J Korean Neuropsychiatr Assoc.  2016 Feb;55(1):25-32. 10.4306/jknpa.2016.55.1.25.

The Correlation between Clinical Symptoms, Serum Uric Acid Level and EEG in Patient with Bipolar I Disorder

• Kim YI
• Kim SM
• Hong JS
• Song J
• Han DH
• Min KJ
• Lee YS

• KMID: 2192905
• DOI: http://doi.org/10.4306/jknpa.2016.55.1.25

Abstract

OBJECTIVES
High uric acid level is related to increased locomotor activities and refractory mood swings. The purpose of this study is to examine the correlation between clinical symptoms of mania, serum uric acid level, and quantitative electroencephalography (QEEG) findings.
METHODS
Twenty-four patients with bipolar disorder and 24 healthy control subjects agreed to participate in the study. When they were hospitalized, the degree of clinical symptoms, uric acid level in blood, and brain QEEG were measured.
RESULTS
The bipolar disorder group showed higher scores on the Young Mania Rating Scale (YMRS ; z=6.02, p<0.05). Patients in their manic episodes showed higher plasma uric acid levels (4.9+/-1.3 mg/dL) than healthy control subjects (4.2+/-0.9 mg/dL ; z=2.14, p<0.05). Uric acid levels showed correlation with severity of manic symptoms as assessed using the YMRS in all participants (rho=0.28, p<0.05). The bipolar disorder group showed decreased relative delta and alpha activity in the fronto-temporo-occipital region compared to the control group (p<0.05). Relative beta in Fp1 (frontopolar), Cz (central mid-line), and Pz (parietal mid-line) and relative gamma in Fp1 were increased in the bipolar disorder group, relative to the control group (p<0.05). The relative beta (rho=0.47, p<0.05) and gamma (rho=0.41, p<0.05) in Fp1 electrodes showed positive correlation with the YMRS scores.
CONCLUSION
Adenosinergic transmission dysfunction may lead to occurrence of manic symptoms, considering that a key role of central nervous system adenosinergic receptors is to inhibit the release of various neurotransmitters and limit neuronal excitability. In addition, QEEG appeared to indicate excitatory neuro-modulation in manic patients.

Keyword

Uric acid; Bipolar disorder; Mania; Quantitative electroencephalography

MeSH Terms

Bipolar Disorder
Brain
Central Nervous System
Electrodes
Electroencephalography*
Humans
Motor Activity
Neurons
Neurotransmitter Agents
Plasma
Uric Acid*
Neurotransmitter Agents
Uric Acid

Figure

• 

  Fig. 1 The placement of electroencephalography electrodes : the international 10-20 system. Standardized location and nomenclature of the electrodes (adapted from wikimedia, https://commons.wikimedia.org/wiki/File:21_electrodes_of_International_10-20_system_ for_EEG.svg).

• 

  Fig. 2 The distribution of plasma uric acid levels in the patients with bipolar disorder and healthy controls.

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  Fig. 3 The relationship between uric acid levels and YMRS scores tested with Spearman's correlations (A) in total participants and (B) in patients with bipolar disorder. A : r=0.275, p=0.06. B : r=0.104, p=0.63. YMRS : Young Mania Rating Scale.

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  Fig. 4 The relationship between (A) relative power of beta band and (B) relative power of gamma band in left frontal region (Fp1) and YMRS scores tested with Spearman's correlations in patients with bipolar disorder. A : r=0.467, p<0.05. B : r=0.412, p<0.05. YMRS : Young Mania Rating Scale.

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