Short TE (7) Li-MRS confirms Bi-exponential lithium T2 relaxation in humans and clearly delineates two patient subtypes

J Magn Reson Imaging. 2013 Jun;37(6):1451-9. doi: 10.1002/jmri.23935. Epub 2012 Nov 12.

Abstract

Purpose: (i) To develop an MRS technique to measure (7) Li levels in human brain in a reasonable scan time, (ii) to develop a technique to quantify (7) Li T2 relaxation times as measured from human brain in patients taking lithium for the treatment of their bipolar disorder, and (iii) to confirm or refute the presence of bi-exponential (7) Li T2 relaxation in human brain.

Materials and methods: We modified a spin-echo MRS pulse sequence to decrease its minimum echo time. With IRB approval, we performed lithium MRS with the modified pulse sequence on 13 euthymic bipolar patients stable on long-term lithium to treat their disease.

Results: We were able to achieve a total scan time per sample of 8:20; total scan time including imaging, calibration and MRS was approximately 1 h 15 min. We observed bi-exponential T2 relaxation in the majority of patients, with an average short decay time of 5.3 ± 1.4 ms and an average long decay time of 68.2 ± 10.2 ms. However, in two patients we observed strongly mono-exponential T2 relaxation with an average decay time of 47.4 ± 1.3 ms.

Conclusion: (7) Li relaxation patterns may prove useful to distinguish between lithium-responsive and lithium nonresponsive bipolar patients.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antimanic Agents / pharmacokinetics
  • Antimanic Agents / therapeutic use
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / metabolism*
  • Brain / metabolism*
  • Female
  • Humans
  • Isotopes / pharmacokinetics
  • Lithium / pharmacokinetics*
  • Lithium Carbonate / pharmacokinetics*
  • Lithium Carbonate / therapeutic use*
  • Magnetic Resonance Spectroscopy / methods*
  • Male
  • Middle Aged
  • Tissue Distribution

Substances

  • Antimanic Agents
  • Isotopes
  • Lithium Carbonate
  • Lithium