Table 3:

Cross-sectional MRS studies of youth at risk for bipolar disorder

Study	Sample	Methods (Device/FS/TR/TE/Sequence)	Region-of-Interest Voxel Size and Location	Findings
Cecil et al, 2003⁶⁹	9 Patients with euthymic mood disorder with at least 1 parent with BD, medicated (n = 1), unmedicated (n = 8), (mean age, 9.9 yr),	Signa^{^a}/1.5T/2000/35/PRESS	8 mL in the cerebellar vermis,	↑ mIns/tCre levels in patients with mood disorder in the medial frontal cortex (16%);
			8 mL in the medial frontal cortex,	↓ NAA/tCre in patients with mood disorder in the cerebellar vermis (8%);
	10 healthy volunteers, (mean age, 10.6 yr)		8 mL in frontal lobe white matter	no significant differences in NAA/tCre, tChol/tCre, or mIns/tCre in frontal lobe white matter
Gallelli et al, 2005⁸⁴	60 Offspring of parents with BD, 32 patients with BD, medicated (n = 28), unmedicated (n = 4), (mean age, 14.1 yr),	Signa/3T/2000/35/ PRESS	8 mL in the left and right dorsolateral prefrontal cortices	No significant group difference in NAA/tCre in the left (P = .99) or right (P = .75) dorsolateral prefrontal cortex;
Gallelli et al, 2005⁸⁴	28 patients with subsyndromal BD symptoms, medicated (n = 20), unmedicated (n = 8), (mean age, 12.2 yr), mood state not reported, though “most subjects were not experiencing a manic or depressive episode at the time of scan,” 26 unaffected controls, (mean age, 14.2 yr)	Signa/3T/2000/35/ PRESS	8 mL in the left and right dorsolateral prefrontal cortices	no significant group difference in mIns/tCre in the left (P = .15) or right (P = .19) dorsolateral prefrontal cortex; no significant group difference in tChol/tCre in the left (P = .31) or right (P = .46) dorsolateral prefrontal cortex
Singh et al, 2010⁸⁵	20 Patients with euthymic BD, medicated (n = 17), unmedicated (n = 3), (mean age, 15.9 yr),	Signa/3T/2000/35/ PRESS	8 mL in the anterior cingulate cortex	↓ Glu in BD compared with both healthy volunteers (P < .04) and subsyndromal BD (P < .04);
	20 euthymic patients with subsyndromal BD, medicated (n = 17), unmedicated (n = 3), (mean age, 12.9),			no significant group differences in NAA or mIns
	20 healthy volunteers, (mean age, 15.1 yr)			no significant group differences in NAA or mIns
Singh et al, 2011⁸⁶	22 Euthymic youth at risk for BD with a parent with BD, medicated (n = 17), unmedicated (n = 5), psychostimulants discontinued 24 hours prior to scan, (mean age, 13.3 yr),	Signa/3T/2000/35/PRESS	8 mL in the cerebellar vermis	↓ mIns in children at risk for BD (P < .01);
Singh et al, 2011⁸⁶	25 healthy volunteers, (mean age, 13.5 yr)	Signa/3T/2000/35/PRESS	8 mL in the cerebellar vermis	↓ tChol in children at risk for BD (P < .01)
Wozniak et al, 2012⁸⁷	24 Euthymic youth at risk for BD, with a parent with BD, medicated (n = 11), unmedicated (n = 13), (mean age, 11.8 yr),	Varian^{^b}/4T/2000/30/PRESS	8 mL in the anterior cingulate cortex	Positive correlation between emotional dysregulation score and Glu (Pearson correlation = 0.659; P < .02)
Wozniak et al, 2012⁸⁷	13 healthy volunteers (mean age, 11.5 yr)	Varian^{^b}/4T/2000/30/PRESS

Note:—TR and TE are expressed in milliseconds. FS indicates field strength; PRESS, point-resolved spectroscopic sequence; ↓, decreased; ↑, increased; tCre, total creatine.
↵a GE Healthcare, Milwaukee, Wisconsin.
↵b Varian, Palo Alto, California.