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excitatory and inhibitory (E\/I) neurotransmitters in the brain may contribute to the pathophysiology of bipolar disorder (BD). Proton magnetic resonance spectroscopy (\n 1<\/jats:sup>\n H\u2010MRS) measures glutamatergic neurometabolites and gamma\u2010aminobutyric acid (GABA) as indices of E\/I neurotransmission. Previous meta\u2010analyses reported higher glutamatergic neurometabolite levels in the medial prefrontal cortex of BD, but findings on GABA levels in the anterior cingulate cortex (ACC) of BD patients remain inconsistent.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a cross\u2010sectional study using\n 1<\/jats:sup>\n H\u2010MRS to compare GABA and glutamate plus glutamine (Glx) levels in the dorsal ACC (dACC) of 27 patients with BD and 27 age\u2010 and sex\u2010matched healthy controls (HCs). We used the\n 1<\/jats:sup>\n H\u2010MRS (3\u2009T MRI, MEGAPRESS, 256 averages, TR\u2009=\u20091500\u2009ms, TE\u2009=\u200968\u2009ms). Clinical symptoms were evaluated using standardized rating scales. Statistical analyses were conducted to assess group differences in neurometabolite levels and to explore the associations between these neurometabolite levels and clinical symptom severity within the BD group.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n No significant differences in dACC GABA levels, Glx levels, or Glx\/GABA ratio were observed between the BD and HC groups. There were no significant differences within the BD group based on BD subtype (I or II) or clinical phase (depression or euthymic). Patients with lithium treatment had higher GABA levels compared to those without.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Our results suggest that GABAergic function in the dACC may not play a pivotal role in the pathophysiology of BD. Given possible GABAergic dysregulation in BD, further research using alternative methodologies is warranted to elucidate the pathological basis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/npr2.70085","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T03:45:20Z","timestamp":1766461520000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of\n GABAergic<\/scp>\n and Glutamatergic Levels in the Dorsal Anterior Cingulate Cortex of Patients With Bipolar Disorder: A Cross\u2010Sectional\n \n 1<\/sup>\n H\n <\/scp>\n \u2010\n MRS<\/scp>\n Study"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8142-5665","authenticated-orcid":false,"given":"Sotaro","family":"Moriyama","sequence":"first","affiliation":[{"name":"Department of Neuropsychiatry Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Noda","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry Keio University School of Medicine Tokyo Japan"},{"name":"Department of Psychiatry International University of Health and Welfare, Mita Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiori","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry Keio University School of Medicine Tokyo Japan"},{"name":"Department of Psychiatry and Behavioral Health, Renaissance School of Medicine Stony Brook University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A. 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