Acute mania is accompanied by elevated glutamate/glutamine levels within the left dorsolateral prefrontal cortex

• DOI: 10.1007/s00213-003-1440-z
• Publication Date: 2003-10-27T18:45:19Z
• Authors: Nikolaus Michael; Andreas Erfurth; Patricia Ohrmann; Michael G�ssling; Volker Arolt; Walter Heindel; Bettina Pfleiderer
• Keywords: Dorsolateral prefrontal cortex; Pathophysiology

The dorsolateral prefrontal cortex (DLPFC) participates in the pathophysiology of mania. In particular, left-sided structural and metabolic abnormalities have been described.Clinical symptoms may be due to hyperactivity of cortical glutamatergic neurons, resulting in increased excitatory neurotransmitter flux and thus enhanced Glx levels.Glutamate/glutamine (Glx) levels were assessed by proton magnetic resonance spectroscopy ((1)H-MRS) in eight acute manic patients compared with age- and gender-matched controls.Manic patients had significantly elevated Glx levels ( t-test; t=-3.1, P=0.008) within the left DLPFC.Our results indicate that the prefrontal cortical glutamatergic system is involved in the pathophysiology of acute mania. This may have implications for the treatment of mania.