This study used 31P and 1H MRS to study brain metabolic differences in bipolar disorder. Data from 64 participants with BD and 42 controls was acquired from the right putamen and cerebellar vermis were acquired at 7T. The study observed reduced pHi in support of prior work that has proposed mitochondrial dysfunction in BD where there is an impaired ability to utilize pyruvate in oxidative phosphorylation. A shift from oxidative phosphorylation toward glycolytic energy production likely increases lactate acid, CO2 levels, and free protons resulting in tissue acidosis. This shift in energy production may also lead to increased glutathione.
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