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Glutamate as a spectroscopic marker of hippocampal structural plasticity is elevated in long-term euthymic bipolar patients on chronic lithium therapy and correlates inversely with diurnal cortisol

Molecular Psychiatry volume 14, pages 696–704 (2009)Cite this article

Abstract

While an excess of glucocorticoids is associated with hippocampal pathology in mood disorders, lithium exerts robust neuroprotective and neurotrophic effects. Here, 21 stably remitted bipolar I patients who had been on chronic lithium maintenance therapy, on average, for more than a decade, and 19 carefully matched healthy controls were studied using 3 T 1H-magnetic resonance spectroscopy of left and right hippocampus. Salivary cortisol samples were obtained to assess activity of the hypothalamus–pituitary–adrenal system. Absolute concentrations of N-acetylaspartate (NAA), choline-containing compounds and total creatine were similar in euthymic bipolar patients and healthy controls. Hippocampal glutamate concentrations were significantly increased as an effect of patient status (patients>controls) and laterality (left hippocampus>right hippocampus). Hippocampal glutamate content (Glu) was strongly correlated with NAA. Across groups and within the patient group, diurnal saliva cortisol levels showed a significant inverse relationship with both Glu and NAA. Taken together, these results add to the concept of bipolar disorder as an illness involving disturbed hippocampal structural plasticity under the opposing influences of lithium and glucocorticoids.

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Acknowledgements

We thank Rainer Hellweg and Dietrich von Calker for helpful comments on the article. We also thank Herbert Rinneberg for valuable technical support. This study was supported in part by a grant from the Bundesministerium für Bildung und Forschung (Kompetenznetz Depression to IH).

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  1. I Heuser and G Kronenberg: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany

    M Colla, M Bubner, M Bajbouj, A Luborzewski, I Heuser & G Kronenberg

  2. Physikalisch-Technische Bundesanstalt, Berlin, Germany

    F Schubert & F Seifert

  3. Department of Radiology and Nuclear Medicine, Charité, Campus Benjamin Franklin, Berlin, Germany

    J O Heidenreich

  4. Department of Radiology, University of Louisville Hospital, Louisville, KY, USA

    J O Heidenreich

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Colla, M., Schubert, F., Bubner, M. et al. Glutamate as a spectroscopic marker of hippocampal structural plasticity is elevated in long-term euthymic bipolar patients on chronic lithium therapy and correlates inversely with diurnal cortisol. Mol Psychiatry 14, 696–704 (2009). https://doi.org/10.1038/mp.2008.26

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