Cerebral glucose metabolism in bipolar disorder: A voxel‐based meta‐analysis of positron emission tomography studies

Abstract

Background Previous positron emission tomography studies have reported the changes of cerebral glucose metabolism in bipolar disorder. However, the findings across studies remain controversial, containing differing results. Methods A systematic literature search of the PubMed, Embase, Cochrane Library, and Web of Science databases was conducted. We conducted a voxel‐wide meta‐analysis of cerebral glucose metabolism studies, using the seed‐based mapping approach, in patients with bipolar disorder (BD). Results We identified 7 studies suitable for inclusion, which included a total of 126 individuals with BD and 160 healthy controls. The most consistent and robust findings were an increase in cerebral glucose metabolism in the right precentral gyrus and a decrease in the left superior temporal gyrus, left middle temporal gyrus, and cerebellum. Additionally, the sex distribution and illness duration had significant moderating effects on cerebral glucose metabolism alterations. Conclusions Cerebral glucose metabolism alterations in these brain regions are likely to reflect the disease‐related functional abnormalities such as emotion and cognition. These findings contribute to a better understanding of the neurobiological underpinnings of bipolar disorder. Limitations. This study was done at a study level and cannot be addressed at the patient level. Subgroup analysis of BD I and BD II is not possible due to limited literature data.

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“…This is particularly relevant, given the evidence in favour of an imbalanced cAMP and calcium signalling and glycogen synthesis, with a potential impact on lactate metabolism and the overall cortical activity [99][100][101] . Clinical imaging studies have shown that glucose metabolism is altered in BD 102,103 and our study, in accordance with literature, underlines the contribution of microglia and astrocytes in this process 104,105 . It is important to note that 5 of the patients in our cohort where diabetic, although they were equally distributed between the samples (n = 2 in BD, n= 3 in CT) so the downregulation of insulin pathway genes is therefore probably not the result of this comorbidity.…”

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“…Generation of ATP in mitochondria depends largely on oxidative phosphorylation driven by glucose metabolism. Evidence from magnetic resonance spectroscopy [MRS], positron emission tomography [PET] and blood metabolomics indicate that glucose metabolism is impaired or dysregulated in bipolar disorder [ 14 ].…”

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“…It contained many large pyramidal cells and was the center for movement control. 14 In patients with bipolar disorder, glucose metabolism in the right precentral gyrus increases and might affect the disease and dysfunction, perhaps with links to emotional and cognitive impairment 15 . One recent study showed that the cortex in the right precentral gyrus in some progressive neurodegenerative disorders was becoming thinner such as amyotrophic lateral sclerosis 16 .…”