CSF metabolite linked to affective disorder burden
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Researchers have found a positive relationship between cerebrospinal
(CSF) concentrations of a
monoamine metabolite and the accumulated burden of mood swings in
treatment-refractory affective disorders.
The finding supports theories that affective disorders may result in
allostasis as opposed to
homeostasis, in which the stress the body endures leads to catecholamine
systems adapting to new
levels, say Anna Ehnvall (Varberg, Hospital, Sweden) and colleagues.
Reviewing a computerized program charting every previous affective
episode for 37 patients with
severe treatment-refractory affective disorders, the team calculated the
"accumulated burden of
mood swings" (ABMS). This included the length and severity of each episode.
In addition, CSF concentrations of homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol
(MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were measured and
compared with those for
27 healthy controls.
Analyses showed that, of all the monoamine metabolites, CSF MHPG was the strongest
contributor to the overall variance of ABMS.
Altogether, the eight predictive variables - CSF concentrations of HVA,
MHPG, 5-HIAA, gender,
the bipolar/unipolar distinction, age, body height, and Hamilton
Depression Rating Scale scores -
xplained 56% of the total variation in ABMS, with MHPG in isolation
explaining 23% of the
"Our findings indicate that CSF concentrations of MHPG in severe
illness is positively related to the ABMS measure over a lifetime,
irrespective of age, gender, uni- or
bipolarity, and current severity of the illness," the team writes in the
Journal of Affective
Thus, the involvement of norepinephrine turnover in the long-term burden
of affective illness is a