{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T16:51:07Z","timestamp":1779900667667,"version":"3.53.1"},"reference-count":52,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T00:00:00Z","timestamp":1479168000000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81471730"],"award-info":[{"award-number":["81471730"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2016,11]]},"abstract":"Objectives<\/jats:title>Bipolar disorder (BD<\/jats:styled-content>) is a mental disorder characterized by periods of elevated mood and depression. Many individuals with BD<\/jats:styled-content> are initially misdiagnosed and treated for unipolar depression (UD<\/jats:styled-content>). In this study, we report direct comparisons between medication\u2010free individuals with BD<\/jats:styled-content> and those with UD<\/jats:styled-content> in terms of the neurometabolites in the anterior cingulate cortex (ACC<\/jats:styled-content>), medial prefrontal cortex (mPFC<\/jats:styled-content>), parietal cortex (PC<\/jats:styled-content>), and posterior cingulate cortex (PCC<\/jats:styled-content>) of the brain.<\/jats:p><\/jats:sec>Methods<\/jats:title>Participants included medication\u2010free patients with BD<\/jats:styled-content> or UD<\/jats:styled-content>, and matched healthy controls. All patients were in the depressive state and had similar symptoms. All subjects were subjected to a multi\u2010voxel proton magnetic resonance spectroscopy procedure with a 3.0 T GE<\/jats:styled-content> Signa MR<\/jats:styled-content> scanner. After post\u2010processing, the absolute concentrations of glycerophosphocholine + phosphocholine (GPC<\/jats:styled-content>\u00a0+\u00a0PC<\/jats:styled-content>), phosphocreatine + creatine (PC<\/jats:styled-content>r\u00a0+\u00a0Cr), Glx (glutamate + glutamine), myo\u2010inositol (MI<\/jats:styled-content>), and N<\/jats:italic>\u2010acetyl aspartate (NAA<\/jats:styled-content>) from the above brain regions were compared across the three groups.<\/jats:p><\/jats:sec>Results<\/jats:title>Patients with BD<\/jats:styled-content> showed significantly higher levels of Glx in their ACC<\/jats:styled-content>, lower GPC<\/jats:styled-content>\u00a0+\u00a0PC<\/jats:styled-content>, PC<\/jats:styled-content>r\u00a0+\u00a0Cr, MI<\/jats:styled-content>, and NAA<\/jats:styled-content> in their PC<\/jats:styled-content>, and lower NAA<\/jats:styled-content> in their mPFC<\/jats:styled-content>, compared to healthy controls; patients with UD<\/jats:styled-content> presented significantly lower levels of GPC<\/jats:styled-content>\u00a0+\u00a0PC<\/jats:styled-content>, PC<\/jats:styled-content>r\u00a0+\u00a0Cr, and NAA<\/jats:styled-content> in their PCC<\/jats:styled-content>, and lower Glx in their mPFC<\/jats:styled-content>. All analyzed brain metabolites, except Glx, were significantly lower in the PC<\/jats:styled-content> of patients with BD<\/jats:styled-content>, whereas levels of GPC<\/jats:styled-content>\u00a0+\u00a0PC<\/jats:styled-content>, PC<\/jats:styled-content>r\u00a0+\u00a0Cr, and NAA<\/jats:styled-content> were significantly reduced in the PCC<\/jats:styled-content> of patients with UD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>These results add to the evidence of brain metabolite differences in brains of patients with UD<\/jats:styled-content> and BD<\/jats:styled-content> which may be of help in differentiating these two mood disorders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12445","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T18:25:19Z","timestamp":1479320719000},"page":"583-590","source":"Crossref","is-referenced-by-count":39,"title":["Differential neurometabolite alterations in brains of medication\u2010free individuals with bipolar disorder and those with unipolar depression: a two\u2010dimensional proton magnetic resonance spectroscopy study"],"prefix":"10.1111","volume":"18","author":[{"given":"Hui","family":"Li","sequence":"first","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"},{"name":"Department of Medical Imaging The 2nd Affiliated Hospital Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyun","family":"Xu","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinnan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitian","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging The 2nd Affiliated Hospital Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongtao","family":"Xu","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging The 2nd Affiliated Hospital Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Xiao","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlian","family":"Liang","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Mental Health Center Shantou University Medical College Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renhua","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging The 2nd Affiliated Hospital Shantou University Medical College Shantou China"},{"name":"The Provincial Key Laboratory of Medical Molecular Imaging Shantou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,15]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Institute of Mental Health.Bipolar Disorder Among Adults.2014."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60857-0"},{"key":"e_1_2_8_4_1","first-page":"141","article-title":"Manic\u2010depressive illness: Bipolar disorders and recurrent depression","volume":"47","author":"Goodwin FK","year":"2007","journal-title":"New Eng J Med"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v64n0209"},{"key":"e_1_2_8_6_1","first-page":"S85","article-title":"Bipolar disorder\u2013costs and comorbidity","volume":"11","author":"Hirschfeld RM","year":"2005","journal-title":"Am J Manag Care"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.12.046"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2010.122"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.11m07166"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.03.014"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2010.00768.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.111.095349"},{"key":"e_1_2_8_13_1","first-page":"221","article-title":"Corpus callosum signal intensity in patients with bipolar and unipolar disorder","volume":"75","author":"Brambilla P","year":"2004","journal-title":"J Neurol Neurosur Ps"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2010.04.036"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171100242X"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.05.019"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2013.02.008"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-011-0900-0"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg216"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2006.03.013"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.07.024"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.98.2.676"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.04.009"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.152033"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.1910300604"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301387"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2012.203"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2015.05.010"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2007.03.017"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2008.26"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.841"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2010.08.010"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2005.12.004"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2007.0102"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2012.02.003"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.3109\/15622970701472086"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2007.151"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2006.07.029"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1614.2002.00992.x"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2832-3-13"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2004.12.008"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2008.07.007"},{"key":"e_1_2_8_43_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12888-015-0489-7","article-title":"A MRS study of metabolic alterations in the frontal white matter of major depressive disorder patients with the treatment of SSRIs","volume":"15","author":"Zhang Y","year":"2015","journal-title":"BMC Psychiat"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1053\/scnp.2002.35226"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3956(98)00033-8"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.217976"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.rli.0000073446.43445.20"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.02.022"},{"key":"e_1_2_8_49_1","first-page":"22","article-title":"New understanding of mechanisms of action of bipolar medications","volume":"69","author":"Sanacora G","year":"2008","journal-title":"J Clin Psychiat"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2011.180"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2015.09.004"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2007.00454.x"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00726-016-2194-3"}],"container-title":["Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbdi.12445","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbdi.12445","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.12445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T09:09:57Z","timestamp":1696237797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bdi.12445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11]]},"references-count":52,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1111\/bdi.12445"],"URL":"https:\/\/doi.org\/10.1111\/bdi.12445","archive":["Portico"],"relation":{},"ISSN":["1398-5647","1399-5618"],"issn-type":[{"value":"1398-5647","type":"print"},{"value":"1399-5618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11]]}}}