{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T18:33:03Z","timestamp":1793817183925,"version":"4.6.1"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,10,29]],"date-time":"2015-10-29T00:00:00Z","timestamp":1446076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2009\/14891\u20109"],"award-info":[{"award-number":["2009\/14891\u20109"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to evaluate brain lithium levels using <jats:sup>7<\/jats:sup>Li magnetic resonance spectroscopy after 6 weeks of lithium therapy in bipolar depression to test the hypothesis that brain and plasma lithium are correlated. It was also tested whether responders and remitters have different pharmacokinetics, blood and brain lithium levels (ratio) compared with those presenting suboptimal antidepressant improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Twenty\u2010three patients with bipolar disorder (I and <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>) during depressive episodes were included and followed up for 6 weeks at the University of Sao Paulo using flexible dose of lithium (450\u2013900 mg\/day). Sixteen patients were drug\u2010na\u00efve. At endpoint, patients underwent a <jats:sup>7<\/jats:sup>Li\u2010<jats:styled-content style=\"fixed-case\">MRS<\/jats:styled-content> scan and brain lithium concentrations were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant association between central and peripheral lithium levels was found only in remitters (<jats:italic>r<\/jats:italic> = 0.7, <jats:italic>P<\/jats:italic> = 0.004) but not in non\u2010remitters (<jats:italic>r<\/jats:italic> = \u22120.12, <jats:italic>P<\/jats:italic> = 0.76). Also, brain lithium (but not plasma) was inversely correlated with age (<jats:italic>r<\/jats:italic> = \u22120.46, <jats:italic>P<\/jats:italic> = 0.025). Plasma lithium did not correlate with any clinical outcome, lithium dosage or adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings suggest that non\u2010remitters may not transport lithium properly to the brain, which may underlie treatment resistance to lithium in <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>. Future studies with <jats:sup>7<\/jats:sup>Li\u2010<jats:styled-content style=\"fixed-case\">MRS<\/jats:styled-content> integrated with the evaluation of blood\u2013brain barrier transport mechanisms and longitudinal clinical outcomes in <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> and aging are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.12511","type":"journal-article","created":{"date-parts":[[2015,10,29]],"date-time":"2015-10-29T12:38:40Z","timestamp":1446122320000},"page":"214-220","source":"Crossref","is-referenced-by-count":30,"title":["A Selective Association between Central and Peripheral Lithium Levels in Remitters in Bipolar Depression: A 3T\u2010<sup>7<\/sup>Li Magnetic Resonance Spectroscopy Study"],"prefix":"10.1111","volume":"133","author":[{"given":"R.","family":"Machado\u2010Vieira","sequence":"first","affiliation":[{"name":"Laboratory of Neuroscience LIM\u2010 27 Institute and Department of Psychiatry University of Sao Paulo Sao Paulo Brazil"},{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"},{"name":"Experimental Therapeutics and Pathophysiology Branch National Institute of Mental Health NIH Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"Otaduy","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"},{"name":"Laboratory of Magnetic Resonance in Neuroradiology LIM\u2010 44 Institute and Department of Radiology University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. V.","family":"Zanetti","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroscience LIM\u2010 27 Institute and Department of Psychiatry University of Sao Paulo Sao Paulo Brazil"},{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. T.","family":"De Sousa","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroscience LIM\u2010 27 Institute and Department of Psychiatry University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. V.","family":"Dias","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. C.","family":"Leite","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"},{"name":"Laboratory of Magnetic Resonance in Neuroradiology LIM\u2010 44 Institute and Department of Radiology University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. V.","family":"Forlenza","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroscience LIM\u2010 27 Institute and Department of Psychiatry University of Sao Paulo Sao Paulo Brazil"},{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. F.","family":"Busatto","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"},{"name":"Laboratory of Psychiatric Neuroimaging LIM\u201021 Institute and Department of Psychiatry University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"Soares","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Texas Medical School Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. F.","family":"Gattaz","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroscience LIM\u2010 27 Institute and Department of Psychiatry University of Sao Paulo Sao Paulo Brazil"},{"name":"Center for Interdisciplinary Research on Applied Neurosciences (NAPNA) University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00714.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12025"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/15622975.2013.830775"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.2929"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(96)00330-7"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(00)00985-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.7.1240"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-977X(00)00057-2"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0925-4927(92)90013-T"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-199410000-00007"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2014.1864"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1021\/cn500058v"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198911303212201"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12060751"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12027"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-199816010-00002"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(87)90050-3"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0893-133X(96)00241-2"}],"container-title":["Acta Psychiatrica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facps.12511","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acps.12511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:02:01Z","timestamp":1695571321000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acps.12511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,29]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1111\/acps.12511"],"URL":"https:\/\/doi.org\/10.1111\/acps.12511","archive":["Portico"],"relation":{},"ISSN":["0001-690X","1600-0447"],"issn-type":[{"value":"0001-690X","type":"print"},{"value":"1600-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,29]]}}}