Striatal glutamate, subcortical structure and clinical response to first-line treatment in first-episode psychosis patients.
Striatal glutamate, subcortical structure and clinical response to first-line treatment in first-episode psychosis patients.
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DOI：
10.1016/j.pnpbp.2021.110473
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发表时间：
2022-03-08
影响因子：
5.6
通讯作者：
de la Fuente-Sandoval C
中科院分区：
文献类型：
--
作者：
Reyes-Madrigal F;Guma E;León-Ortiz P;Gómez-Cruz G;Mora-Durán R;Graff-Guerrero A;Kegeles LS;Chakravarty MM;de la Fuente-Sandoval C
最近的研究已经观察到，难治性精神分裂症患者以及在药物试验中没有反应的精神分裂症患者表现出谷氨酸系统的过度活性。在这项研究中，我们试图复制试验内谷氨酸异常，并调查结构差异和治疗引起的变化的可能性，以提高对药物反应和无反应的识别。我们在一项为期4周的利培酮试验中招募了48名medication-naïve患者，并根据临床标准将他们回顾性地分为反应者和无反应者。治疗前后分别获得质子磁共振波谱和t1加权结构MRI来量化纹状体谷氨酸水平和皮质下脑结构的一些测量。患者分为29例有反应者和19例无反应者。治疗前后无应答者纹状体谷氨酸水平均高于应答者（F1,39=7.15, p=0.01）。体积测量结果显示，组×时间相互作用（t=5.163, <1%FDR）和组×时间×谷氨酸相互作用（t=4.23, <15%FDR）在多个脑区可见。两组治疗后纹状体体积均呈趋势增加，无应答者纹状体体积与谷氨酸水平呈正相关。将解剖学测量与谷氨酸水平相结合，有可能加强对抗精神病药物的反应和无反应的分类，并为这些药物引起的神经解剖学和神经化学变化之间的相互作用提供机制理解。
Recent studies have observed that patients with treatment-resistant schizophrenia as well as patients with schizophrenia who do not respond within a medication trial exhibit excess activity of the glutamate system. In this study we sought to replicate the within-trial glutamate abnormality and to investigate the potential for structural differences and treatment-induced changes to improve identification of medication responders and non-responders. We enrolled 48 medication-naïve patients in a 4-week trial of risperidone and classified them retrospectively into responders and non-responders using clinical criteria. Proton magnetic resonance spectroscopy and T1-weighted structural MRI were acquired pre- and post-treatment to quantify striatal glutamate levels and several measures of subcortical brain structure. Patients were classified as 29 responders and 19 non-responders. Striatal glutamate was higher in the non-responders than responders both pre- and post-treatment (F1,39=7.15, p=0.01). Volumetric measures showed a significant group × time interaction (t=5.163, <1%FDR), and group × time × glutamate interaction (t=4.23, <15%FDR) were seen in several brain regions. Striatal volumes increased at trend level with treatment in both groups, and a positive association of striatal volumes with glutamate levels was seen in the non-responders. Combining anatomic measures with glutamate levels offers the potential to enhance classification of responders and non-responders to antipsychotic medications as well as to provide mechanistic understanding of the interplay between neuroanatomical and neurochemical changes induced by these medications.
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影响因子：
6.6
作者：
Blessing, Esther M.;Murty, Vishnu P.;Goff, Donald C.
通讯作者：
Goff, Donald C.
影响因子：
17.7
作者：
Gur, RE;Maany, V;Gur, RC
通讯作者：
Gur, RC
影响因子：
5.7
作者：
Chung, MK;Worsley, KJ;Evanst, AC
通讯作者：
Evanst, AC
影响因子：
5.7
作者：
Avants BB;Tustison NJ;Song G;Cook PA;Klein A;Gee JC
通讯作者：
Gee JC
DOI：
10.1073/pnas.97.14.8104
发表时间：
2000-07-05
影响因子：
11.1
作者：
Abi-Dargham, A;Rodenhiser, J;Laruelle, M
通讯作者：
Laruelle, M