Prefrontal NAA and Glx Levels in Different Stages of Psychotic Disorders: a 3T 1H-MRS Study

Sci Rep. 2016 Feb 23:6:21873. doi: 10.1038/srep21873.

Abstract

H-Magnetic Resonance Spectroscopy ((1)H-MRS) can offer insights in various neuropathologies by measuring metabolite levels in the brain. In the current study we investigated the levels of glutamate + glutamine (Glx, neurotransmitter and precursor) and N-Acetyl Aspartate + glutamic acid (NAA + NAAG; neuronal viability) in the prefrontal cortex of patients with a psychotic disorder and people at Ultra High Risk (UHR) for psychosis. A (1)H-MRS spectrum was acquired in 31 patients with a recent onset psychotic disorder and 60 with a chronic state, 16 UHR patients and 36 healthy controls. Absolute metabolite levels were calculated using LCModel with a reference water peak. Groups were compared while taking into account age and partial volume effects. Moreover, we investigated associations with positive and negative symptoms, duration of illness, and antipsychotic treatment in patients. The most notable finding is that chronicity of schizophrenia was related to decreased levels of Glx and NAA. On the other hand, although on an exploratory note, UHR showed increased levels of prefrontal Glx and NAA levels with increasing age. Our results may indicate an initial Glx and NAA increase and subsequent decrease during illness progression that may be related to the neurotoxic effects of glutamate.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antipsychotic Agents / therapeutic use
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / metabolism
  • Case-Control Studies
  • Disease Progression
  • Female
  • Glutamic Acid / metabolism*
  • Glutamine / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Neurotransmitter Agents / metabolism*
  • Prefrontal Cortex / metabolism
  • Prefrontal Cortex / physiopathology
  • Proton Magnetic Resonance Spectroscopy
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / metabolism*
  • Psychotic Disorders / physiopathology
  • Regression Analysis
  • Risk
  • Severity of Illness Index
  • Time Factors

Substances

  • Antipsychotic Agents
  • Neurotransmitter Agents
  • Glutamine
  • Aspartic Acid
  • Glutamic Acid
  • N-acetylaspartate