Anterior Cingulate Glutamate Levels Related to Clinical Status Following Treatment in First-Episode Schizophrenia
Anterior Cingulate Glutamate Levels Related to Clinical Status Following Treatment in First-Episode Schizophrenia
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DOI：
10.1038/npp.2012.113
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发表时间：
2012-10-01
影响因子：
7.6
通讯作者：
Stone, James M.
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文献类型：
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作者：
Egerton, Alice;Brugger, Stefan;Stone, James M.
许多精神分裂症患者对多巴胺能抗精神病药治疗的症状反应有限。这可能反映了额外的参与非多巴胺能神经化学功能障碍的病理生理障碍。我们检验了这样的假设：有症状的首发精神病患者与抗精神病治疗后症状最轻的患者之间的脑谷氨酸水平会有所不同。对15例首发精神病症状缓解期患者和17例首发精神病患者在至少一个疗程的抗精神病药物治疗后仍有症状的患者，在3特斯拉下采集前扣带皮层和左侧丘脑的质子磁共振波谱（1H-MRS）。使用LC模型估计代谢物水平与肌酸（Cr）的比值。前扣带皮层中谷氨酸/Cr水平在仍有症状的患者中显著高于缓解期患者（T（30）= 3.02; P = 0.005）。在整个样本中，前扣带皮层中谷氨酸/Cr水平较高与阴性症状的严重程度较高（r = 0.42; P = 0.017）和整体功能水平较低（r = -0.47; P = 0.007）相关。这些发现表明，精神分裂症抗精神病药物治疗后的临床状态与谷氨酸功能障碍有关。因此，对多巴胺能抗精神病药反应差的患者，使用作用于多巴胺能系统的化合物进行治疗可能是有益的。Neuropsychopharmacology（2012）37，2515-2521; doi：10.1038/npp.2012.113; 2012年7月4日在线发表
Many patients with schizophrenia show a limited symptomatic response to treatment with dopaminergic antipsychotics. This may reflect the additional involvement of non-dopaminergic neurochemical dysfunction in the pathophysiology of the disorder. We tested the hypothesis that brain glutamate levels would differ between patients with first-episode psychosis who were symptomatic compared with those with minimal symptoms following antipsychotic treatment. Proton magnetic resonance spectroscopy (1H-MRS) spectra were acquired at 3 Tesla in the anterior cingulate cortex and left thalamus in 15 patients with first-episode psychosis in symptomatic remission, and 17 patients with first-episode psychosis who were still symptomatic following at least one course of antipsychotic treatment. Metabolite levels were estimated in ratio to creatine (Cr) using LCModel. Levels of glutamate/Cr in the anterior cingulate cortex were significantly higher in patients who were still symptomatic than in those in remission (T(30) = 3.02; P = 0.005). Across the entire sample, higher levels of glutamate/Cr in the anterior cingulate cortex were associated with a greater severity of negative symptoms (r = 0.42; P = 0.017) and a lower level of global functioning (r = -0.47; P = 0.007). These findings suggest that clinical status following antipsychotic treatment in schizophrenia is linked to glutamate dysfunction. Treatment with compounds acting on the glutamatergic system might therefore be beneficial in patients who respond poorly to dopaminergic antipsychotics. Neuropsychopharmacology (2012) 37, 2515-2521; doi:10.1038/npp.2012.113; published online 4 July 2012