Improving the diagnostic accuracy of bipolar disorder through metabolomic profiling

Studies have suggested the involvement of serotonergic and N-methyl-D-aspartate (NMDA) glutamate receptor complex dysfunction may involve in the pathophysiology of several neuropsychiatric disorders. However, the exact association with bipolar disorder remains unclear. Hence, the purpose of this stu...

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Bibliographic Details
Main Author: Nasru, Wan Norashikin Wan
Format: Thesis
Language:English
Published: 2020
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Online Access:http://eprints.usm.my/56971/1/WAN%20NORASHIKIN%20BINTI%20WAN%20NASRU%20-%20e%2024.pdf
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Summary:Studies have suggested the involvement of serotonergic and N-methyl-D-aspartate (NMDA) glutamate receptor complex dysfunction may involve in the pathophysiology of several neuropsychiatric disorders. However, the exact association with bipolar disorder remains unclear. Hence, the purpose of this study was to measure the plasma concentrations of glutamate, glycine and tryptophan in bipolar disorder patients and compared with the healthy controls. A case-control study was conducted from October 2017 till June 2018 in Hospital Universiti Sains Malaysia (HUSM). We had measured the plasma levels of glutamate, glycine and tryptophan in 83 bipolar patients and data were compared to a group of 82 healthy controls using high performance liquid chromatography (HPLC) method. The mean (SD) age of bipolar patients were 40.87 (12.08) while the mean (SD) age for control groups was 35.60 (7.68) years. The participants from the bipolar group and control group differ significantly in age (p=0.001), however, there was no significant difference between patients and controls with respect to gender. The median (IQR) of glutamate and tryptophan level in bipolar patients was 61.5 (122) and 33.5 (24) respectively, while the mean (SD) of glycine level in bipolar patients was 273.6 (66.4). A significant higher glutamate and glycine levels were found in bipolar disorder patients more markedly in bipolar I in manic episode as compared to the healthy controls. However, there was no significant difference in the level of plasma tryptophan between bipolar patients and control group. The findings provide additional evidence regarding the involvement of serotonergic and N-methyl-D-aspartate (NMDA) glutamate receptor complex in the pathogenesis of bipolar disorder and the possibility of these amino acids to serve as the peripheral biomarkers to support the diagnosis of bipolar disorder.