Dorsal Anterior Cingulate Lactate and Glutathione Levels in Euthymic Bipolar I Disorder: 1H-MRS Study

Márcio Gerhardt Soeiro-de-Souza, Bruno F Pastorello, Cláudia da Costa Leite, Anke Henning, Ricardo A Moreno, Maria Concepción Garcia Otaduy, Márcio Gerhardt Soeiro-de-Souza, Bruno F Pastorello, Cláudia da Costa Leite, Anke Henning, Ricardo A Moreno, Maria Concepción Garcia Otaduy

Abstract

Objective: Oxidative stress and mitochondrial dysfunction are 2 closely integrated processes implicated in the physiopathology of bipolar disorder. Advanced proton magnetic resonance spectroscopy techniques enable the measurement of levels of lactate, the main marker of mitochondrial dysfunction, and glutathione, the predominant brain antioxidant. The objective of this study was to measure brain lactate and glutathione levels in bipolar disorder and healthy controls.

Methods: Eighty-eight individuals (50 bipolar disorder and 38 healthy controls) underwent 3T proton magnetic resonance spectroscopy in the dorsal anterior cingulate cortex (2x2x4.5cm(3)) using a 2-D JPRESS sequence. Lactate and glutathione were quantified using the ProFit software program.

Results: Bipolar disorder patients had higher dorsal anterior cingulate cortex lactate levels compared with controls. Glutathione levels did not differ between euthymic bipolar disorder and controls. There was a positive correlation between lactate and glutathione levels specific to bipolar disorder. No influence of medications on metabolites was observed.

Conclusion: This is the most extensive magnetic resonance spectroscopy study of lactate and glutathione in bipolar disorder to date, and results indicated that euthymic bipolar disorder patients had higher levels of lactate, which might be an indication of altered mitochondrial function. Moreover, lactate levels correlated with glutathione levels, indicating a compensatory mechanism regardless of bipolar disorder diagnosis.

Trial registration: ClinicalTrials.gov NCT01237158.

Keywords: bipolar disorder; glutathione; lactate; mitochondrial disease; oxidative stress.

© The Author 2016. Published by Oxford University Press on behalf of CINP.

Figures

Figure 1.
Figure 1.
Magnetic resonance spectroscopy (MRS) voxel location in the sagittal plane. Size 20 x 20 x 45mm3.
Figure 2.
Figure 2.
Mean dorsal anterior cingulate cortex (dACC) levels of lactate (Lac) in bipolar disorder (BD) type I compared with healthy controls (HC).
Figure 3.
Figure 3.
Correlation between dorsal anterior cingulate cortex (dACC) levels of lactate (Lac) and glutathione (GSH) adjusted for age and gender.

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