P-31 Nuclear magnetic resonance spectroscopy findings in bipolar illness: a meta-analysis

Published literature comparing P-31 MR brain spectra of bipolar patients to healthy controls was evaluated, focusing on phosphomonoester (PME)/phospho diester (PDE) resonance areas because these metabolites are related to memb rane phospholipids and membrane defects in bipolar disorder have been sugge sted. Studies comparing PME: and/or PDE values of bipolar subjects to value s observed in healthy controls were reviewed. Data from the studies meeting our inclusion criteria (8 reports involving 139 bipolar and 189 comparison subjects) were grouped according to the mood state of the subjects. Meta-a nalyses of data were performed to compare PME and PDE levels of euthymic bi polar patients to healthy controls, as well as comparing PME levels during euthymia in bipolar subjects to values observed during manic and depressed states. The PME values of euthymic bipolar patients were found to be signif icantly lower than PME values of healthy controls. Depressed bipolar patien ts had significantly higher PME values in comparison to euthymic bipolar pa tients. No significant difference could be detected between the PDE values of bipolars and controls. This meta-analysis found support for trait- and p ossibly state-dependent abnormalities of membrane phospholipid metabolism, which may reflect a dysregulation in brain signal transduction systems of r elevance in bipolar illness. (C) 2001 Elsevier Science Ireland Ltd. All rig hts: reserved.