%0 Journal Article
%T Brain choline concentrations may not be altered in euthymic bipolar disorder patients chronically treated with either lithium or sodium valproate
%A Ren H Wu
%A Tina O'Donnell
%A Michele Ulrich
%A Sheila J Asghar
%A Christopher C Hanstock
%A Peter H Silverstone
%J Annals of General Psychiatry
%D 2004
%I BioMed Central
%R 10.1186/1475-2832-3-13
%X The present study utilized 1H 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.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.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.Bipolar disorder is a chronic severe mental illness affecting approximately 1% of the adult population. The most widely used mood stabilizer for this condition is lithium [1], although the exact mechanism by which it is clinically effective remains undetermined. One suggestion is that it acts via effects on choline metabolism. This is based upon findings that lithium can inhibit the membrane transport of choline in both animals [2], and human post-mortem brain tissue [3]. It also increases the accumulation of erythrocyte choline in lithium-treated patients [4-7]. Also of note is that choline concentrations increase sign
%K Bipolar disorder
%K lithium
%K sodium valproate
%K magnetic resonance spectroscopy
%K choline
%U http://www.annals-general-psychiatry.com/content/3/1/13