Neurometabolite levels in antipsychotic-naïve/free patients with schizophrenia

A systematic review and meta-analysis of 1H-MRS studies

Yusuke Iwata, Shinichiro Nakajima, Eric Plitman, Yukiko Mihashi, Fernando Caravaggio, Jun Ku Chung, Julia Kim, Philip Gerretsen, Masaru Mimura, Gary Remington, Ariel Graff-Guerrero

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Background: Studies using proton magnetic resonance spectroscopy (1H-MRS) have reported altered neurometabolite levels in patients with schizophrenia. However, results are possibly confounded by the influence of antipsychotic (AP). Thus, this meta-analysis aimed to examine neurometabolite levels in AP-naïve/free patients with schizophrenia. Methods: A literature search was conducted using Embase, Medline, and PsycINFO to identify studies that compared neurometabolite levels in AP-naïve/free patients with schizophrenia to healthy controls (HCs). Eight neurometabolites (glutamate, glutamine, glutamate + glutamine, N-acetylaspartate [NAA], choline, creatine, myo-inositol, and γ-Aminobutyric acid [GABA]) and seven regions of interest (ROI; medial prefrontal cortex, dorsolateral prefrontal cortex, frontal white matter, occipital lobe, basal ganglia, hippocampus/medial temporal lobe, and thalamus) were examined. Results: Twenty-one studies (N = 1281) were included in the analysis. The results showed lower thalamic NAA levels (3 studies, n = 174, effect size = −0.56, P = 0.0005) in the patient group. No group differences were identified for other neurometabolites. Conclusions: Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia.

Original languageEnglish
Pages (from-to)340-352
Number of pages13
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume86
DOIs
Publication statusPublished - 2018 Aug 30

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Antipsychotic Agents
Meta-Analysis
Schizophrenia
Prefrontal Cortex
Glutamine
Thalamus
Glutamic Acid
Aminobutyrates
Occipital Lobe
Creatine
Inositol
Temporal Lobe
Choline
Basal Ganglia
gamma-Aminobutyric Acid
Hippocampus
Proton Magnetic Resonance Spectroscopy
N-acetylaspartate

Keywords

  • Antipsychotic-naïve
  • Proton magnetic resonance spectroscopy
  • Schizophrenia
  • Untreated

ASJC Scopus subject areas

  • Pharmacology
  • Biological Psychiatry

Cite this

Neurometabolite levels in antipsychotic-naïve/free patients with schizophrenia : A systematic review and meta-analysis of 1H-MRS studies. / Iwata, Yusuke; Nakajima, Shinichiro; Plitman, Eric; Mihashi, Yukiko; Caravaggio, Fernando; Chung, Jun Ku; Kim, Julia; Gerretsen, Philip; Mimura, Masaru; Remington, Gary; Graff-Guerrero, Ariel.

In: Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 86, 30.08.2018, p. 340-352.

Research output: Contribution to journalReview article

Iwata, Yusuke ; Nakajima, Shinichiro ; Plitman, Eric ; Mihashi, Yukiko ; Caravaggio, Fernando ; Chung, Jun Ku ; Kim, Julia ; Gerretsen, Philip ; Mimura, Masaru ; Remington, Gary ; Graff-Guerrero, Ariel. / Neurometabolite levels in antipsychotic-naïve/free patients with schizophrenia : A systematic review and meta-analysis of 1H-MRS studies. In: Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2018 ; Vol. 86. pp. 340-352.
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abstract = "Background: Studies using proton magnetic resonance spectroscopy (1H-MRS) have reported altered neurometabolite levels in patients with schizophrenia. However, results are possibly confounded by the influence of antipsychotic (AP). Thus, this meta-analysis aimed to examine neurometabolite levels in AP-na{\"i}ve/free patients with schizophrenia. Methods: A literature search was conducted using Embase, Medline, and PsycINFO to identify studies that compared neurometabolite levels in AP-na{\"i}ve/free patients with schizophrenia to healthy controls (HCs). Eight neurometabolites (glutamate, glutamine, glutamate + glutamine, N-acetylaspartate [NAA], choline, creatine, myo-inositol, and γ-Aminobutyric acid [GABA]) and seven regions of interest (ROI; medial prefrontal cortex, dorsolateral prefrontal cortex, frontal white matter, occipital lobe, basal ganglia, hippocampus/medial temporal lobe, and thalamus) were examined. Results: Twenty-one studies (N = 1281) were included in the analysis. The results showed lower thalamic NAA levels (3 studies, n = 174, effect size = −0.56, P = 0.0005) in the patient group. No group differences were identified for other neurometabolites. Conclusions: Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia.",
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T2 - A systematic review and meta-analysis of 1H-MRS studies

AU - Iwata, Yusuke

AU - Nakajima, Shinichiro

AU - Plitman, Eric

AU - Mihashi, Yukiko

AU - Caravaggio, Fernando

AU - Chung, Jun Ku

AU - Kim, Julia

AU - Gerretsen, Philip

AU - Mimura, Masaru

AU - Remington, Gary

AU - Graff-Guerrero, Ariel

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N2 - Background: Studies using proton magnetic resonance spectroscopy (1H-MRS) have reported altered neurometabolite levels in patients with schizophrenia. However, results are possibly confounded by the influence of antipsychotic (AP). Thus, this meta-analysis aimed to examine neurometabolite levels in AP-naïve/free patients with schizophrenia. Methods: A literature search was conducted using Embase, Medline, and PsycINFO to identify studies that compared neurometabolite levels in AP-naïve/free patients with schizophrenia to healthy controls (HCs). Eight neurometabolites (glutamate, glutamine, glutamate + glutamine, N-acetylaspartate [NAA], choline, creatine, myo-inositol, and γ-Aminobutyric acid [GABA]) and seven regions of interest (ROI; medial prefrontal cortex, dorsolateral prefrontal cortex, frontal white matter, occipital lobe, basal ganglia, hippocampus/medial temporal lobe, and thalamus) were examined. Results: Twenty-one studies (N = 1281) were included in the analysis. The results showed lower thalamic NAA levels (3 studies, n = 174, effect size = −0.56, P = 0.0005) in the patient group. No group differences were identified for other neurometabolites. Conclusions: Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia.

AB - Background: Studies using proton magnetic resonance spectroscopy (1H-MRS) have reported altered neurometabolite levels in patients with schizophrenia. However, results are possibly confounded by the influence of antipsychotic (AP). Thus, this meta-analysis aimed to examine neurometabolite levels in AP-naïve/free patients with schizophrenia. Methods: A literature search was conducted using Embase, Medline, and PsycINFO to identify studies that compared neurometabolite levels in AP-naïve/free patients with schizophrenia to healthy controls (HCs). Eight neurometabolites (glutamate, glutamine, glutamate + glutamine, N-acetylaspartate [NAA], choline, creatine, myo-inositol, and γ-Aminobutyric acid [GABA]) and seven regions of interest (ROI; medial prefrontal cortex, dorsolateral prefrontal cortex, frontal white matter, occipital lobe, basal ganglia, hippocampus/medial temporal lobe, and thalamus) were examined. Results: Twenty-one studies (N = 1281) were included in the analysis. The results showed lower thalamic NAA levels (3 studies, n = 174, effect size = −0.56, P = 0.0005) in the patient group. No group differences were identified for other neurometabolites. Conclusions: Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia.

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