제1형 양극성 장애 환자에서 조증 삽화의 증상 심각도, 혈청 요산 농도 및 정량화 뇌파 소견의 관계
The Correlation between Clinical Symptoms, Serum Uric Acid Level and EEG in Patient with Bipolar I Disorder
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ObjectivesZZHigh uric acid level is related to increased locomotor activities and refractory mood swings. The purpose of this study is to examine the correlation between clinical symptoms of mania, serum uric acid level, and quantitative electroencephalography (QEEG) findings. MethodsZZTwenty-four patients with bipolar disorder and 24 healthy control subjects agreed to participate in the study. When they were hospitalized, the degree of clinical symptoms, uric acid level in blood, and brain QEEG were measured. ResultsZZThe bipolar disorder group showed higher scores on the Young Mania Rating Scale (YMRS ; z=6.02, p<0.05). Patients in their manic episodes showed higher plasma uric acid levels (4.9±1.3 mg/dL) than healthy control subjects (4.2±0.9 mg/dL ; z=2.14, p<0.05). Uric acid levels showed correlation with severity of manic symptoms as assessed using the YMRS in all participants (ρ=0.28, p<0.05). The bipolar disorder group showed decreased relative delta and alpha activity in the fronto-temporo-occipital region compared to the control group (p<0.05). Relative beta in Fp1 (frontopolar), Cz (central mid-line), and Pz (parietal mid-line) and relative gamma in Fp1 were increased in the bipolar disorder group, relative to the control group (p<0.05). The relative beta (ρ=0.47, p<0.05) and gamma (ρ=0.41, p<0.05) in Fp1 electrodes showed positive correlation with the YMRS scores. ConclusionZZAdenosinergic transmission dysfunction may lead to occurrence of manic symptoms, considering that a key role of central nervous system adenosinergic receptors is to inhibit the release of various neurotransmitters and limit neuronal excitability. In addition, QEEG appeared to indicate excitatory neuro-modulation in manic patients.
Abstract
ObjectivesZZHigh uric acid level is related to increased locomotor activities and refractory mood swings. The purpose of this study is to examine the correlation between clinical symptoms of mania, serum uric acid level, and quantitative electroencephalography (QEEG) findings. MethodsZZTwenty-four patients with bipolar disorder and 24 healthy control subjects agreed to participate in the study. When they were hospitalized, the degree of clinical symptoms, uric acid level in blood, and brain QEEG were measured. ResultsZZThe bipolar disorder group showed higher scores on the Young Mania Rating Scale (YMRS ; z=6.02, p<0.05). Patients in their manic episodes showed higher plasma uric acid levels (4.9±1.3 mg/dL) than healthy control subjects (4.2±0.9 mg/dL ; z=2.14, p<0.05). Uric acid levels showed correlation with severity of manic symptoms as assessed using the YMRS in all participants (ρ=0.28, p<0.05). The bipolar disorder group showed decreased relative delta and alpha activity in the fronto-temporo-occipital region compared to the control group (p<0.05). Relative beta in Fp1 (frontopolar), Cz (central mid-line), and Pz (parietal mid-line) and relative gamma in Fp1 were increased in the bipolar disorder group, relative to the control group (p<0.05). The relative beta (ρ=0.47, p<0.05) and gamma (ρ=0.41, p<0.05) in Fp1 electrodes showed positive correlation with the YMRS scores. ConclusionZZAdenosinergic transmission dysfunction may lead to occurrence of manic symptoms, considering that a key role of central nervous system adenosinergic receptors is to inhibit the release of various neurotransmitters and limit neuronal excitability. In addition, QEEG appeared to indicate excitatory neuro-modulation in manic patients.
참고문헌 (34)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders (DSM-5®)" (2013), American Psychiatric Association
- Mitchell PB, "Lithium treatment for bipolar disorder", Bull World Health Organ, 78, pp.515~517 (2000)
- Machado-Vieira R, "Purinergic dysfunction in mania: an integrative model", Med Hypotheses, 58, pp.297~304 (2002)
- Salvadore G, "Increased uric acid levels in drug-naïve subjects with bipolar disorder during a first manic episode", Prog Neuropsychopharmacol Biol Psychiatry, 34, pp.819~821 (2010)
- Simonato M, "Adenosine A1 receptors in the rat brain in the kindling model of epi-lepsy", Eur J Pharmacol, 265, pp.121~124 (1994)
- Fredholm BB, "Adenosine and brain function", Int Rev Neurobiol, 63, pp.191~270 (2005)
- Waldeck B, "Effect of caffeine on locomotor activity and central catecholamine mechanisms: a study with special reference to drug interaction", Acta Pharmacol Toxicol (Copenh), 36(Suppl 4), pp.1~23 (1975)
- Holmes EW, "Control of purine biosynthesis in normal and pathologic states", Bull Rheum Dis, 26, pp.848~853 (1976)
- Machado-Vieira R, "Therapeutic efficacy of allopurinol in mania associated with hyperuricemia", J Clin Psychopharmacol, 21, pp.621~622 (2001)
- Machado-Vieira R, "A double-blind, randomized, placebo-controlled 4-week study on the efficacy and safety of the purinergic agents allopurinol and dipyridamole adjunctive to lithium in acute bipolar mania", J Clin Psychiatry, 69, pp.1237~1245 (2008)
- Anumonye A, "Uric-acid metabolism in manic-depressive illness and during lithium therapy", Lancet, 1, pp.1290~1293 (1968)
- Painold A, "Brain electrical source imaging in manic and depressive episodes of bipolar disorder", Bipolar Disord, 16, pp.690~702 (2014)
- Clementz BA, "Resting EEG in first-episode schizophrenia patients, bipolar psychosis patients, and their first-degree relatives", Psychophysiology, 31, pp.486~494 (1994)
- Small JG, "Topographic EEG studies of mania", Clin Electroencephalogr, 29, pp.59~66 (1998)
- "American Electroencephalographic Society guidelines for standard electrode position nomenclature", J Clin Neurophysiol, 8, pp.200~202 (1991)
- Young RC, "A rating scale for mania:reliability, validity and sensitivity", Br J Psychiatry, 133, pp.429~435 (1978)
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- Hamilton M, "Rating depressive patients", J Clin Psychiatry, 41(12 Pt 2), pp.21~24 (1980)
- 이중서, "한국판 Hamilton 우울증 평가 척도의 신뢰도, 타당도 연구", 신경정신의학, 44(4), pp.456~465 (2005), 대한신경정신의학회
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Hahn HM, "A standardization study of Beck Depression Inventory in Korea", J Korean Neuropsychiatr Assoc, 25, pp.487~502 (1986)
- Beck AT, "An inventory for measuring clinical anxiety: psychometric properties", J Consult Clin Psychol, 56, pp.893~897 (1988)
- Yook SP, "A clinical study on the Korean version of Beck Anxiety Inventory: comparative study of patient and non-patient", Korean J Clin Psychol, 16, pp.185~197 (1997)
- Albert U, "Increased uric acid levels in bipolar disorder subjects during different phases of illness", J Affect Disord, 173, pp.170~175 (2015)
- De Berardis D, "Evaluation of plasma antioxidant levels during different phases of illness in adult patients with bipolar disorder", J Biol Regul Homeost Agents, 22, pp.195~200 (2008)
- Kesebir S, "Uric acid levels may be a biological marker for the differentiation of unipolar and bipolar disorder: the role of affective temperament", J Affect Disord, 165, pp.131~134 (2014)
- Gast H, "EEG correlation and power during maintenance of wakefulness test after sleep-deprivation", Clin Neurophysiol, 122, pp.2025~2031 (2011)
- Mitra S, "Evaluation of resting state gamma power as a response marker in schizophrenia", Psychiatry Clin Neurosci, 69, pp.630~639 (2015)
- Davidson RJ, "Affective style and affective disorders: perspectives from affective neuroscience", Cognit Emot, 12, pp.307~330 (1998)
- Henriques JB, "Left frontal hypoactivation in depression", J Abnorm Psychol, 100, pp.535~545 (1991)
- Hammond DC, "Neurofeedback with anxiety and affective disorders", Child Adolesc Psychiatr Clin N Am, 14, pp.105~123 (2005)
- Degabriele R, "A review of EEG and ERP studies in bipolar disorder", Acta Neuropsychiatr, 21, pp.58~66 (2009)
- Strakowski SM, "Neuroimaging in bipolar disorder", Bipolar Disord, 2(3 Pt 1), pp.148~164 (2000)
- Blumberg HP, "Significance of adolescent neurodevelopment for the neural circuitry of bipolar disorder", Ann N Y Acad Sci, 1021, pp.376~383 (2004)
