3D 7Li magnetic resonance imaging of brain lithium distribution in bipolar disorder

Smith, Fiona E, Thelwall, Peter Edward, Necus, Joe, Flowers, Carly Jay, Blamire, Andrew Matthew and Cousins, David Andrew (2018) 3D 7Li magnetic resonance imaging of brain lithium distribution in bipolar disorder. Molecular Psychiatry, 23 (11). pp. 2184-2191. ISSN 1359-4184

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Abstract

Lithium is a major treatment for bipolar disorder and the likelihood of a favourable response may be determined by its distribution in the brain. Lithium can be directly detected by magnetic resonance (MR), but previous 7Li MR spectroscopy studies have demonstrated that this is challenging compared to conventional 1H MR imaging due to the MR properties of the lithium nucleus and its low concentration in brain tissue, as dictated by therapeutic dose. We have tested and implemented a highly efficient balanced steady-state free precession 7Li-MRI method to address these challenges and enable MRI of brain lithium in a short duration scan. We report a 3D 7Li-MRI acquisition with 25 mm isotropic resolution in an 8-min scan that demonstrates heterogeneity in lithium concentration within the brain in subjects with bipolar disorder. This represents the direct imaging of a pharmaceutical agent in its target organ and notably expands the repertoire of techniques available to investigate the effects of lithium in man.