{"doi":"10.1017/s0033291706008968","title":"Hippocampal <sup>1</sup>H MRS in patients with bipolar disorder taking valproate <i>versus</i> valproate plus quetiapine","abstract":"<jats:p><jats:bold>Background.</jats:bold> No study to date has examined the effects of mood stabilizer alone and the combination of mood stabilizer and atypical antipsychotic, quetiapine, on hippocampal neurochemical markers of bipolar disordered patients concurrently. We therefore undertook a proton magnetic resonance spectroscopy (<jats:sup>1</jats:sup>H MRS) study of drug-free patients with bipolar disorder (drug-free group), patients undergoing valproate treatment (valproate group), patients administered valproate+quetiapine (valprote+quetiapine group) and healthy controls, focusing on the <jats:italic>in vivo</jats:italic> neuroanatomy of the hippocampus.</jats:p><jats:p><jats:bold>Method.</jats:bold> Thirty patients from the Firat University School of Medicine Department of Psychiatry and 10 healthy controls gave written informed consent to participate in the study. The patients and controls underwent proton magnetic resonance spectroscopic imaging (<jats:sup>1</jats:sup>H MRSI), and measures of <jats:italic>N</jats:italic>-acetylaspartate (NAA), choline-containing compounds (CHO), and creatine+phosphocreatine (CRE) in hippocampal regions were obtained.</jats:p><jats:p><jats:bold>Results.</jats:bold> The drug-free patients had significantly lower NAA/CRE and NAA/CHO ratios compared with the valproate and valproate+quetiapine groups and the healthy controls. The lower NAA/CRE and NAA/CHO ratios remained statistically significant even after covarying for age or whole brain volume compared with the valproate and valproate+quetiapine groups and healthy controls. In <jats:italic>post hoc</jats:italic> comparisons, a significant difference was found between the valproate+quetiapine group and the valproate group only with regard to NAA/CHO.</jats:p><jats:p><jats:bold>Conclusion.</jats:bold> Our findings suggest that valproate has a neuroprotective effect. In <jats:italic>post hoc</jats:italic> comparisons, a significant difference was found between the valproate+quetiapine and the valproate group with regard to NAA/CHO, indicating that the addition of quetiapine further increases the level of NAA and provides an additional neuroprotective effect.</jats:p>","journal":"Psychological Medicine","year":2007,"id":595726,"datarank":0.5926865577872142,"base_score":3.9512437185814275,"endowment":3.9512437185814275,"self_citation_contribution":0.5926865577872142,"citation_network_contribution":0.0,"self_endowment_contribution":0.5926865577872142,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":51,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1525605,"name":"HANEFI YILDIRIM","orcid":null,"position":1,"is_corresponding":false},{"id":1525606,"name":"HUSEYIN OZDEMIR","orcid":null,"position":2,"is_corresponding":false},{"id":1525608,"name":"ERKIN OGUR","orcid":null,"position":3,"is_corresponding":false},{"id":1525609,"name":"ERTAN TEZCAN","orcid":null,"position":4,"is_corresponding":false},{"id":1525604,"name":"MURAD ATMACA","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Hippocampal <sup>1</sup>H MRS in patients with bipolar disorder taking valproate <i>versus</i> valproate plus quetiapine","abstract":"<jats:p><jats:bold>Background.</jats:bold> No study to date has examined the effects of mood stabilizer alone and the combination of mood stabilizer and atypical antipsychotic, quetiapine, on hippocampal neurochemical markers of bipolar disordered patients concurrently. We therefore undertook a proton magnetic resonance spectroscopy (<jats:sup>1</jats:sup>H MRS) study of drug-free patients with bipolar disorder (drug-free group), patients undergoing valproate treatment (valproate group), patients administered valproate+quetiapine (valprote+quetiapine group) and healthy controls, focusing on the <jats:italic>in vivo</jats:italic> neuroanatomy of the hippocampus.</jats:p><jats:p><jats:bold>Method.</jats:bold> Thirty patients from the Firat University School of Medicine Department of Psychiatry and 10 healthy controls gave written informed consent to participate in the study. The patients and controls underwent proton magnetic resonance spectroscopic imaging (<jats:sup>1</jats:sup>H MRSI), and measures of <jats:italic>N</jats:italic>-acetylaspartate (NAA), choline-containing compounds (CHO), and creatine+phosphocreatine (CRE) in hippocampal regions were obtained.</jats:p><jats:p><jats:bold>Results.</jats:bold> The drug-free patients had significantly lower NAA/CRE and NAA/CHO ratios compared with the valproate and valproate+quetiapine groups and the healthy controls. The lower NAA/CRE and NAA/CHO ratios remained statistically significant even after covarying for age or whole brain volume compared with the valproate and valproate+quetiapine groups and healthy controls. In <jats:italic>post hoc</jats:italic> comparisons, a significant difference was found between the valproate+quetiapine group and the valproate group only with regard to NAA/CHO.</jats:p><jats:p><jats:bold>Conclusion.</jats:bold> Our findings suggest that valproate has a neuroprotective effect. In <jats:italic>post hoc</jats:italic> comparisons, a significant difference was found between the valproate+quetiapine and the valproate group with regard to NAA/CHO, indicating that the addition of quetiapine further increases the level of NAA and provides an additional neuroprotective effect.</jats:p>","is_dataset_classified":null,"base_score":3.9512437185814275,"endowment":3.9512437185814275,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"17094813","pmcid":null,"openalex_id":"https://openalex.org/W1967606399","authors":[],"funders":[],"total_grants":0,"fwci":3.4882,"citation_percentile":0.92145888,"influential_citations":0,"citation_trend":[{"year":2012,"count":7},{"year":2013,"count":1},{"year":2014,"count":1},{"year":2015,"count":3},{"year":2017,"count":1},{"year":2021,"count":3},{"year":2022,"count":2},{"year":2023,"count":1},{"year":2024,"count":1}],"oa_status":"closed","license":"https://www.cambridge.org/core/terms","oa_locations":[{"url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0033291706008968","host_type":"publisher"},{"url":"https://doi.org/10.1017/s0033291706008968","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/17094813","host_type":"repository"}],"fields_of_study":["Bipolar Disorder and Treatment","Pharmacological Effects and Toxicity Studies","Schizophrenia research and treatment"],"mesh_terms":["Quetiapine Fumarate","Adult","Analysis of Variance","Bipolar Disorder","Dibenzothiazepines","Drug Therapy, Combination","Female","Hippocampus","Humans","Male","Magnetic Resonance Spectroscopy","Antipsychotic Agents","Valproic Acid","Antimanic Agents"],"keywords":["Quetiapine","Lamotrigine","Quetiapine Fumarate","Mood stabilizer","Atypical antipsychotic","Bipolar disorder","Medicine","Phosphocreatine","Aripiprazole","Creatine","Internal medicine","Hippocampus","Treatment of bipolar disorder","Psychology","Pharmacology","Psychiatry","Epilepsy","Antipsychotic","Mania","Lithium (medication)","Schizophrenia (object-oriented programming)"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-27T17:49:34.195091Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}