• Nick C Patel, Kim M Cecil, Stephen M Strakowski, Caleb M Adler, and Melissa P DelBello.
• LifeSynch, Fort Worth, Texas 76102, USA. npatel@lifesynch.com
• J Child Adolesc Psychopharmacol. 2008 Dec 1; 18 (6): 623-7.

ObjectiveIdentifying neurochemical alterations in adolescent bipolar depression may enhance our understanding of the neurophysiology of bipolar disorder across the age spectrum. The objective of this study was to compare in vivo neurometabolite concentrations in bipolar adolescents with a depressed episode and healthy adolescents using proton magnetic resonance spectroscopy ((1)H MRS).MethodBipolar adolescents with a depressed episode (n = 28) and healthy adolescents (n = 10) underwent a (1)H MRS scan. Anterior cingulate (ACC) and left and right ventral lateral prefrontal (LVLPFC, RVLPFC) metabolite concentrations were calculated and compared between groups using analysis of covariance (ANCOVA).ResultsANCOVA showed significant group differences in ACC N-acetyl-aspartate (NAA) (F(1,33) = 17.8, p = 0.0002), LVLPFC choline (Cho) (F(1,32) = 13.1, p = 0.001), creatine/phosphocreatine (Cr) (F(1,32) = 18.5, p = 0.0002), and NAA (F(1,32) = 13.6, p = 0.0008), and RVLPFC Cr (F(1,32) = 9.6, p = 0.004), mI (F(1,32) = 11.1, p = 0.002), and NAA (F(1,32) = 11.4, p = 0.002) concentrations. In general, the bipolar depressed group had higher neurometabolite concentrations than the healthy group.ConclusionsThere may be localized alterations in brain neurometabolites in adolescents with bipolar depression. Limitations include lack of bipolar adolescents in other mood states and potential confounding effects of prior psychotropic medication use. Confirmatory (1)H MRS studies in larger samples of youths with bipolar depression are needed.

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