Neurochemical pathology in hippocampus in euthymic patients with bipolar I disorder

Acta Psychiatr Scand. 2008 Apr;117(4):283-8. doi: 10.1111/j.1600-0447.2007.01142.x. Epub 2008 Jan 16.


Objective: Subcortical regions such as hippocampus, thalamus and ventral putamen are assumed to be involved in the pathophysiology of mood regulation. Disturbed hippocampal neuronal function indicated by reduced N-acetyl-aspartate (NAA) levels in bipolar patients was shown by several studies. Results in thalamus and putamen are inconsistent.

Method: N-acetyl-aspartate, choline (Cho), creatine (Cr) and myo-inositol (Ins) were measured in left hippocampus, left thalamus and left putamen using proton magnetic resonance spectroscopy in 13 euthymic patients with bipolar I disorder and 13 pairwise matched healthy control subjects. Metabolic ratios NAA/Cr, NAA/Cho, Cho/Cr and Ins/Cr were calculated.

Results: Patients with bipolar I disorder demonstrated significantly reduced NAA/Cr in the left hippocampus compared with healthy control subjects. No alterations were found in thalamus or putamen.

Conclusion: We hypothesize that this NAA/Cr reduction might reflect neuronal dysfunction in the left hippocampus in patients with bipolar disorder.

MeSH terms

  • Adult
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / metabolism
  • Bipolar Disorder* / epidemiology
  • Bipolar Disorder* / metabolism
  • Bipolar Disorder* / physiopathology
  • Choline / metabolism*
  • Creatine / metabolism*
  • Dysthymic Disorder* / epidemiology
  • Dysthymic Disorder* / metabolism
  • Dysthymic Disorder* / physiopathology
  • Female
  • Hippocampus / metabolism*
  • Hippocampus / physiopathology*
  • Humans
  • Inositol / metabolism*
  • Male
  • Putamen / metabolism
  • Putamen / physiopathology
  • Thalamus / metabolism
  • Thalamus / physiopathology


  • Aspartic Acid
  • Inositol
  • N-acetylaspartate
  • Creatine
  • Choline