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The role of mitochondria in the pathophysiology of schizophrenia: A critical review of the evidence focusing on mitochondrial complex one. Neurosci Biobehav Rev 2021; 132:449-464. [PMID: 34864002 DOI: 10.1016/j.neubiorev.2021.11.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/30/2021] [Accepted: 11/30/2021] [Indexed: 12/30/2022]
Abstract
There has been increasing interest in the role of mitochondrial dysfunction in the pathophysiology of schizophrenia. Mitochondrial complex one (MCI) dysfunction may represent a mechanism linking bioenergetic impairment with the alterations in dopamine signalling, glutamatergic dysfunction, and oxidative stress found in the disorder. New lines of evidence from novel approaches make it timely to review evidence for mitochondrial involvement in schizophrenia, with a specific focus on MCI. The most consistent findings in schizophrenia relative to controls are reductions in expression of MCI subunits in post-mortem brain tissue (Cohen's d> 0.8); reductions in MCI function in post-mortem brains (d> 0.7); and reductions in neural glucose utilisation (d= 0.3 to 0.6). Antipsychotics may affect glucose utilisation, and, at least in vitro, affect MC1. The findings overall are consistent with MCI dysfunction in schizophrenia, but also highlight the need for in vivo studies to determine the link between MCI dysfunction and symptoms in patients. If new imaging tools confirm MCI dysfunction in the disease, this could pave the way for new treatments targeting this enzyme.
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Haszto CS, Stanley JA, Iyengar S, Prasad KM. Regionally Distinct Alterations in Membrane Phospholipid Metabolism in Schizophrenia: A Meta-analysis of Phosphorus Magnetic Resonance Spectroscopy Studies. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:264-280. [PMID: 31748123 DOI: 10.1016/j.bpsc.2019.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Existing data on altered membrane phospholipid metabolism in schizophrenia are diverse. We conducted a meta-analysis of studies of phosphorus magnetic resonance spectroscopy, a noninvasive imaging approach that can assess molecular biochemistry of cortex by measuring phosphomonoester (PME) and phosphodiester (PDE) levels, which can provide evidence of altered biochemical processes involved in neuropil membrane expansion and contraction in schizophrenia. METHODS We analyzed PME and PDE data in the frontal and temporal lobes in subjects with schizophrenia from 24 peer-reviewed publications using the MAVIS package in R by building random- and fixed-effects models. Heterogeneity of effect sizes, effects of publication bias, and file drawer analysis were also assessed. RESULTS Subjects with schizophrenia showed lower PME levels in the frontal regions (p = .008) and elevated PDE levels in the temporal regions (p < .001) with significant heterogeneity. We noted significant publication bias and file drawer effect for frontal PME and PDE and temporal PDE levels, but not for temporal PME levels. Fail-safe analysis estimated that a high number of negative studies were required to provide nonsignificant results. CONCLUSIONS Despite methodological differences, these phosphorus magnetic resonance spectroscopy studies demonstrate regionally specific imbalance in membrane phospholipid metabolism related to neuropil in subjects with schizophrenia compared with control subjects reflecting neuropil contraction. Specifically, decreased PME levels in the frontal regions and elevated PDE levels in the temporal regions provide evidence of decreased synthesis and increased degradation of neuropil membrane, respectively. Notwithstanding significant heterogeneity and publication bias, a large number of negative studies are required to render the results of this meta-analysis nonsignificant. These findings warrant further postmortem and animal studies.
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Affiliation(s)
- Connor S Haszto
- Kenneth Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University School of Medicine, Detroit, Michigan
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Konasale M Prasad
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Veterans Affairs Pittsburgh Health System, Pittsburgh, Pennsylvania.
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Du F, Yuksel C, Chouinard VA, Huynh P, Pingali S, Ryan K, Cohen BM, Öngür D. Abnormalities in High-Energy Phosphate Metabolism in First-Episode Bipolar Disorder Measured Using 31P-Magnetic Resonance Spectroscopy. Biol Psychiatry 2018; 84:797-802. [PMID: 28527566 PMCID: PMC5632123 DOI: 10.1016/j.biopsych.2017.03.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/28/2017] [Accepted: 03/30/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Brain energy metabolism is critical for supporting synaptic function and information processing. A growing body of evidence suggests abnormalities in brain bioenergetics in psychiatric disorders, including both bipolar disorder (BD) and schizophrenia. 31P magnetic resonance spectroscopy provides a noninvasive window into these processes in vivo. Using this approach, we previously showed that patients with BD show normal adenosine triphosphate (ATP) and phosphocreatine levels at rest but cannot maintain normal ATP levels in the visual cortex during times of high energy demand (photic stimulation). Because ATP is replenished from phosphocreatine via the creatine kinase reaction, we have now measured the creatine kinase forward reaction rate constant in BD. METHODS We studied 20 patients experiencing a first episode of BD and 28 healthy control participants at 4T and quantified creatine kinase forward reaction rate constant using 31P magnetization transfer magnetic resonance spectroscopy as described previously. RESULTS We found a significant reduction in creatine kinase forward reaction rate constant in the BD group (F = 4.692, p = .036), whereas brain ATP and phosphocreatine concentrations, as well as brain parenchymal pH, were normal. CONCLUSIONS These results pinpoint a specific molecular mechanism underlying our previous observation of an inability to replenish brain ATP during times of high energy demand in BD.
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Affiliation(s)
- Fei Du
- McLean Hospital, Belmont, MA,Harvard Medical School, Boston, MA
| | - Cagri Yuksel
- McLean Hospital, Belmont, MA,Harvard Medical School, Boston, MA
| | | | | | | | | | - Bruce M. Cohen
- McLean Hospital, Belmont, MA,Harvard Medical School, Boston, MA
| | - Dost Öngür
- McLean Hospital, Belmont, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Huang YC, Lin PY, Lee Y, Hung CF, Hsu ST, Wu CC, Wang LJ. Serum levels of β-hydroxybutyrate and pyruvate, metabolic changes and cognitive function in patients with schizophrenia during antipsychotic treatment: a preliminary study. Neuropsychiatr Dis Treat 2018; 14:799-808. [PMID: 29593413 PMCID: PMC5865581 DOI: 10.2147/ndt.s157055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND β-hydroxybutyrate (β-HB) and pyruvate have been associated with the brain energy utilization, which may play a role in the pathophysiology of schizophrenia. In this prospective study, we aim to investigate the trends of β-HB and pyruvate levels, metabolic changes, and cognitive function in schizophrenia patients receiving antipsychotic treatment. OBJECTIVE We recruited 38 schizophrenia patients who had been treated with antipsychotics for 12 weeks, as well as 38 healthy age- and gender-matched subjects. Blood samples were taken from the patients at baseline and week 12 to determine the serum levels of β-HB, pyruvate, and metabolic parameters, while blood samples of the healthy controls were taken at baseline. We evaluated the psychopathology using the Positive and Negative Syndrome Scale and cognitive function using the Brief Assessment of Cognition in Schizophrenia. RESULTS During the 12-week follow-up period, the β-HB levels in patients with schizophrenia showed a decreasing trend, particularly in those undergoing treatment with aripiprazole or ziprasidone. The serum levels of β-HB in patients at baseline and week 12 were both higher than the levels in the healthy controls. Among the schizophrenia patients, changes in β-HB were positively correlated with changes in executive function. On the other hand, serum pyruvate levels remained steady during the 12-week follow-up period, and we found no significant correlation between pyruvate changes and changes in cognitive function or clinical symptoms. CONCLUSION Our findings indicate that β-HB may possess a potential indicator of energy utilization and have a protective role in executive function in patients with schizophrenia. Additional longitudinal studies with a larger sample size and longer follow-up periods are necessary to identify the relationship of metabolite regulation and cognitive function during schizophrenia patients' exposure to antipsychotics.
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Affiliation(s)
- Yu-Chi Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan.,Chung Shan Medical University School of Medicine, Taichung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chi-Fa Hung
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Su-Ting Hsu
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chih-Ching Wu
- Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Tao-Yuan, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Yuksel C, Tegin C, O'Connor L, Du F, Ahat E, Cohen BM, Ongur D. Phosphorus magnetic resonance spectroscopy studies in schizophrenia. J Psychiatr Res 2015; 68:157-66. [PMID: 26228415 DOI: 10.1016/j.jpsychires.2015.06.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 06/15/2015] [Accepted: 06/18/2015] [Indexed: 12/26/2022]
Abstract
Phosphorus magnetic resonance spectroscopy ((31)P MRS) allows in vivo quantification of phosphorus metabolites that are considered to be related to membrane turnover and energy metabolism. In schizophrenia (SZ), (31)P MRS studies found several abnormalities in different brain regions suggesting that alterations in these pathways may be contributing to the pathophysiology. In this paper, we systematically reviewed the (31)P MRS studies in SZ published to date by taking patient characteristics, medication status and brain regions into account. Publications written in English were searched on http://www.ncbi.nlm.nih.gov/pubmed/, by using the keywords 'phosphomonoester', 'phosphodiester', 'ATP', 'phosphocreatine', 'phosphocholine', 'phosphoethanolamine','glycerophosphocholine', 'glycerophosphoethanolamine', 'pH', 'schizophrenia', and 'MRS'. Studies that measured (31)P metabolites in SZ patients were included. This search identified 52 studies. Reduced PME and elevated PDE reported in earlier studies were not replicated in several subsequent studies. One relatively consistent pattern was a decrease in PDE in chronic patients in the subcortical structures. There were no consistent patterns for the comparison of energy related phosphorus metabolites between patients and controls. Also, no consistent pattern emerged in studies seeking relationship between (31)P metabolites and antipsychotic use and other clinical variables. Despite emerging patterns, methodological heterogeneities and shortcomings in this literature likely obscure consistent patterns among studies. We conclude with recommendations to improve study designs and (31)P MRS methods in future studies. We also stress the significance of probing into the dynamic changes in energy metabolism, as this approach reveals abnormalities that are not visible to steady-state measurements.
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Affiliation(s)
- Cagri Yuksel
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Cuneyt Tegin
- University of Louisville, Department of Psychiatry, 323 E. Chestnut Street, Louisville, KY, USA.
| | | | - Fei Du
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Ezgi Ahat
- Istanbul University, Cerrahpasa School of Medicine. Kocamustafapaşa Cad. No:53, Istanbul, Turkey.
| | - Bruce M Cohen
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Dost Ongur
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
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Burns MJ, Rayner PJ, Green GGR, Highton LAR, Mewis RE, Duckett SB. Improving the hyperpolarization of (31)P nuclei by synthetic design. J Phys Chem B 2015; 119:5020-7. [PMID: 25811635 PMCID: PMC4428009 DOI: 10.1021/acs.jpcb.5b00686] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
![]()
Traditional 31P NMR or
MRI measurements suffer from
low sensitivity relative to 1H detection and consequently
require longer scan times. We show here that hyperpolarization of 31P nuclei through reversible interactions with parahydrogen can deliver substantial signal enhancements in a range of
regioisomeric phosphonate esters containing a heteroaromatic motif
which were synthesized in order to identify the optimum molecular
scaffold for polarization transfer. A 3588-fold 31P signal
enhancement (2.34% polarization) was returned for a partially deuterated
pyridyl substituted phosphonate ester. This hyperpolarization level
is sufficient to allow single scan 31P MR images of a phantom
to be recorded at a 9.4 T observation field in seconds that have signal-to-noise
ratios of up to 94.4 when the analyte concentration is 10 mM. In contrast,
a 12 h 2048 scan measurement under standard conditions yields a signal-to-noise
ratio of just 11.4. 31P-hyperpolarized images are also
reported from a 7 T preclinical scanner.
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Affiliation(s)
- Michael J Burns
- Centre for Hyperpolarization in Magnetic Resonance, Department of Chemistry, University of York, York YO10 5NY, United Kingdom
| | - Peter J Rayner
- Centre for Hyperpolarization in Magnetic Resonance, Department of Chemistry, University of York, York YO10 5NY, United Kingdom
| | - Gary G R Green
- Centre for Hyperpolarization in Magnetic Resonance, Department of Chemistry, University of York, York YO10 5NY, United Kingdom
| | - Louise A R Highton
- Centre for Hyperpolarization in Magnetic Resonance, Department of Chemistry, University of York, York YO10 5NY, United Kingdom
| | - Ryan E Mewis
- Centre for Hyperpolarization in Magnetic Resonance, Department of Chemistry, University of York, York YO10 5NY, United Kingdom
| | - Simon B Duckett
- Centre for Hyperpolarization in Magnetic Resonance, Department of Chemistry, University of York, York YO10 5NY, United Kingdom
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Nenadic I, Dietzek M, Langbein K, Rzanny R, Gussew A, Reichenbach JR, Sauer H, Smesny S. Superior temporal metabolic changes related to auditory hallucinations: a (31)P-MR spectroscopy study in antipsychotic-free schizophrenia patients. Brain Struct Funct 2013; 219:1869-72. [PMID: 23821342 DOI: 10.1007/s00429-013-0604-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/22/2013] [Indexed: 01/11/2023]
Abstract
Structural deficits in the superior temporal cortex and transverse temporal gyri appear to be related to auditory hallucinations in schizophrenia, which are a key symptom of this disorder. However, the cellular and neurochemical underpinnings are poorly understood and hardly studied in vivo. We used (31)P-MRS (magnetic resonance spectroscopy) with chemical shift imaging to assess the association between left superior temporal cortex metabolism and severity of auditory hallucinations in 29 schizophrenia patients off antipsychotics. Hallucinations scores derived from the Scale for the Assessment of Positive Symptoms showed significant positive correlations with both measures of phospholipids (phosphomonoesters and phosphodiesters), and energy (inorganic phosphate and phosphocreatine, but not adenosine tri-phosphate) metabolism in left superior temporal gyrus/Heschl gyrus voxels. There was no correlation of metabolites in these regions with formal thought disorder, a symptom also linked to superior temporal pathology, thus suggesting symptom specificity. Our findings provide a link between established structural deficits and neurochemical pathology related to membrane pathology and markers of general metabolic turnover.
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Affiliation(s)
- Igor Nenadic
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany,
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