한빛사 논문
In Kyoon Lyoo*,1,2, Stephen R Dager3,4, Jieun E Kim1, Sujung J Yoon5, Seth D Friedman4, David L Dunner6 and Perry F Renshaw7,8,9
1Department of Psychiatry, Seoul National University, Seoul, South Korea; 2Interdisciplinary Program in Brain Science, Seoul National University, Seoul, South Korea; 3Department of Radiology, University of Washington, Seattle, WA, USA; 4Department of Bioengineering, University of Washington, Seattle, WA, USA; 5Department of Psychiatry, Catholic University of Korea School of Medicine, Seoul, South Korea; 6Center for Anxiety and Depression, Mercer Island, WA, USA; 7Department of Psychiatry, University of Utah, Salt Lake City, UT, USA; 8The Brain Institute, University of Utah, Salt Lake City, UT, USA; 9Department of Veterans Affairs VISN 19 MIRECC, Salt Lake City, UT, USA
*Correspondence: Dr IK Lyoo, Departments of Psychiatry and Brain Science, Seoul National University, 28 Yongon-dong, Chongro-gu, Seoul 110-744, South Korea.
Abstract
Preclinical studies suggest that lithium may exert neurotrophic effects that counteract pathological processes in the brain of patients with bipolar disorder (BD). To describe and compare the course and magnitude of gray matter volume changes in patients with BD who are treated with lithium or valproic acid (VPA) compared to healthy comparison subjects, and to assess clinical relationships to gray matter volume changes induced by lithium in patients with BD, we conducted longitudinal brain imaging and clinical evaluations of treatment response in 22 mood-stabilizing and antipsychotic medications-naive patients with BD who were randomly assigned to either lithium or VPA treatment after baseline assessment. Fourteen healthy comparison subjects did not take any psychotropic medications during follow-up. Longitudinal data analyses of 93 serial magnetic resonance images revealed lithium-induced increases in gray matter volume, which peaked at week 10–12 and were maintained through 16 weeks of treatment. This increase was associated with positive clinical response. In contrast, VPA-treated patients with BD or healthy comparison subjects did not show gray matter volume changes over time. Results suggest that lithium induces sustained increases in cerebral gray matter volume in patients with BD and that these changes are related to the therapeutic efficacy of lithium.
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