesla 1H-MRS Study

Illness versus substance use effects on the frontal white matter in earlyphase schizophrenia: A 4 Tesla1H-MRS studyDenise Berniera,RobertBarthab, David McAllindona,c, Christopher C. Hanstockd, Yannick Marchande,Kim N.H. Dillena, Michelle Gallanta, Kimberly P. Gooda,PhilipG.Tibboa,⁎aDepartment of Psychiatry, Dalhousie University, Nova Scotia, CanadabRobarts Research Institute, University of Western Ontario, Ontario, CanadacBiomedical Translational Imaging Centre, Halifax, Nova Scotia, CanadadDepartment of Biomedical Engineering, University of Alberta, Alberta, CanadaeFaculty of Computer Science, Department of Psychology and Neuroscience, Dalhousie University, Nova Scotia, Canadaabstractarticle infoArticle history:Received 4 September 2015Received in revised form 13 April 2016Accepted 15 April 2016Available online 6 May 2016Objective:Young adults with early phase schizophrenia often report a past or current pattern of illicit substanceuse and/or alcohol misuse. Still, little is known about the cumulative and separate effects of each stressor onwhite matter tissue, at this vulnerable period of brain development.Methods:Participants involved 24 healthy controls with a past or current history of sustained illicit drug use and/or alcohol misuse (users), 23 healthy controls without such history (normative data), and 27 users with earlyphase schizophrenia.1H-MRSdata were acquired from a large frontal volumeencompassing95% of white matter,using a 4 Tesla scanner (LASER sequence, TR/TE 3200/46 ms).Results:Reduced levels of choline-containing compounds (Cho) were specific to the effect of illness (Cohen\u27sd=0.68), with 22% of the variance in Cho levels accounted for by duration of illness. Reduced levels of myoInositol(d= 1.10) and creatine plus phosphocreatine (d= 1.07) were specific to the effects of illness plus substanceuse. Effect of substance use on its own was revealed by reductions in levels of glutamate plus glutamine (d=0.83) in control users relative to normative data.Conclusions:The specific effect of illness on white matter might indicate a decreased synthesis of membranephospholipids or alternatively, reduced membrane cellular density. In terms of limitations, this study did notinclude patients without a lifetime history of substance use (non-users), and the specific effect of each substanceused could not be studied separately