tailieunhanh - TREATMENT OF BIPOLAR DISORDER IN CHILDREN AND ADOLESCENTS - PART 2

Tác dụng của thuốc hướng thần khác về nồng độ BHYT não đã không được nghiên cứu rộng rãi. Bình thường của mi nồng độ ở các vùng trán, trước trán, và thời gian của bộ não đã được báo cáo ở người lớn (Cecil et al, 2002, Moore, Breeze, et al, 2000, Silverstone et al, 2002) và trẻ em | 30 DIAGNOSIS AND TREATMENTS The effects of other psychotropic medications on brain ml concentration have not been extensively studied. Normalization of ml concentrations in frontal prefrontal and temporal regions of the brain has been reported in adults Cecil et al. 2002 Moore Breeze et al. 2000 Silverstone et al. 2002 and children Chang et al. 2003 previously exposed to or on valproate. However chronic valproate treatment has not been shown to significantly affect regional gray matter or ACC mI in adults Friedman et al. 2004 Moore Breeze et al. 2000 . In an unpublished study of children with bipolar disorder no significant difference was observed in mI Cr ratios in the ACC before and after divalproex treatment Davanzo et al. 2002 . Treatment with olanzapine also did not significantly affect prefrontal mI of adolescents with bipolar disorder who were experiencing a manic or mixed episode DelBello Cecil et al. 2006 . In contrast an increase in DLPFC mI Cr ratios was reported with lamotrigine treatment in adolescents with bipolar depression Chang et al. 2005 . There are no data available examining the effects of carbamazapine and other atypical antipsychotics on mI concentrations in bipolar disorder. Choline The Cho peak mainly consists of phosphorylcholine and glycerophos-phorylcholine and represents a potential biomarker for membrane phospholipid metabolism. Increases in Cho may indicate membrane catabolism which may be reflective of neurodegenerative conditions Moore Galloway 2002 . Evidence from 1H MRS studies in adult patients with bipolar disorder suggests that Cho is elevated in the BG during euthymia Hamakawa Kato Murashita Kato 1998 Kato Hamakawa et al. 1996 and in the ACC and BG during a depressive episode Hamakawa et al. 1998 Moore Breeze et al. 2000 . In the study by Moore Breeze et al. 2000 severity of depressive symptoms positively correlated with ACC Cho concentrations. One study of adults with bipolar mania has reported a trend of decreased Cho in the

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