Abstract
Background: Regional cerebral blood flow (CBF) is reportedly altered in both adolescents and adults with bipolar disorder (BD). Whether these CBF differences are part of an overall imbalance in cerebral energy homeostasis remains unknown. Therefore, we examined global cerebral metabolic rate of oxygen consumption (CMRO2) as a physiological index of brain metabolism in adolescents with and without BD. Methods: One hundred and fifteen adolescents (mean age 17.3 ± 1.4 years), including 58 BD (type I, II, or not otherwise specified [NOS]) and 57 age-matched healthy controls (HCs) participated in this magnetic resonance imaging (MRI) study. Global estimates for venous blood oxygenation (Yv) and grey matter CBF were measured using T2-relaxation-under-spin-tagging (TRUST) and arterial spin labeling (ASL) MRI, respectively. CMRO2 was calculated using the Fick principle of arteriovenous difference to test for a group difference. We also examined CMRO2 in relation to mood states (i.e. euthymic, depressed, or hypomanic/mixed). Results: Although CBF was significantly higher in BD compared to HCs, there was no group difference in global CMRO2, nor Yv. Meanwhile, Yv significantly decreased with age, and females tended to have greater CBF and CMRO2 in comparison to males. Lastly, there was no significant association between CMRO2 and mood states. Conclusions: Our results indicate a potential mismatch between cerebral blood supply and oxygen metabolism in BD, suggesting inefficiency in energy homeostasis in the brain. Mapping CMRO2 would provide the spatial resolution to investigate regional alterations in metabolism, particularly in the brain regions where CBF is increased.
Highlights
Bipolar disorder (BD) is a severe chronic mood disorder associated with an increased risk of developing premature cardiovascular disease (CVD) [1, 2]
We evaluated the relationship between cerebral blood flow (CBF), YV, and CMRO2 and mood states
We hypothesized that individuals with BD would show alterations in baseline CMRO2 to reflect the change in CBF observed in prior studies [12, 39]
Summary
Bipolar disorder (BD) is a severe chronic mood disorder associated with an increased risk of developing premature cardiovascular disease (CVD) [1, 2]. There has been increasing support for the notion regarding vascular pathology as an important neurobiological underpinning of BD [1, 5] This link between vascular pathology and BD is further evidenced by research showing alterations in cerebral blood flow (CBF) in individuals with BD [6]. CBF is an important physiological parameter which reflects the supply of oxygen and glucose to the brain and is known to be associated with cardiometabolic risk factors [7]. Regional cerebral blood flow (CBF) is reportedly altered in both adolescents and adults with bipolar disorder (BD). Whether these CBF differences are part of an overall imbalance in cerebral energy homeostasis remains unknown. We examined global cerebral metabolic rate of oxygen consumption (CMRO2) as a physiological index of brain metabolism in adolescents with and without BD
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