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

Young In Kim; Sun Mi Kim; Ji Sun Hong; Jinuk Song; Doug Hyun Han; Kyung Joon Min; Young Sik Lee

doi:10.4306/jknpa.2016.55.1.25

Journal List > J Korean Neuropsychiatr Assoc > v.55(1) > 1017806

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Kim, Kim, Hong, Song, Han, Min, and Lee: The Correlation between Clinical Symptoms, Serum Uric Acid Level and EEG in Patient with Bipolar I Disorder

Original Article

Journal of Korean Neuropsychiatric Association 2016; 55(1): 25-32.

Published online: 29 February 2016

DOI: https://doi.org/10.4306/jknpa.2016.55.1.25

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

Young In Kim, MD, Sun Mi Kim, MD, PhD, Ji Sun Hong, MD, Jinuk Song, MD, Doug Hyun Han, MD, PhD, Kyung Joon Min, MD, PhD, Young Sik Lee, MD, PhD

Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea.

Address for correspondence: Sun Mi Kim, MD, PhD. Department of Psychiatry, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea. Tel +82-2-6299-1519, Fax +82-2-6298-1508, sunmikim706@gmail.com

Received 9 July 2015 Revised 6 October 2015 Accepted 15 October 2015

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 (ρ=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 (ρ=0.47, p<0.05) and gamma (ρ=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.

Keywords: Uric acid, Bipolar disorder, Mania, Quantitative electroencephalography

Figures and Tables

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.

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.

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.

Table 1

General demographic and clinical characteristics of the study population

^*: Mood episodes include manic, hypomanic, depressive episodes. YMRS : Young Mania Rating Scale, HAM-D : Hamilton Rating Scale for Depression, BDI : Beck Depression Inventory, BAI : Beck Anxiety Inventory

Table 2

The relative power of different frequency bands that showed statistically significant differences in between patients with current manic episode and healthy controls

F : Frontal lobe, P : Parietal lobe, O : Occipital lobe, T : Temporal lobe, Fp : Frontopolar area, C : Central, Cz : Central mid line, Pz : Parietal mid line

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

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