Regionally specific neuronal pathology in untreated patients with schizophrenia: A proton magnetic resonance spectroscopic imaging study
Regionally specific neuronal pathology in untreated patients with schizophrenia: A proton magnetic resonance spectroscopic imaging study
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DOI：
10.1016/s0006-3223(97)00555-6
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发表时间：
1998-05-01
影响因子：
10.6
通讯作者：
Weinberger, DR
中科院分区：
文献类型：
--
作者：
Bertolino, A;Callicott, JH;Weinberger, DR
背景：质子磁共振波谱成像（H-1-MRSI）研究报道了在药物治疗的精神分裂症患者的海马区（HIPPO）和背外侧前额叶皮层（DLPFC）中神经元完整性标记物n -乙酰天冬氨酸（NAA）的减少。本研究的目的有两个：排除药物治疗作为先前发现的来源，并检查长期未经治疗的患者的独特样本中的NAA相对浓度。方法：选取12例无药物治疗的患者，其中5例为“初用药”且症状平均为12年，对照组12例。测定了多个皮质区和皮质下区质子谱代谢物峰下面积的比值[即NAA/肌酸（CRE）， NAA/胆碱（CHO）， CHO/CRE]。海马体形成和额叶体积也被测量，以测试与H-1-MRSI数据的相关性。结果：HIPPO和DLPFC双侧NAA/CRE和NAA/CHO均显著降低。在任何其他采样地区，CHO/CRE或NAA比率没有显著变化。代谢物比率、病程长短与海马区和额叶体积之间没有明显的相关性。与亚急性患者和先前研究的接受药物治疗的慢性患者相比，慢性疾病但仍未接受药物治疗的患者的平均比率和效应大小没有差异。结论：HIPPO和DLPFC双侧NAA比值降低是可靠的发现。这些发现暗示了一种相对局部的神经化学病理模式，无论药物治疗还是未药物治疗，这种模式似乎都不会随着长期疾病而改变。1998年出版于生物精神病学学会。
Background: Proton magnetic resonance spectroscopic imaging (H-1-MRSI) studies have reported reductions of N-acetyl aspartate (NAA), a marker of neuronal integrity, in the hippocampal region (HIPPO) and dorsolateral prefrontal cortex (DLPFC) of pharmacologically treated patients with schizophrenia. The purpose of the present study was twofold: to exclude drug treatment as a source of the previous findings and to examine NAA relative concentrations in a unique sample of chronically untreated patients.Methods: We studied 12 medication-free patients, 5 of whom were "drug naive" and symptomatic for a mean of 12 years, and 12 control subjects. Ratios of areas under the metabolite peaks of the proton spectra were determined [i.e., NAA/creatine (CRE), NAA/choline (CHO), CHO/CRE] for multiple cortical and subcortical regions. Hippocampal formation and frontal lobe volumes were also measured to test for correlations with H-1-MRSI data.Results: Significant reductions of NAA/CRE and NAA/CHO were found bilaterally in HIPPO and DLPFC. There were no significant changes in CHO/CRE or in NAA ratios in any other area sampled. No significant correlation was found between metabolite ratios, length of illness, and volumes of the hippocampal region and frontal lobe. Mean ratios and effect sizes were not different in chronically ill but still medication-naive patients in comparison with subacute patients and previously studied chronic patients receiving medications.Conclusions: Bilateral reductions of NAA ratios in HIPPO and DLPFC are reliable findings. The findings implicate a relatively localized pattern of neurochemical pathology that does not appear to change with prolonged illness whether medicated or unmedicated. Published 1998 Society of Biological Psychiatry.