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首页> 外文期刊>Journal of psychiatry & neuroscience: JPN >Large positive effect of lithium on prefrontal cortex N-acetylaspartate in patients with bipolar disorder: 2-centre study
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Large positive effect of lithium on prefrontal cortex N-acetylaspartate in patients with bipolar disorder: 2-centre study

机译：锂对双相情感障碍患者前额叶皮层N-乙酰天门冬氨酸的积极影响：2中心研究

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Background: Neuroprotective effects of lithium (Li) have been well documented in tissue cultures and animal models, whereas human data continue to be limited. Previous studies investigating the association between Li treatment and brain N-acetylaspartate (NAA), a putative neuronal marker, showed mixed results because of methodological heterogeneity. Methods: To investigate the effects of Li on prefrontal cortex NAA levels, we compared patients with bipolar disorder from specialized Li clinics in Berlin and Halifax with at least 2 years of ongoing Li treatment (Li group), patients with lifetime Li exposure of less than 3 months more than 2 years ago (non-Li group) and healthy controls. Participants in both patient groups had at least 10 years of illness and 5 episodes. We measured left prefrontal NAA levels using 1.5-T magnetic resonance spectroscopy. Results: We enrolled 27 participants in the Li, 16 in the non-Li and 21 in the healthy control groups. The non-Li group had lower prefrontal NAA levels than the Li group (t 41 = -3.44, corrected p 0.01) or control participants (t 35 = -2.91, corrected p 0.05), who did not differ from the Li group (t 46 = -0.14, p = 0.89). The same pattern of prefrontal NAA differences was replicated in both sites. In addition, there was a negative correlation between prefrontal NAA and duration of illness in the non-Li group (r = -0.60, p = 0.019) but not in the Li group (r = 0.07, p = 0.74). Limitations: Study limitations include the cross-sectional design and exposure to other medications. Conclusion: Whereas patients with bipolar disorder, substantial illness burden and limited lifetime Li exposure had significantly lower prefrontal NAA levels than controls, Li-treated patients with similar illness burden showed prefrontal NAA levels comparable to those of healthy controls. These findings provide indirect support for neuroprotective effects of Li and for negative effects of illness burden on prefrontal NAA levels in patients with bipolar disorder.
机译：背景：锂（Li）的神经保护作用已在组织培养和动物模型中得到了充分证明，而人类数据仍然受到限制。先前研究调查Li治疗与脑N-乙酰天门冬氨酸（NAA）（一种可能的神经元标志物）之间的关联的研究显示，由于方法的异质性，结果不一。方法：为了研究锂对前额叶皮质NAA水平的影响，我们比较了来自柏林和哈利法克斯专门锂诊所的躁郁症患者，他们接受了至少2年的持续锂治疗（Li组），终生Li暴露少于比2年前多3个月（非Li组），并保持健康。两个患者组的参与者至少有10年的病情和5次发作。我们使用1.5-T磁共振波谱仪测量了左前额叶NAA水平。结果：我们招募了27名Li参与者，16名非Li参与者和21名健康对照组的参与者。非Li组的前额叶NAA水平低于Li组（t 41 = -3.44，校正后的p <0.01）或对照组参与者（t 35 = -2.91，校正后的p <0.05），与Li组没有差异（t 46 ＝ -0.14，p ＝ 0.89）。在两个部位都复制了相同的前额叶NAA差异模式。此外，非Li组前额NAA与疾病持续时间之间呈负相关（r = -0.60，p = 0.019），而Li组则无（r = 0.07，p = 0.74）。局限性：研究局限性包括横断面设计和暴露于其他药物。结论：躁郁症，重大疾病负担和有限的终生Li暴露患者的前额叶NAA水平明显低于对照组，而Li相似疾病负担的经治疗患者的前额叶NAA水平与健康对照组相当。这些发现间接支持了锂的神经保护作用以及疾病负担对双相情感障碍患者前额叶NAA水平的负面影响。

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