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Alteration of mitochondrial function in the hippocampus of bipolar disorder patients
Recurrent episodes of depression and either mania or hypomania are the clinical features of bipolar disorder. Although studies have reported a high degree of heritability and linkage to chromosomal loci, the disease mechanisms are unknown. Recently abnormal mitochondrial energy metabolism in the frontal and temporal lobes of patients suffering from bipolar disorder has been demonstrated. The aim of a the present study was to determine the degree of expression of 12,558 nuclear genes in the hippocampus in subjects with bipolar disorder in comparison with healthy controls and schizophrenic patients.
Brains obtained postmortem from 10 healthy controls, 9 patients with bipolar disorder, and 8 subjects with schizophrenia, were dissected to isolate the hippocampus which was subsequently sliced. Tissue preparation and RNA extraction were performed and expression of mRNA expression was studied using gene arrays. Real-time quantitative polymerase chain reaction assay allowed data to be verified.
The expression of 43 nuclear genes was significantly decreased in bipolar disorder but not in schizophrenia, 18 of which (42%) coded for mitochondrial proteins. More precisely this reduction in gene expression concerned the regulation of oxidative phosphorylation and the adenosine triphosphate-dependent process of proteasome degradation. Other genes were involved in neurotransmission with decreased expression of glutamic acid decarboxylase, the enzyme synthesizing the inhibitory neurotransmitter,
g-aminobutyric acid (GABA). The mRNA coding for the neuropeptide, somatostatin, was also decreased.
These results provide novel evidence for abnormal mitochondrial energy metabolism in bipolar disorder patients, which can lead to increased lactate levels, glutamate excitotoxicity, and apoptosis. Reduced expression of genes coding for proteins of the proteasome system can also have other negative consequences such as, an impairment of synapse remodeling. These two-levels of deficit could represent potential targets for new compounds for the treatment of bipolar disorder.

Konradi C, Eaton M, MacDonald ML, Walsh J, Benes FM, Heckers S. Molecular evidence for mitochondrial dysfunction in bipolar disorder. Arch Gen Psychiatry 61: 300-308, 2004.

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