Evaluation of neuroprotective effects of lithium and olanzapin on brain tissue in bipolar affective disorder: a comperative study with MR spectroscopy

A Comparative study with MR spectroscopy. Purpose: We aimed to determine n-acetyl aspartate and choline content changes to evaluate neuroprotective effects of lithium and olanzapin on brain tissue in patients with bipolar affective disorder during remission. Material and Methods: Ten patients with bipolar affective disorders who were followed-up in psychiatrics clinic between February and June 2003, had no manic or depressive attacs for the last 3 years and had Lithium as the only therapy for the last 6 months were included oiled in this study. They were evaluated during and 14 days after cessation of lithium treatment and at the end of 4th week on olazapine treatment. Clinical interview, HDDÖ pschometric evaluation test, BRMO and MR spectroscopy were assesed on each evaluation. According to the results of interview and psychiometric evaluation, patients who were diagnosed as manic or depressive disorder were ruled out of the study. Cases underwent single voxel MR spect (136) with PRESS sequence. N- acetyl aspartate (NAA), Choline (Cho) and their ratio to Creatinine (Cr) were evaluated quantitavely right prefrontal cortex and left hippocampus areas on MR spectroscopy. Results of three MR spects were compared. 47Result: 5 women and 5 men comleted to the study, mean age of the patients were 33.10±9.17. No significant difference was determined between NAA/Cr and Cho/Cr values of MR spects, in each three phases as on lithium treatment, in unmedicated period and in olanzapine treatment. Conclusion: This is the first study evaluating neuroprotective effects of Li and Olanzapine on patients with bipolar affective disorder on during remission phase. No significant difference was demonstrated between NAA/Cr and Cho/Cr ratios in MR spect of patients in patients on remission while on Li treatment, drug-free period and on olanzapine treatment. Our study revealed medication of lithuril and olanzapine did not effect brain NAA and Cho levels in the remission phases of bipolar affective disorder. Our results of NAA levels, results did not support the results of studies performed in patients with attac phase of bipolar affective disorder. Our results of Cho levels are consistent with other previous studies. We concluded that lithium does not effect Cho levels. Key words: bipolar affective disorder, lithium, olanzapine, neuroprotective effect, NAA, Cho. 48