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Unal GA, Kenar ANI. Association of Age and Response to Methylphenidate HCL Treatment in Adult ADHD: A Proton Magnetic Resonance Spectroscopy Study. Neuropsychiatr Dis Treat 2024; 20:317-324. [PMID: 38405424 PMCID: PMC10893786 DOI: 10.2147/ndt.s442655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose This study investigated the age-dependent effects of methylphenidate (MPH) on brain metabolites including choline (Cho), N-acetyl aspartate (NAA) and creatine (Cr) levels in the dorsolateral prefrontal cortex (DLPFC), striatum, cerebellum, and anterior cingulate cortex (ACC) regions of the brain in adult patients with attention deficit hyperactivity disorder (ADHD). Patients and Methods The study was included 60 patients with ADHD between the ages of 18 and 60 years. The patients were grouped with respect to their ages as follows: 18-24 years, 25-30 years, and 31 and over years. Levels of NAA, Cr and Cho in DLPFC, ACC, cerebellum and striatum were measured with magnetic resonance spectroscopy (MRS). Subjects were then given 10 mg of oral MPH and the same metabolite levels were measured 30 minutes apart. Results Twelve (20%) of the cases were female and 48 (80%) were male. The age distribution of the cases is as follows: 15 subjects between the ages of 18-24, 26 subjects between the ages of 25-30 and 19 subjects over the age of 30. NAA levels were higher after MPH in the DLPFC of the 18-24 age group (p = 0.016) and in the cerebellum of the 25-30 age group (p = 0.041). No increase in Cho and Cr levels was observed after treatment compared to before (p > 0.05). Conclusion It is thought that treatment of MPH can be effective on metabolites in different brain regions and this effect can vary upon age adult ADHD patients. After MPH treatment, both the 18-24 age group (in the DLPFC) and the 25-30 age group (in the cerebellum) was detected significantly higher NAA levels compared to pre-treatment levels. This increase in NAA levels suggested that pharmacotherapy, especially at early ages, may be effective on neuronal damage.
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Affiliation(s)
| | - Ayse Nur Inci Kenar
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Chan KL, Ziegs T, Henning A. Improved signal-to-noise performance of MultiNet GRAPPA 1 H FID MRSI reconstruction with semi-synthetic calibration data. Magn Reson Med 2022; 88:1500-1515. [PMID: 35657035 DOI: 10.1002/mrm.29314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To further develop MultiNet GRAPPA, a neural-network-based reconstruction, for lower SNR proton MRSI (1 H MRSI) data using adapted undersampling schemes and improved training sets. METHODS 1 H FID-MRSI data and an anatomical image for GRAPPA reconstruction were acquired in two slices in the human brain (n = 6) at 7T. MRSI data were retrospectively undersampled for a 4×, 6×, and 7× acceleration rate. Signal-to-noise, relative error (RE) between accelerated and fully sampled metabolic maps, RMS of the lipid artifacts, and fitting reliability were compared across acceleration rates, to the fully sampled data, and with different kinds and amounts of training images. RESULTS Training with semi-synthetic images resulted in higher SNR and lower lipid RMS relative to training with acquired images from one or several subjects. SNR increased with the number of semi-synthetic training images and the 4× accelerated data retains ∼30% more SNR than other accelerated data. Spectra reconstructed with 20 semi-synthetic averages retained ∼100% more SNR and had ∼5% lower lipid RMS than those reconstructed with the center k-space points of one image as was originally proposed for very high SNR MRSI data and had higher fitting reliability. The metabolite RE was lowest when training with 20-semi-synthetic training images and highest when training with the center k-space points of one image. CONCLUSION MultiNet GRAPPA is feasible with lower SNR 1 H MRSI data if 20-semi-synthetic training images are used at a 4× acceleration rate. This acceleration rate provided the best trade-off between scan time and spectral SNR.
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Affiliation(s)
- Kimberly L Chan
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Theresia Ziegs
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Anke Henning
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Max Planck Institute for Biological Cybernetics, Tübingen, Germany
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Metabolite differences in the medial prefrontal cortex in schizophrenia patients with and without persistent auditory verbal hallucinations: a 1H MRS study. Transl Psychiatry 2022; 12:116. [PMID: 35322015 PMCID: PMC8943150 DOI: 10.1038/s41398-022-01866-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 11/08/2022] Open
Abstract
Studies of schizophrenia (SCZ) have associated auditory verbal hallucinations (AVH) with structural and functional abnormalities in frontal cortex, especially medial prefrontal cortex (mPFC). Although abnormal prefrontal network connectivity associated with language production has been studied extensively, the relationship between mPFC dysfunction (highly relevant to the pathophysiology of SCZ) and AVH has been rarely investigated. In this study, proton magnetic resonance spectroscopy was used to measure metabolite levels in the mPFC in 61 SCZ patients with persistent AVH (pAVH), 53 SCZ patients without AVH (non-AVH), and 59 healthy controls (HC). The pAVH group showed significantly lower levels of N-acetyl-aspartate + N-acetyl-aspartyl-glutamate (tNAA) and glutamate + glutamine (Glx), compared with the non-AVH (tNAA: p = 0.022, Glx: p = 0.012) and HC (tNAA: p = 0.001, Glx: p = 0.001) groups. No difference was found in the levels of tNAA and Glx between non-AVH and HC. The levels of tNAA and Glx in the mPFC was negatively correlated with the severity of pAVH (tNAA: r = -0.24, p = 0.014; Glx: r = -0.30, p = 0.002). In conclusion, pAVH in SCZ patients might be related to decreased levels of tNAA and Glx in the mPFC, indicating that tNAA or Glx might play a key role in the pathogenesis of pAVH.
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Malaspina D, Lotan E, Rusinek H, Perez SA, Walsh-Messinger J, Kranz TM, Gonen O. Preliminary Findings Associate Hippocampal 1H-MR Spectroscopic Metabolite Concentrations with Psychotic and Manic Symptoms in Patients with Schizophrenia. AJNR Am J Neuroradiol 2021; 42:88-93. [PMID: 33184071 PMCID: PMC7814798 DOI: 10.3174/ajnr.a6879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Previous hippocampal proton MR spectroscopic imaging distinguished patients with schizophrenia from controls by elevated Cr levels and significantly more variable NAA and Cho concentrations. This goal of this study was to ascertain whether this metabolic variability is associated with clinical features of the syndrome, possibly reflecting heterogeneous hippocampal pathologies and perhaps variability in its "positive" (psychotic) and "negative" (social and emotional deficits) symptoms. MATERIALS AND METHODS In a sample of 15 patients with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, we examined the association of NAA and Cho levels with research diagnostic interviews and clinical symptom ratings of the patients. Metabolite concentrations were previously obtained with 3D proton MR spectroscopic imaging at 3T, a technique that facilitates complete coverage of this small, irregularly shaped, bilateral, temporal lobe structure. RESULTS The patient cohort comprised 8 men and 7 women (mean age, 39.1 [SD, 10.8] years, with a mean disease duration of 17.2 [SD, 10.8] years. Despite the relatively modest cohort size, we found the following: 1) Elevated Cho levels predict the positive (psychotic, r = 0.590, P = .021) and manic (r = 0.686, P = .005) symptom severity; and 2) lower NAA levels trend toward negative symptoms (r = 0.484, P = .08). No clinical symptoms were associated with Cr level or hippocampal volume (all, P ≥ .055). CONCLUSIONS These preliminary findings suggest that NAA and Cho variations reflect different pathophysiologic processes, consistent with microgliosis/astrogliosis and/or lower vitality (reduced NAA) and demyelination (elevated Cho). In particular, the active state-related symptoms, including psychosis and mania, were associated with demyelination. Consequently, their deviations from the means of healthy controls may be a marker that may benefit precision medicine in selection and monitoring of schizophrenia treatment.
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Affiliation(s)
- D Malaspina
- From the Departments of Psychiatry, Neuroscience, Genetics, and Genomics (D.M.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - E Lotan
- Department of Radiology (E.L., H.R., S.A.P., O.G.), Center for Advanced Imaging Innovation and Research, New York University Grossman School of Medicine, New York, New York
| | - H Rusinek
- Department of Radiology (E.L., H.R., S.A.P., O.G.), Center for Advanced Imaging Innovation and Research, New York University Grossman School of Medicine, New York, New York
| | - S A Perez
- Department of Radiology (E.L., H.R., S.A.P., O.G.), Center for Advanced Imaging Innovation and Research, New York University Grossman School of Medicine, New York, New York
| | - J Walsh-Messinger
- Department of Psychology (J.W.-M.), University of Dayton, Dayton, Ohio
- Department of Psychiatry (J.W.-M.), Wright State University Boonshoft School of Medicine, Dayton, Ohio
| | - T M Kranz
- Department of Psychiatry, Psychosomatics, and Psychotherapy (T.M.K.), Goethe University, Frankfurt, Germany
| | - O Gonen
- Department of Radiology (E.L., H.R., S.A.P., O.G.), Center for Advanced Imaging Innovation and Research, New York University Grossman School of Medicine, New York, New York
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Metabolite abnormalities in psychosis risk: A meta-analysis of proton magnetic resonance spectroscopy studies. Asian J Psychiatr 2020; 54:102220. [PMID: 32653847 DOI: 10.1016/j.ajp.2020.102220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/23/2020] [Accepted: 06/10/2020] [Indexed: 12/28/2022]
Abstract
Accumulating evidence implicates that individuals at high-risk of psychosis have already exhibited pathophysiological changes in brain metabolites including glutamate, gamma-Aminobutyric Acid (GABA), N-Acetylaspartate (NAA), creatine (Cr), myo-inositol (MI) and choline (Cho). These changes may contribute to the development of schizophrenia and associate with psychotic genes. However, specific metabolic changes of brain sub-regions in individuals at risk have still been controversial. Thus, the current study aimed to investigate the brain metabolic changes including glutamate, Glx, GABA, GABA/Glx, NAA, Cr, MI and Cho levels in individuals at risk by conducting a case-control meta-analysis and meta-regression of proton magnetic resonance spectroscopy studies. Primary outcomes revealed that individuals at risk exhibited increased Cr levels at the rostral medial prefrontal cortex (rmPFC), decreased NAA and Cr levels at the thalamus, and increased MI levels at the dorsolateral prefrontal cortex. Sub-group analyses further indicated that individuals with clinical high-risk (CHR) exhibited increased Cr levels at the medial prefrontal cortex (mPFC) and decreased Glx levels at the thalamus, while individuals with genetic risk (siblings of psychiatric patients) exhibited significant increased Glx and MI levels at the mPFC. However, GABA, GABA/Glx and Cho levels showed no significant result. These findings suggest that the dysfunctional metabolites at the mPFC and the thalamus may be an essential neurobiological basis at the early stage of psychosis.
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Kaminski J, Gleich T, Fukuda Y, Katthagen T, Gallinat J, Heinz A, Schlagenhauf F. Association of Cortical Glutamate and Working Memory Activation in Patients With Schizophrenia: A Multimodal Proton Magnetic Resonance Spectroscopy and Functional Magnetic Resonance Imaging Study. Biol Psychiatry 2020; 87:225-233. [PMID: 31521336 DOI: 10.1016/j.biopsych.2019.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cognitive deficits such as working memory (WM) impairment are core features of schizophrenia. One candidate marker for the integrity of synaptic neurotransmission necessary for cognitive processes is glutamate. It is frequently postulated that antipsychotic medication possibly alters functional mechanisms in the living brain. We tested in vivo for group differences in activation of the dorsolateral prefrontal cortex (DLPFC) during WM performance and the association with glutamate concentration in DLPFC depending on medication status. METHODS A total of 90 subjects (35 control subjects, 36 medicated patients, and 19 unmedicated patients) contributed magnetic resonance spectroscopy data. We estimated glutamate in left DLPFC. Subjects performed an n-back WM task (2-back vs. 0-back) during functional magnetic resonance imaging, and local activation in left DLPFC was measured. For analysis of association with medication status, we calculated linear regression models including an interaction effect with group. RESULTS Medicated and unmedicated patients with schizophrenia showed impaired performance. We found significantly reduced WM activation in left DLPFC in medicated patients and a trendwise reduction in unmedicated patients as compared with control subjects. We found no group difference in local glutamate concentration. However, we found differential effects of medication status on the association between local glutamate concentration and WM activation in left DLPFC, with a positive association in unmedicated patients but not in medicated patients. CONCLUSIONS We provide evidence that WM-dependent activation is associated with glutamate concentration in unmedicated patients with schizophrenia. Our finding points to putative allostatic changes that affect the functioning of the brain and might be altered through medication.
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Affiliation(s)
- Jakob Kaminski
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany.
| | - Tobias Gleich
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Yu Fukuda
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Teresa Katthagen
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jürgen Gallinat
- University Clinic Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; Bernstein Center for Computational Neuroscience, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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7
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Bartolomeo LA, Wright AM, Ma RE, Hummer TA, Francis MM, Visco AC, Mehdiyoun NF, Bolbecker AR, Hetrick WP, Dydak U, Barnard J, O'Donnell BF, Breier A. Relationship of auditory electrophysiological responses to magnetic resonance spectroscopy metabolites in Early Phase Psychosis. Int J Psychophysiol 2019; 145:15-22. [PMID: 31129143 DOI: 10.1016/j.ijpsycho.2019.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 12/19/2022]
Abstract
Both auditory evoked responses and metabolites measured by magnetic resonance spectroscopy (MRS) are altered in schizophrenia and other psychotic disorders, but the relationship between electrophysiological and metabolic changes are not well characterized. We examined the relation of MRS metabolites to cognitive and electrophysiological measures in individuals during the early phase of psychosis (EPP) and in healthy control subjects. The mismatch negativity (MMN) of the auditory event-related potential to duration deviant tones and the auditory steady response (ASSR) to 40 Hz stimulation were assessed. MRS was used to quantify glutamate+glutamine (Glx), N-Acetylasparate (NAA), creatine (Cre), myo-inositol (Ins) and choline (Cho) at a voxel placed medially in the frontal cortex. MMN amplitude and ASSR power did not differ between groups. The MRS metabolites Glx, Cre and Cho were elevated in the psychosis group. Partial least squares analysis in the patient group indicated that elevated levels of MRS metabolites were associated with reduced MMN amplitude and increased 40 Hz ASSR power. There were no correlations between the neurobiological measures and clinical measures. These data suggest that elevated neurometabolites early in psychosis are accompanied by altered auditory neurotransmission, possibly indicative of a neuroinflammatory or excitotoxic disturbance which disrupts a wide range of metabolic processes in the cortex.
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Affiliation(s)
- Lisa A Bartolomeo
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, United States of America
| | - Andrew M Wright
- School of Health Sciences, Purdue University, Lafayette, IN, United States of America
| | - Ruoyun E Ma
- School of Health Sciences, Purdue University, Lafayette, IN, United States of America; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Tom A Hummer
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America; Department of Psychiatry, Prevention and the Recovery Center for Early Psychosis, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Michael M Francis
- Department of Psychiatry, Prevention and the Recovery Center for Early Psychosis, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Andrew C Visco
- Department of Psychiatry, Prevention and the Recovery Center for Early Psychosis, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Nicole F Mehdiyoun
- Department of Psychiatry, Prevention and the Recovery Center for Early Psychosis, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Amanda R Bolbecker
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, United States of America
| | - William P Hetrick
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, United States of America
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, Lafayette, IN, United States of America; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - John Barnard
- Section of Biostatistics, Cleveland Clinic, Cleveland, OH, United States of America
| | - Brian F O'Donnell
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, United States of America.
| | - Alan Breier
- Department of Psychiatry, Prevention and the Recovery Center for Early Psychosis, Indiana University School of Medicine, Indianapolis, IN, United States of America
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Modinos G, Egerton A, McLaughlin A, McMullen K, Kumari V, Lythgoe DJ, Barker GJ, Aleman A, Williams SCR. Neuroanatomical changes in people with high schizotypy: relationship to glutamate levels. Psychol Med 2018; 48:1880-1889. [PMID: 29198207 PMCID: PMC5884418 DOI: 10.1017/s0033291717003403] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cortical glutamatergic dysfunction is thought to be fundamental for psychosis development, and may lead to structural degeneration through excitotoxicity. Glutamate levels have been related to gray matter volume (GMV) alterations in people at ultra-high risk of psychosis, and we previously reported GMV changes in individuals with high schizotypy (HS), which refers to the expression of schizophrenia-like characteristics in healthy people. This study sought to examine whether GMV changes in HS subjects are related to glutamate levels. METHODS We selected 22 healthy subjects with HS and 23 healthy subjects with low schizotypy (LS) based on their rating on a self-report questionnaire for psychotic-like experiences. Glutamate levels were measured in the bilateral anterior cingulate cortex (ACC) using proton magnetic resonance spectroscopy, and GMV was assessed using voxel-based morphometry. RESULTS Subjects with HS showed GMV decreases in the rolandic operculum/superior temporal gyrus (pFWE = 0.045). Significant increases in GMV were also detected in HS, in the precuneus (pFWE = 0.043), thereby replicating our previous finding in a separate cohort, as well as in the ACC (pFWE = 0.041). While the HS and LS groups did not differ in ACC glutamate levels, in HS subjects ACC glutamate was negatively correlated with ACC GMV (pFWE = 0.026). Such association was absent in LS. CONCLUSIONS Our study shows that GMV findings in schizotypy are related to glutamate levels, supporting the hypothesis that glutamatergic function may lead to structural changes associated with the expression of psychotic-like experiences.
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Affiliation(s)
- Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Anna McLaughlin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Katrina McMullen
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Veena Kumari
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - André Aleman
- University of Groningen, Department of Neuroscience, University Medical Centre Groningen, The Netherlands
| | - Steve CR Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
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Duarte JMN, Xin L. Magnetic Resonance Spectroscopy in Schizophrenia: Evidence for Glutamatergic Dysfunction and Impaired Energy Metabolism. Neurochem Res 2018; 44:102-116. [PMID: 29616444 PMCID: PMC6345729 DOI: 10.1007/s11064-018-2521-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 01/03/2023]
Abstract
In the past couple of decades, major efforts were made to increase reliability of metabolic assessments by magnetic resonance methods. Magnetic resonance spectroscopy (MRS) has been valuable for providing in vivo evidence and investigating biomarkers in neuropsychiatric disorders, namely schizophrenia. Alterations of glutamate and glutamine levels in brains of schizophrenia patients relative to healthy subjects are generally interpreted as markers of glutamatergic dysfunction. However, only a small fraction of MRS-detectable glutamate is involved in neurotransmission. Here we review and discuss brain metabolic processes that involve glutamate and that are likely to be implicated in neuropsychiatric disorders.
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Affiliation(s)
- João M N Duarte
- Department of Experimental Medical Science, Faculty of Medicine, Lund University, BMC C11, Sölvegatan 19, 221 84, Lund, Sweden. .,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden.
| | - Lijing Xin
- Animal Imaging and Technology Core (AIT), Center for Biomedical Imaging (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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10
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Pasternak O, Kubicki M, Shenton ME. In vivo imaging of neuroinflammation in schizophrenia. Schizophr Res 2016; 173:200-212. [PMID: 26048294 PMCID: PMC4668243 DOI: 10.1016/j.schres.2015.05.034] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/18/2015] [Accepted: 05/20/2015] [Indexed: 12/18/2022]
Abstract
In recent years evidence has accumulated to suggest that neuroinflammation might be an early pathology of schizophrenia that later leads to neurodegeneration, yet the exact role in the etiology, as well as the source of neuroinflammation, are still not known. The hypothesis of neuroinflammation involvement in schizophrenia is quickly gaining popularity, and thus it is imperative that we have reliable and reproducible tools and measures that are both sensitive, and, most importantly, specific to neuroinflammation. The development and use of appropriate human in vivo imaging methods can help in our understanding of the location and extent of neuroinflammation in different stages of the disorder, its natural time-course, and its relation to neurodegeneration. Thus far, there is little in vivo evidence derived from neuroimaging methods. This is likely the case because the methods that are specific and sensitive to neuroinflammation are relatively new or only just being developed. This paper provides a methodological review of both existing and emerging positron emission tomography and magnetic resonance imaging techniques that identify and characterize neuroinflammation. We describe \how these methods have been used in schizophrenia research. We also outline the shortcomings of existing methods, and we highlight promising future techniques that will likely improve state-of-the-art neuroimaging as a more refined approach for investigating neuroinflammation in schizophrenia.
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Affiliation(s)
- Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Applied Mathematics, Tel Aviv University, Tel Aviv 69978, Israel.
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA; VA Boston Healthcare System, Brockton, MA, USA
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11
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KIRTAŞ D, KARADAĞ RF, BALCI ŞENGÜL MC, KIROĞLU Y. 1H-magnetic resonance spectroscopy in first episode and chronic schizophrenia patients. Turk J Med Sci 2016; 46:862-71. [DOI: 10.3906/sag-1502-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 08/16/2015] [Indexed: 11/03/2022] Open
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Association of adult attention deficit hyperactivity disorder subtypes and response to methylphenidate HCL treatment: A magnetic resonance spectroscopy study. Neurosci Lett 2015; 604:188-92. [PMID: 26257254 DOI: 10.1016/j.neulet.2015.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 08/02/2015] [Accepted: 08/03/2015] [Indexed: 01/18/2023]
Abstract
The effects of methylphenidate (MPH) treatment on N-acetyl aspartate (NAA), choline and creatine are being examined in individuals with different subtypes of attention deficit hyperactivity disorder (ADHD). Sixty ADHD subjects were included into the study aging between 18 and 60 years. Levels of NAA, creatine and choline in anterior cingulate cortex, cerebellum, striatum and dorsolateral prefrontal cortex were measured with magnetic resonance spectroscopy. Then, 10mg oral MPH was given to the subjects and the same metabolite levels were measured after an interval of 30min. Distribution of the patients according to the ADHD subtypes was as follows: 21 of them (35.0%) were in the inattentive type, 11 of them (18.3%) were in the hyperactive type and 28 of them were (46.7%) in the combined type. Changes of brain metabolite levels after MPH were found not to be statistically significantly different between the subtypes. The increase of choline levels after MPH compared to the levels of choline before MPH in striatum in the combined type patients were statistically significant. No clear association was found between ADHD subtypes and changes of brain metabolites with use of MPH in adult ADHD.
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Shao Y, Yan G, Xuan Y, Peng H, Huang QJ, Wu R, Xu H. Chronic social isolation decreases glutamate and glutamine levels and induces oxidative stress in the rat hippocampus. Behav Brain Res 2015; 282:201-8. [PMID: 25591473 DOI: 10.1016/j.bbr.2015.01.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/31/2014] [Accepted: 01/05/2015] [Indexed: 02/05/2023]
Abstract
Social isolation (SI) rearing of rodents is a developmental manipulation, which is commonly compared with the psychological stressors in humans as it produces several behavioral outcomes similar to those observed in humans with early life stress. To explain the SI-induced behavioral outcomes, animal studies have been performed to examine the dopaminergic and glutamatergic systems in the brain. In this study, we measured possible changes in levels of glutamate and glutamine of SI-rats using proton magnetic resonance spectroscopy. We also assessed the oxidative stress parameters in certain brain regions to see if glutamate and/or glutamine changes, if any, are associated with oxidative stress. SI rearing for 8 weeks decreased the activities of antioxidant enzymes catalase, glutathione peroxidase, superoxide dismutase, and the total antioxidant capacity, but increased levels of hydrogen peroxide, in certain brain regions, of which prefrontal cortex and hippocampus were most vulnerable. It also decreased levels of glutamate, glutamine, N-acetyl-l-aspartate (NAA), and phosphocreatine in the dorsal hippocampus, but not in the cerebral cortex. Decreased phosphocreatine and NAA indicate energy metabolism deficit in brain cells; the latter also suggests the neuronal viability was inhibited. Decreased glutamate and glutamine may suggest the neuron-glial integrity was implicated by chronic SI. These neurochemical and biochemical changes may contribute to the SI-induced behavioral abnormalities including a high level of anxiety, social interaction deficit, and impaired spatial working memory shown in this study.
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Affiliation(s)
- Yuan Shao
- The Mental Health Center, Shantou University Medical College, China
| | - Gen Yan
- Department of Radiology, the Second Affiliated Hospital, Shantou University Medical College, China
| | - Yinghua Xuan
- The Mental Health Center, Shantou University Medical College, China; Department of Anatomy, Shantou University Medical College, China
| | - Hui Peng
- Department of Anatomy, Shantou University Medical College, China
| | - Qing-Jun Huang
- The Mental Health Center, Shantou University Medical College, China
| | - Renhua Wu
- Department of Radiology, the Second Affiliated Hospital, Shantou University Medical College, China
| | - Haiyun Xu
- The Mental Health Center, Shantou University Medical College, China; Department of Anatomy, Shantou University Medical College, China.
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14
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Yan G, Xuan Y, Dai Z, Shen Z, Zhang G, Xu H, Wu R. Brain metabolite changes in subcortical regions after exposure to cuprizone for 6 weeks: potential implications for schizophrenia. Neurochem Res 2015; 40:49-58. [PMID: 25347963 DOI: 10.1007/s11064-014-1464-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/29/2014] [Accepted: 10/23/2014] [Indexed: 02/05/2023]
Abstract
Cuprizone is a copper chelating agent able to selectively damage the white matter in the mouse brain. Recent studies have reported behavioral abnormalities relevant to some of schizophrenia symptoms. While associating white matter damage to the behavioral abnormalities, these previous studies did not rule out the possible impairment in neuronal functions in cuprizone-exposed mice. The aim of this study was to examine brain metabolites of the cuprizone-exposed mice by proton magnetic resonance spectroscopy ((1)H-MRS). The examined brain regions were the caudoputamen, midbrain, and thalamus; these subcortical regions showed different susceptibilities to cuprizone in terms of demyelination and oligodendrocyte loss in previous studies. Young C57BL/6 mice were fed a standard rodent chow without or with cuprizone (0.2 %) for 6 weeks. At the end, open-field and Y-maze tests were performed to measure the emotional and cognitive behaviors of the animals, followed by (1)H-MRS procedure to evaluate the brain metabolites. Cuprizone-exposure increased anxiety levels and impaired spatial working memory. The same treatment increased T2 signal intensity in the cerebral cortex, hippocampus, and caudoputamen, but not in the thalamus. Cuprizone-exposure decreased the concentrations of NAA and NAA+NAAG in caudoputamen, but not in thalamus and midbrain. It decreased levels of Cr+PCr, GPC+PCh and myo-inositol in all the three brain regions. These results provided neurochemical evidence for the impairment in neuronal functions by cuprizone treatment.
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Affiliation(s)
- Gen Yan
- Department of Radiology, Second Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
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15
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Modinos G, Allen P, Grace AA, McGuire P. Translating the MAM model of psychosis to humans. Trends Neurosci 2014; 38:129-38. [PMID: 25554679 DOI: 10.1016/j.tins.2014.12.005] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/12/2014] [Accepted: 12/02/2014] [Indexed: 12/13/2022]
Abstract
Elevated dopamine function and alterations in medial temporal lobe (MTL) structure and function are two of the most robust findings in schizophrenia, but how interactions between these abnormalities underlie the onset of psychosis is unclear. The methylazoxymethanol acetate (MAM) rodent model proposes that psychosis develops as a result of a perturbation of MTL function, leading to elevated striatal dopamine dysfunction. Here, we review several recent neuroimaging studies that examine components of the putative model in humans with an ultra high risk (UHR) of the psychosis. While data from these studies are broadly consistent with the MAM model, caution is required when comparing data across animal and human studies.
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Affiliation(s)
- Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry, and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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16
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Ma G, Song T, Chen M, Fu Y, Xu Y, Ma E, Wang W, Du J, Huang M. Hippocampal and thalamic neuronal metabolism in a putative rat model of schizophrenia. Neural Regen Res 2014; 8:2415-23. [PMID: 25206551 PMCID: PMC4146111 DOI: 10.3969/j.issn.1673-5374.2013.26.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 07/01/2013] [Indexed: 12/17/2022] Open
Abstract
The transcription factor early growth response protein 3 (EGR3) is involved in schizophrenia. We developed a putative rat model of schizophrenia by transfecting lentiviral particles carrying the Egr3 gene into bilateral hippocampal dentate gyrus. We assessed spatial working memory using the Morris water maze test, and neuronal metabolite levels in bilateral hippocampus and thalamus were determined by 3.0 T proton magnetic resonance spectroscopy. Choline content was significantly greater in the hippocampus after transfection, while N-acetylaspartate and the ratio of N-acetylaspartate to creatine/phosphocreatine in the thalamus were lower than in controls. This study is the first to report evaluation of brain metabolites using 3.0 T proton magnetic resonance spectroscopy in rats transfected with Egr3, and reveals metabolic abnormalities in the hippocampus and thalamus in this putative model of schizophrenia.
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Affiliation(s)
- Guolin Ma
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Tianbin Song
- Department of Radiology, Beijing Shunyi Hospital, Beijing 101300, China
| | - Min Chen
- Department of Radiology, Beijing Hospital Affiliated to the Ministry of Public Health, Beijing 100730, China
| | - Yuan Fu
- Department of Radiology, Beijing Hospital Affiliated to the Ministry of Public Health, Beijing 100730, China
| | - Yong Xu
- Department of Mental Health, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
| | - Ensen Ma
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Wu Wang
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA 92103-8226, USA
| | - Mingxiong Huang
- Radiology Imaging Laboratory, Department of Radiology, University of California, San Diego, CA 92121, USA
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17
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Falkenberg LE, Westerhausen R, Craven AR, Johnsen E, Kroken RA, L Berg EM, Specht K, Hugdahl K. Impact of glutamate levels on neuronal response and cognitive abilities in schizophrenia. NEUROIMAGE-CLINICAL 2014; 4:576-84. [PMID: 24749064 PMCID: PMC3989526 DOI: 10.1016/j.nicl.2014.03.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/29/2014] [Accepted: 03/31/2014] [Indexed: 12/20/2022]
Abstract
Schizophrenia is characterized by impaired cognitive functioning, and brain regions involved in cognitive control processes show marked glutamatergic abnormalities. However, it is presently unclear whether aberrant neuronal response is directly related to the observed deficits at the metabolite level in schizophrenia. Here, 17 medicated schizophrenia patients and 17 matched healthy participants underwent functional magnetic resonance imaging (fMRI) when performing an auditory cognitive control task, as well as proton magnetic resonance spectroscopy (1H-MRS) in order to assess resting-state glutamate in the anterior cingulate cortex. The combined fMRI–1H-MRS analysis revealed that glutamate differentially predicted cortical blood-oxygen level-dependent (BOLD) response in patients and controls. While we found a positive correlation between glutamate and BOLD response bilaterally in the inferior parietal lobes in the patients, the corresponding correlation was negative in the healthy control participants. Further, glutamate levels predicted task performance in patients, such that lower glutamate levels were related to impaired cognitive control functioning. This was not seen for the healthy controls. These findings suggest that schizophrenia patients have a glutamate-related dysregulation of the brain network supporting cognitive control functioning. This could be targeted in future research on glutamatergic treatment of cognitive symptoms in schizophrenia. Neuronal processing of cognitive control is different in schizophrenia patients (SZ). Cingulum glutamate levels predict the degree of parietal neuronal response. Lower glutamate predicts poorer cognitive control abilities in SZ. SZ have a glutamate-related neuronal dysregulation of cognitive control processing.
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Affiliation(s)
- Liv E Falkenberg
- Department of Biological and Medical Psychology, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - René Westerhausen
- Department of Biological and Medical Psychology, University of Bergen, Haukeland University Hospital, Bergen, Norway ; Division of Psychiatry, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Alexander R Craven
- Department of Biological and Medical Psychology, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, University of Bergen, Haukeland University Hospital, Bergen, Norway ; Department of Clinical Medicine, Psychiatry Section, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Rune A Kroken
- Division of Psychiatry, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Else-Marie L Berg
- Department of Biological and Medical Psychology, University of Bergen, Haukeland University Hospital, Bergen, Norway ; Division of Psychiatry, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Karsten Specht
- Department of Biological and Medical Psychology, University of Bergen, Haukeland University Hospital, Bergen, Norway ; Department of Clinical Engineering, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Haukeland University Hospital, Bergen, Norway ; Division of Psychiatry, University of Bergen, Haukeland University Hospital, Bergen, Norway ; Department of Radiology, Haukeland University Hospital, Bergen, Norway ; NORMENT Senter for Fremragende Forskning, Oslo, Norway
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18
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Abstract
OBJECTIVE This article reviews neuroimaging studies that inform psychotherapy research. An introduction to neuroimaging methods is provided as background for the increasingly sophisticated breadth of methods and findings appearing in psychotherapy research. METHOD We compiled and assessed a comprehensive list of neuroimaging studies of psychotherapy outcome, along with selected examples of other types of studies that also are relevant to psychotherapy research. We emphasized magnetic resonance imaging (MRI) since it is the dominant neuroimaging modality in psychological research. RESULTS We summarize findings from neuroimaging studies of psychotherapy outcome, including treatment for depression, obsessive compulsive disorder (OCD), and schizophrenia. CONCLUSIONS The increasing use of neuroimaging methods in the study of psychotherapy continues to refine our understanding of both outcome and process. We suggest possible directions for future neuroimaging studies in psychotherapy research.
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Affiliation(s)
- Carol P Weingarten
- a Department of Psychiatry and Behavioral Sciences , Duke University , Durham , NC , USA
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Schultz CC, Fusar-Poli P, Wagner G, Koch K, Schachtzabel C, Gruber O, Sauer H, Schlösser RGM. Multimodal functional and structural imaging investigations in psychosis research. Eur Arch Psychiatry Clin Neurosci 2012; 262 Suppl 2:S97-106. [PMID: 22940744 DOI: 10.1007/s00406-012-0360-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 08/15/2012] [Indexed: 12/15/2022]
Abstract
Substantial pathophysiological questions about the relationship of brain pathologies in psychosis can only be answered by multimodal neuroimaging approaches combining different imaging modalities such as structural MRI (sMRI), functional MRI (fMRI), diffusion tensor imaging (DTI), positron emission tomography (PET) and magnetic-resonance spectroscopy. In particular, the multimodal imaging approach has the potential to shed light on the neuronal mechanisms underlying the major brain structural and functional pathophysiological features of schizophrenia and high-risk states such as prefronto-temporal gray matter reduction, altered higher-order cognitive processing, or disturbed dopaminergic and glutamatergic neurotransmission. In recent years, valuable new findings have been revealed in these fields by multimodal imaging studies mostly reflecting a direct and aligned correlation of brain pathologies in psychosis. However, the amount of multimodal studies is still limited, and further efforts have to be made to consolidate previous findings and to extend the scope to other pathophysiological parameters contributing to the pathogenesis of psychosis. Here, investigating the genetic foundations of brain pathology relationships is a major challenge for future multimodal imaging applications in psychosis research.
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Affiliation(s)
- C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740 Jena, Germany.
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20
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Preclinical (1)H-MRS neurochemical profiling in neurological and psychiatric disorders. Bioanalysis 2012; 4:1787-804. [PMID: 22877223 DOI: 10.4155/bio.12.129] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The ongoing development of animal models of neurological and psychiatric disorders in combination with the development of advanced nuclear magnetic resonance (NMR) techniques and instrumentation has led to increased use of in vivo proton NMR spectroscopy ((1)H-MRS) for neurochemical analyses. (1)H-MRS is one of only a few analytical methods that can assay in vivo and longitudinal neurochemical changes associated with neurological and psychiatric diseases, with the added advantage of being a technique that can be utilized in both preclinical and clinical studies. In this review, recent progress in the use of (1)H-MRS to investigate animal models of neurological and psychiatric disorders is summarized with examples from the literature and our own work.
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