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Wiseman RL, Bigos KL, Dastgheyb RM, Barker PB, Rubin LH, Slusher BS. Brain N -acetyl-aspartyl-glutamate is associated with cognitive function in older virally suppressed people with HIV. AIDS 2024; 38:1003-1011. [PMID: 38411600 PMCID: PMC11062820 DOI: 10.1097/qad.0000000000003871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Cognitive impairment persists in virally suppressed people with HIV (VS-PWH) especially in higher order domains. One cortical circuit, linked to these domains, is regulated by N -acetyl-aspartyl glutamate (NAAG), the endogenous agonist of the metabotropic glutamate receptor 3. The enzyme glutamate carboxypeptidase II (GCPII) catabolizes NAAG and is upregulated in aging and disease. Inhibition of GCPII increases brain NAAG and improves learning and memory in rodent and primate models. DESIGN As higher order cognitive impairment is present in VS-PWH, and NAAG has not been investigated in earlier magnetic resonance spectroscopy studies (MRS), we investigated if brain NAAG levels measured by MRS were associated with cognitive function. METHODS We conducted a retrospective analysis of 7-Tesla MRS data from a previously published study on cognition in older VS-PWH. The original study did not separately quantify NAAG, therefore, work for this report focused on relationships between regional NAAG levels in frontal white matter (FWM), left hippocampus, left basal ganglia and domain-specific cognitive performance in 40 VS-PWH after adjusting for confounds. Participants were older than 50 years, negative for affective and neurologic disorders, and had no prior 3-month psychoactive-substance use. RESULTS Higher NAAG levels in FWM were associated with better attention/working memory. Higher left basal ganglia NAAG related to better verbal fluency. There was a positive relationship between hippocampal NAAG and executive function which lost significance after correction for confounds. CONCLUSION These data suggest brain NAAG serves as a biomarker of cognition in VS-PWH. Pharmacological modulation of brain NAAG warrants investigation as a therapeutic approach for cognitive deficits in VS-PWH.
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Affiliation(s)
- Robyn L. Wiseman
- Department of Pharmacology and Molecular Sciences
- Johns Hopkins Drug Discovery
- Department of Medicine, Division of Clinical Pharmacology
| | - Kristin L. Bigos
- Department of Pharmacology and Molecular Sciences
- Department of Medicine, Division of Clinical Pharmacology
- Department of Psychiatry and Behavioral Sciences
| | | | - Peter B. Barker
- Russell H. Morgan Department of Radiology and Radiological Sciences
| | - Leah H. Rubin
- Department of Psychiatry and Behavioral Sciences
- Department of Neurology
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Barbara S. Slusher
- Department of Pharmacology and Molecular Sciences
- Johns Hopkins Drug Discovery
- Department of Medicine, Division of Clinical Pharmacology
- Department of Psychiatry and Behavioral Sciences
- Department of Neurology
- Department of Oncology
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Yang YS, Smucny J, Zhang H, Maddock RJ. Meta-analytic evidence of elevated choline, reduced N-acetylaspartate, and normal creatine in schizophrenia and their moderation by measurement quality, echo time, and medication status. Neuroimage Clin 2023; 39:103461. [PMID: 37406595 PMCID: PMC10509531 DOI: 10.1016/j.nicl.2023.103461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Brain metabolite abnormalities measured with magnetic resonance spectroscopy (MRS) provide insight into pathological processes in schizophrenia. Prior meta-analyses have not yet answered important questions about the influence of clinical and technical factors on neurometabolite abnormalities and brain region differences. To address these gaps, we performed an updated meta-analysis of N-acetylaspartate (NAA), choline, and creatine levels in patients with schizophrenia and assessed the moderating effects of medication status, echo time, measurement quality, and other factors. METHODS We searched citations from three earlier meta-analyses and the PubMed database after the most recent meta-analysis to identify studies for screening. In total, 113 publications reporting 366 regional metabolite datasets met our inclusion criteria and reported findings in medial prefrontal cortex (MPFC), dorsolateral prefrontal cortex, frontal white matter, hippocampus, thalamus, and basal ganglia from a total of 4445 patient and 3944 control observations. RESULTS Patients with schizophrenia had reduced NAA in five of the six brain regions, with a statistically significant sparing of the basal ganglia. Patients had elevated choline in the basal ganglia and both prefrontal cortical regions. Patient creatine levels were normal in all six regions. In some regions, the NAA and choline differences were greater in studies enrolling predominantly medicated patients compared to studies enrolling predominantly unmedicated patients. Patient NAA levels were more reduced in hippocampus and frontal white matter in studies using longer echo times than those using shorter echo times. MPFC choline and NAA abnormalities were greater in studies reporting better metabolite measurement quality. CONCLUSIONS Choline is elevated in the basal ganglia and prefrontal cortical regions, suggesting regionally increased membrane turnover or glial activation in schizophrenia. The basal ganglia are significantly spared from the well-established widespread reduction of NAA in schizophrenia suggesting a regional difference in disease-associated factors affecting NAA. The echo time findings agree with prior reports and suggest microstructural changes cause faster NAA T2 relaxation in hippocampus and frontal white matter in schizophrenia. Separating the effects of medication status and illness chronicity on NAA and choline abnormalities will require further patient-level studies. Metabolite measurement quality was shown to be a critical factor in MRS studies of schizophrenia.
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Affiliation(s)
- Yvonne S Yang
- VISN22 Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA.
| | - Jason Smucny
- Imaging Research Center, University of California, Davis, 4701 X Street, Sacramento, CA 95817, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Davis, 2230 Stockton Blvd, Sacramento, CA 95817, USA
| | - Huailin Zhang
- Department of Internal Medicine, Adventist Health White Memorial, 1720 E Cesar E Chavez Ave, Los Angeles, CA 90033, USA
| | - Richard J Maddock
- Imaging Research Center, University of California, Davis, 4701 X Street, Sacramento, CA 95817, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Davis, 2230 Stockton Blvd, Sacramento, CA 95817, USA.
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3
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Roberts RC, McCollum LA, Schoonover KE, Mabry SJ, Roche JK, Lahti AC. Ultrastructural evidence for glutamatergic dysregulation in schizophrenia. Schizophr Res 2022; 249:4-15. [PMID: 32014360 PMCID: PMC7392793 DOI: 10.1016/j.schres.2020.01.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 12/14/2022]
Abstract
The aim of this paper is to summarize ultrastructural evidence for glutamatergic dysregulation in several linked regions in postmortem schizophrenia brain. Following a brief summary of glutamate circuitry and how synapses are identified at the electron microscopic (EM) level, we will review EM pathology in the cortex and basal ganglia. We will include the effects of antipsychotic drugs and the relation of treatment response. We will discuss how these findings support or confirm other postmortem findings as well as imaging results. Briefly, synaptic and mitochondrial density in anterior cingulate cortex was decreased in schizophrenia, versus normal controls (NCs), in a selective layer specific pattern. In dorsal striatum, increases in excitatory synaptic density were detected in caudate matrix, a compartment associated with cognitive and motor function, and in the putamen patches, a region associated with limbic function and in the core of the nucleus accumbens. Patients who were treatment resistant or untreated had significantly elevated numbers of excitatory synapses in limbic striatal areas in comparison to NCs and responders. Protein levels of vGLUT2, found in subcortical glutamatergic neurons, were increased in the nucleus accumbens in schizophrenia. At the EM level, schizophrenia subjects had an increase in density of excitatory synapses in several areas of the basal ganglia. In the substantia nigra, the protein levels of vGLUT2 were elevated in untreated patients compared to NCs. The density of inhibitory synapses was decreased in schizophrenia versus NCs. In schizophrenia, glutamatergic synapses are differentially affected depending on the brain region, treatment status, and treatment response.
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Affiliation(s)
- Rosalinda C Roberts
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States of America.
| | - Lesley A McCollum
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States of America
| | - Kirsten E Schoonover
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States of America
| | - Samuel J Mabry
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States of America
| | - Joy K Roche
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States of America
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States of America
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Smesny S, Gussew A, Schack S, Langbein K, Wagner G, Reichenbach JR. Neurometabolic patterns of an "at risk for mental disorders" syndrome involve abnormalities in the thalamus and anterior midcingulate cortex. Schizophr Res 2022; 243:285-295. [PMID: 32444202 DOI: 10.1016/j.schres.2020.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/03/2020] [Accepted: 04/19/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The ultra-high risk (UHR) paradigm allows the investigation of individuals at increased risk of developing psychotic or other mental disorders with the aim of making prevention and early intervention as specific as possible in terms of the individual outcome. METHODS Single-session 1H-/31P-Chemical Shift Imaging of thalamus, prefrontal (DLPFC) and anterior midcingulate (aMCC) cortices was applied to 69 UHR patients for psychosis and 61 matched healthy controls. N-acetylaspartate (NAA), glutamate/glutamine complex (Glx), energy (PCr, ATP) and phospholipid metabolites were assessed, analysed by ANOVA (or ANCOVA [with covariates]) and correlated with symptomatology (SCL-90R). RESULTS The thalamus showed decreased NAA, inversely correlated with self-rated aggressiveness, as well as increased PCr, and altered phospholipid breakdown. While the aMCC showed a pattern of NAA decrease and PCr increase, the DLPFC showed PCr increase only in the close-to-psychosis patient subgroup. There were no specific findings in transition patients. CONCLUSION The results do not support the notion of a specific pre-psychotic neurometabolic pattern, but likely reflect correlates of an "at risk for mental disorders syndrome". This includes disturbed neuronal (mitochondrial) metabolism in the thalamus and aMCC, with emphasis on left-sided structures, and altered PL remodeling across structures.
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Affiliation(s)
- Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany.
| | - Alexander Gussew
- Department of Radiology, Halle University Hospital, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Stephan Schack
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Gerd Wagner
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Philosophenweg 3, D-07740 Jena, Germany
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5
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Luttenbacher I, Phillips A, Kazemi R, Hadipour AL, Sanghvi I, Martinez J, Adamson MM. Transdiagnostic role of glutamate and white matter damage in neuropsychiatric disorders: A Systematic Review. J Psychiatr Res 2022; 147:324-348. [PMID: 35151030 DOI: 10.1016/j.jpsychires.2021.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/09/2022]
Abstract
Neuropsychiatric disorders including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) have been considered distinct categories of diseases despite their overlapping characteristics and symptomatology. We aimed to provide an in-depth review elucidating the role of glutamate/Glx and white matter (WM) abnormalities in these disorders from a transdiagnostic perspective. The PubMed online database was searched for studies published between 2010 and 2021. After careful screening, 401 studies were included. The findings point to decreased levels of glutamate in the Anterior Cingulate Cortex in both SZ and BD, whereas Glx is elevated in the Hippocampus in SZ and MDD. With regard to WM abnormalities, the Corpus Callosum and superior Longitudinal Fascicle were the most consistently identified brain regions showing decreased fractional anisotropy (FA) across all the reviewed disorders, except GAD. Additionally, the Uncinate Fasciculus displayed decreased FA in all disorders, except OCD. Decreased FA was also found in the inferior Longitudinal Fasciculus, inferior Fronto-Occipital Fasciculus, Thalamic Radiation, and Corona Radiata in SZ, BD, and MDD. Decreased FA in the Fornix and Corticospinal Tract were found in BD and SZ patients. The Cingulum and Anterior Limb of Internal Capsule exhibited decreased FA in MDD and SZ patients. The results suggest a gradual increase in severity from GAD to SZ defined by the number of brain regions with WM abnormality which may be partially caused by abnormal glutamate levels. WM damage could thus be considered a potential marker of some of the main neuropsychiatric disorders.
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Affiliation(s)
- Ines Luttenbacher
- Department of Social & Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Isha Sanghvi
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto University, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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6
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Hollinger KR, Sharma A, Tallon C, Lovell L, Thomas AG, Zhu X, Wiseman R, Wu Y, Kambhampati SP, Liaw K, Sharma R, Rojas C, Rais R, Kannan S, Kannan RM, Slusher BS. Dendrimer-2PMPA selectively blocks upregulated microglial GCPII activity and improves cognition in a mouse model of multiple sclerosis. Nanotheranostics 2022; 6:126-142. [PMID: 34976589 PMCID: PMC8671953 DOI: 10.7150/ntno.63158] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/04/2021] [Indexed: 12/19/2022] Open
Abstract
Cognitive impairment is a common aspect of multiple sclerosis (MS) for which there are no treatments. Reduced brain N-acetylaspartylglutamate (NAAG) levels are linked to impaired cognition in various neurological diseases, including MS. NAAG levels are regulated by glutamate carboxypeptidase II (GCPII), which hydrolyzes the neuropeptide to N-acetyl-aspartate and glutamate. GCPII activity is upregulated multifold in microglia following neuroinflammation. Although several GCPII inhibitors, such as 2-PMPA, elevate brain NAAG levels and restore cognitive function in preclinical studies when given at high systemic doses or via direct brain injection, none are clinically available due to poor bioavailability and limited brain penetration. Hydroxyl-dendrimers have been successfully used to selectively deliver drugs to activated glia. Methods: We attached 2-PMPA to hydroxyl polyamidoamine (PAMAM) dendrimers (D-2PMPA) using a click chemistry approach. Cy5-labelled-D-2PMPA was used to visualize selective glial uptake in vitro and in vivo. D-2PMPA was evaluated for anti-inflammatory effects in LPS-treated glial cultures. In experimental autoimmune encephalomyelitis (EAE)-immunized mice, D-2PMPA was dosed biweekly starting at disease onset and cognition was assessed using the Barnes maze, and GCPII activity was measured in CD11b+ hippocampal cells. Results: D-2PMPA showed preferential uptake into microglia and robust anti-inflammatory activity, including elevations in NAAG, TGFβ, and mGluR3 in glial cultures. D-2PMPA significantly improved cognition in EAE mice, even though physical severity was unaffected. GCPII activity increased >20-fold in CD11b+ cells from EAE mice, which was significantly mitigated by D-2PMPA treatment. Conclusions: Hydroxyl dendrimers facilitate targeted drug delivery to activated microglia. These data support further development of D-2PMPA to attenuate elevated microglial GCPII activity and treat cognitive impairment in MS.
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Affiliation(s)
| | - Anjali Sharma
- Center for Nanomedicine, Department of Ophthalmology, Johns Hopkins University, Baltimore, MD, USA
| | - Carolyn Tallon
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Lyndah Lovell
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA
| | - Ajit G Thomas
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA
| | - Xiaolei Zhu
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Robyn Wiseman
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Ying Wu
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA
| | - Siva P Kambhampati
- Center for Nanomedicine, Department of Ophthalmology, Johns Hopkins University, Baltimore, MD, USA
| | - Kevin Liaw
- Center for Nanomedicine, Department of Ophthalmology, Johns Hopkins University, Baltimore, MD, USA.,Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Rishi Sharma
- Center for Nanomedicine, Department of Ophthalmology, Johns Hopkins University, Baltimore, MD, USA
| | - Camilo Rojas
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Rana Rais
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Sujatha Kannan
- Center for Nanomedicine, Department of Ophthalmology, Johns Hopkins University, Baltimore, MD, USA.,Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.,Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Rangaramanujam M Kannan
- Center for Nanomedicine, Department of Ophthalmology, Johns Hopkins University, Baltimore, MD, USA.,Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA.,Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Barbara S Slusher
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.,Department of Pharmacology and Molecular Sciences, Johns Hopkins University, Baltimore, MD, USA.,Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA.,Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
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Glutamatergic and GABAergic metabolite levels in schizophrenia-spectrum disorders: a meta-analysis of 1H-magnetic resonance spectroscopy studies. Mol Psychiatry 2022; 27:744-757. [PMID: 34584230 DOI: 10.1038/s41380-021-01297-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/18/2021] [Accepted: 09/08/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The glutamate (Glu) and gamma aminobutyric acid (GABA) hypotheses of schizophrenia were proposed in the 1980s. However, current findings on those metabolite levels in schizophrenia have been inconsistent, and the relationship between their abnormalities and the pathophysiology of schizophrenia remains unclear. To summarize the nature of the alterations of glutamatergic and GABAergic systems in schizophrenia, we conducted meta-analyses of proton magnetic resonance spectroscopy (1H-MRS) studies examining these metabolite levels. METHODS A systematic literature search was conducted using Embase, Medline, PsycINFO, and PubMed. Original studies that compared four metabolite levels (Glu, glutamine [Gln], Glx [Glu+Gln], and GABA), as measured by 1H-MRS, between individuals at high risk for psychosis, patients with first-episode psychosis, or patients with schizophrenia and healthy controls (HC) were included. A random-effects model was used to calculate the effect sizes for group differences in these metabolite levels of 18 regions of interest between the whole group or schizophrenia group and HC. Subgroup analysis and meta-regression were performed based on the status of antipsychotic treatment, illness stage, treatment resistance, and magnetic field strength. RESULTS One-hundred-thirty-four studies met the eligibility criteria, totaling 7993 participants with SZ-spectrum disorders and 8744 HC. 14 out of 18 ROIs had enough numbers of studies to examine the group difference in the metabolite levels. In the whole group, Glx levels in the basal ganglia (g = 0.32; 95% CIs: 0.18-0.45) were elevated. Subgroup analyses showed elevated Glx levels in the hippocampus (g = 0.47; 95% CIs: 0.21-0.73) and dorsolateral prefrontal cortex (g = 0.25; 95% CIs: 0.05-0.44) in unmedicated patients than HC. GABA levels in the MCC were decreased in the first-episode psychosis group compared with HC (g = -0.40; 95% CIs: -0.62 to -0.17). Treatment-resistant schizophrenia (TRS) group had elevated Glx and Glu levels in the MCC (Glx: g = 0.7; 95% CIs: 0.38-1.01; Glu: g = 0.63; 95% CIs: 0.31-0.94) while MCC Glu levels were decreased in the patient group except TRS (g = -0.17; 95% CIs: -0.33 to -0.01). CONCLUSIONS Increased glutamatergic metabolite levels and reduced GABA levels indicate that the disruption of excitatory/inhibitory balance may be related to the pathophysiology of schizophrenia-spectrum disorders.
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8
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Neves TMG, Simoes E, Otaduy MCG, Calfat ELDB, Bertolazzi P, da Costa NA, Duran FLDS, Correia-Lima J, Martin MDGM, Seelander MCL, Otani VHO, Otani TZDS, Vasques DAC, Filho GB, Kochi C, Uchida RR. Inverse Association Between Hypothalamic N-Acetyl Aspartate/Creatine Ratio and Indices of Body Mass in Adolescents with Obesity. J Nutr 2021; 152:663-670. [PMID: 34888674 PMCID: PMC8891176 DOI: 10.1093/jn/nxab415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/06/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Approximately 10% of adolescents worldwide are overweight or obese, hence the urgent and universal need to elucidate possible mechanisms that lead to obesity in the adolescent population. OBJECTIVES We examined the hypothalamic metabolism and its relationship with physical development in obese and eutrophic adolescents. METHODS We performed a case-control study with 115 adolescents between 11 and 18 years of age, to compare obese (BMI z-score ≥ 2) and nonobese individuals (eutrophic controls; BMI z-score ≤ 1). The following hypothalamic metabolite ratios were examined as primary outcomes: glutamate/creatine (Cr), the sum of glutamate and glutamine/Cr, N-acetylaspartate (NAA)/Cr, myoinositol/Cr, and total choline/Cr (glycerophosphocholine + phosphocholine/Cr), quantified by magnetic resonance spectroscopy. BMI z-scores, pubertal status, and scores on the Yale Food Addiction Scale, the Binge Eating Scale, and the Child Depression Inventory were assessed as secondary outcomes. Pearson coefficients (r) or nonparametric Spearman correlation (rho) analyses were performed between hypothalamic metabolite ratios and other parameters, such as BMI z-scores, physical development, food habits, depression symptoms, and serum protein concentrations (cytokines, hormones, and neuropeptides). RESULTS Adolescents with obesity showed a lower hypothalamic NAA/Cr ratio (0.70 ± 0.19) compared to their eutrophic counterparts (0.84 ± 0.20; P = 0.004). The NAA/Cr ratio was negatively correlated with BMI z-scores (r = -0.25; P = 0.03) and serum insulin (rho = -0.27; P = 0.04), C-peptide (rho = -0.26; P = 0.04), amylin (r = -0.27; P = 0.04), ghrelin (rho = -0.30; P = 0.02), and neuropeptide Y (r = -0.27; P = 0.04). Also, the NAA/Cr ratio was positively correlated with circulating IL-8 levels (rho = 0.26; P = 0.04). CONCLUSIONS High BMI z-scores are associated with lower hypothalamic NAA/Cr ratios. The negative correlations found between the NAA/Cr ratio and serum cytokines, hormones, and neuropeptides suggest a broad cross-talk linking hormonal imbalances, neurohumoral alterations, and hypothalamic functions in adolescents with obesity.
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Affiliation(s)
| | | | | | | | - Pâmela Bertolazzi
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Naomi Antunes da Costa
- Neuroimaging Laboratory (LIM-21), Institute Psychiatry, University of São Paulo, São Paulo, Brazil
| | | | - Joanna Correia-Lima
- Cancer Metabolism Research Group, University of São Paulo, São Paulo, Brazil
| | | | - Marília Cerqueira Leite Seelander
- Cancer Metabolism Research Group, University of São Paulo, São Paulo, Brazil,Department of Surgery and LIM 26, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Geraldo Busatto Filho
- Neuroimaging Laboratory (LIM-21), Institute Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Cristiane Kochi
- Pediatrics Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Ricardo Riyoiti Uchida
- Mental Health Department, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
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9
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Iliou A, Vlaikou AM, Nussbaumer M, Benaki D, Mikros E, Gikas E, Filiou MD. Exploring the metabolomic profile of cerebellum after exposure to acute stress. Stress 2021; 24:952-964. [PMID: 34553679 DOI: 10.1080/10253890.2021.1973997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Psychological stress and stress-related disorders constitute a major health problem in modern societies. Although the brain circuits involved in emotional processing are intensively studied, little is known about the implication of cerebellum in stress responses whereas the molecular changes induced by stress exposure in cerebellum remain largely unexplored. Here, we investigated the effects of acute stress exposure on mouse cerebellum. We used a forced swim test (FST) paradigm as an acute stressor. We then analyzed the cerebellar metabolomic profiles of stressed (n = 11) versus control (n = 11) male CD1 mice by a Nuclear Magnetic Resonance (NMR)-based, untargeted metabolomics approach. Our results showed altered levels of 19 out of the 47 annotated metabolites, which are implicated in neurotransmission and N-acetylaspartic acid (NAA) turnover, as well as in energy and purine/pyrimidine metabolism. We also correlated individual metabolite levels with FST behavioral parameters, and reported associations between FST readouts and levels of 4 metabolites. This work indicates an altered metabolomic signature after acute stress in the cerebellum and highlights a previously unexplored involvement of cerebellum in stress responses.
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Affiliation(s)
- Aikaterini Iliou
- Department of Pharmacy, Section of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Angeliki-Maria Vlaikou
- Department of Biological Applications and Technology, Laboratory of Biochemistry, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Biomedical Research Division, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas (FORTH), Ioannina, Greece
| | - Markus Nussbaumer
- Department of Biological Applications and Technology, Laboratory of Biochemistry, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Biomedical Research Division, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas (FORTH), Ioannina, Greece
| | - Dimitra Benaki
- Department of Pharmacy, Section of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Emmanuel Mikros
- Department of Pharmacy, Section of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Evangelos Gikas
- Department of Pharmacy, Section of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens (NKUA), Athens, Greece
- Department of Chemistry, Section of Analytical Chemistry, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Michaela D Filiou
- Department of Biological Applications and Technology, Laboratory of Biochemistry, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Biomedical Research Division, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas (FORTH), Ioannina, Greece
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10
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Smesny S, Berberich D, Gussew A, Schönfeld N, Langbein K, Walther M, Reichenbach JR. Alterations of neurometabolism in the dorsolateral prefrontal cortex and thalamus in transition to psychosis patients change under treatment as usual - A two years follow-up 1H/ 31P-MR-spectroscopy study. Schizophr Res 2021; 228:7-18. [PMID: 33429152 DOI: 10.1016/j.schres.2020.11.063] [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: 09/15/2019] [Revised: 11/22/2020] [Accepted: 11/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The ultra-high risk (UHR) paradigm allows early contact with patients developing acute psychosis and the study of treatment effects on the underlying pathology. METHODS 29 patients with first acute psychosis according to CAARMS criteria (transition patients, TP) (T0) and thereof 22 patients after two-year follow-up (mean 788 d) (T1) underwent 1H-/31P-MR spectroscopy of the prefrontal (DLPFC) and anterior midcingulate (aMCC) cortices and the thalamus. N-acetylaspartate (NAA), glutamate (Glu, Glx), energy (PCr, ATP) and phospholipid metabolites (PME, PDE) were compared to 27 healthy controls by ANCOVA and correlated with patients' symptom ratings (BPRS-E, SCL-90R). For longitudinal analysis, linear mixed model (LMM) and ANCOVA for repeated measures were used. RESULTS DLPFC: In patients, NAA and PME were decreased bilaterally and Glu on the left side at T0. Left-sided Glu and NAA (trend) and bilateral Glx increased during follow-up. Thalamus: In TP, bilateral NAA, left-sided Glu and right-sided Glx were decreased at T0; bilateral NAA and left-sided Glx increased during follow-up. aMCC: In TP, bilateral NAA, right-sided Glu, and bilateral PME and PDE were decreased, while left-sided PCr was increased at T0. No changes were observed during follow-up. CONCLUSION Regardless of the long-term diagnosis, the psychotic state of illness includes disturbed neuronal function in the DLPFC, thalamus and aMCC. Treatment-as-usual (TAU), including antipsychotic/antidepressant medication and supportive psychotherapy, had an effect on the thalamo-frontal area but not or less pronounced on the neurometabolic deficits of the aMCC.
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Affiliation(s)
- Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany.
| | - Diana Berberich
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Alexander Gussew
- Department of Radiology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, D-06120 Halle (Saale), Germany
| | - Nils Schönfeld
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Mario Walther
- Jena University of Applied Sciences, Department of Fundamental Sciences, Carl-Zeiss-Promenade 2, D-07745 Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Philosophenweg 3, D-07740 Jena, Germany
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11
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Kaminski J, Mascarell-Maricic L, Fukuda Y, Katthagen T, Heinz A, Schlagenhauf F. Glutamate in the Dorsolateral Prefrontal Cortex in Patients With Schizophrenia: A Meta-analysis of 1H-Magnetic Resonance Spectroscopy Studies. Biol Psychiatry 2021; 89:270-277. [PMID: 33129486 DOI: 10.1016/j.biopsych.2020.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND To date, there is no systematic overview of glutamate in the dorsolateral prefrontal cortex (DLPFC) of patients with schizophrenia. Here, we meta-analyzed case-control studies of high-field proton magnetic resonance spectroscopy (1H-MRS) investigating glutamate in DLPFC. Additionally, we estimated variance ratios to investigate homo/heterogeneity. METHODS Preregistration of the study was performed on September 20, 2019. The predefined literature search on PubMed comprised articles with search terms (magnetic resonance spectroscopy OR MRS) AND (glutamate OR glut∗ OR GLX) AND (schizophrenia OR psychosis OR schizophren∗). Meta-analyses with a fixed- and random-effects model with inverse variance method, DerSimonian-Laird estimator for τ2, and Cohen's d were calculated. For differences in variability, we calculated a random-effects model for measures of variance ratios. The primary study outcome was the difference in glutamate in the DLPFC in cases versus controls. Secondary outcomes were differences in variability. RESULTS The quantitative analysis comprised 429 cases and 365 controls. Overall, we found no group difference (d = 0.03 [95% confidence interval (CI), -0.20 to 0.26], z = 0.28, p = .78). Sensitivity analysis revealed an effect for medication status (Q = 8.35, p = .039), i.e., increased glutamate in antipsychotic-naïve patients (d = 0.46 [95% CI, 0.08 to 0.84], z = 2.37, p = .018). Concerning variance ratios, we found an effect of medication status (Q = 16.95, p < .001) due to lower coefficient of variation ratio (CVR) in medication-naïve patients (logCVR = -0.49 [95% CI, -0.78 to -0.20], z = -3.33, p < .001). In studies with medicated patients, we found higher CVR (logCVR = 0.22 [95% CI, 0.06 to 0.39], z = 2.67; p = .008). CONCLUSIONS We carefully interpret the higher levels and lower variability in cortical glutamate in antipsychotic-naïve patients as a possible key factor resulting from a putative allostatic mechanism. We conclude that care has to be taken when evaluating metabolite levels in clinical samples in which medication might confound findings.
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Affiliation(s)
- Jakob Kaminski
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy CCM, Berlin, Germany; Berlin Institute of Health, Berlin, Germany.
| | - Lea Mascarell-Maricic
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy CCM, Berlin, Germany
| | - Yu Fukuda
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy CCM, Berlin, Germany
| | - Teresa Katthagen
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy CCM, Berlin, Germany
| | - Andreas Heinz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy CCM, Berlin, Germany; Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Florian Schlagenhauf
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy CCM, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; Bernstein Center for Computational Neuroscience, Berlin, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Science, Leipzig, Germany
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12
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Abstract
RATIONALE Proton magnetic resonance spectroscopy (1H-MRS) is a cross-species neuroimaging technique that can measure concentrations of several brain metabolites, including glutamate and GABA. This non-invasive method has promise in developing centrally acting drugs, as it can be performed repeatedly within-subjects and be used to translate findings from the preclinical to clinical laboratory using the same imaging biomarker. OBJECTIVES This review focuses on the utility of single-voxel 1H-MRS in developing novel glutamatergic or GABAergic drugs for the treatment of psychiatric disorders and includes research performed in rodent models, healthy volunteers and patient cohorts. RESULTS Overall, these studies indicate that 1H-MRS is able to detect the predicted pharmacological effects of glutamatergic or GABAergic drugs on voxel glutamate or GABA concentrations, although there is a shortage of studies examining dose-related effects. Clinical studies have applied 1H-MRS to better understand drug therapeutic mechanisms, including the glutamatergic effects of ketamine in depression and of acamprosate in alcohol dependence. There is an emerging interest in identifying patient subgroups with 'high' or 'low' brain regional 1H-MRS glutamate levels for more targeted drug development, which may require ancillary biomarkers to improve the accuracy of subgroup discrimination. CONCLUSIONS Considerations for future research include the sensitivity of single-voxel 1H-MRS in detecting drug effects, inter-site measurement reliability and the interpretation of drug-induced changes in 1H-MRS metabolites relative to the known pharmacological molecular mechanisms. On-going technological development, in single-voxel 1H-MRS and in related complementary techniques, will further support applications within CNS drug discovery.
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Affiliation(s)
- Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK.
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13
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Glutamine + glutamate level predicts the magnitude of microstructural organization in the gray matter in the healthy elderly. Int Psychogeriatr 2021; 33:21-29. [PMID: 31578159 PMCID: PMC8482373 DOI: 10.1017/s1041610219001418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI), which is a technique for measuring the degree and direction of movement of water molecules in tissue, has been widely used to noninvasively assess white matter (WM) or gray matter (GM) microstructures in vivo. Mean diffusivity (MD), which is the average diffusion across all directions, has been considered as a marker of WM tract degeneration or extracellular space enlargement in GM. Recent lines of evidence suggest that cortical MD can better identify early-stage Alzheimer's disease than structural morphometric parameters in magnetic resonance imaging. However, knowledge of the relationships between cortical MD and other biological factors in the same cortical region, e.g. metabolites, is still limited. METHODS Thirty-three healthy elderly individuals [aged 50-77 years (mean, 63.8±7.4 years); 11 males and 22 females] were enrolled. We estimated the associations between cortical MD and neurotransmitter levels. Specifically, we measured levels of γ-aminobutyric acid (GABA) and glutamate + glutamine (Glx), which are inhibitory and excitatory neurotransmitters, respectively, in medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) using MEGA-PRESS magnetic resonance spectroscopy, and we measured regional cortical MD using DTI. RESULTS Cortical MD was significantly negatively associated with Glx levels in both mPFC and PCC. No significant association was observed between cortical MD and GABA levels in either GM region. CONCLUSION Our findings suggest that degeneration of microstructural organization in GM, as determined on the basis of cortical MD measured by DTI, is accompanied by the decline of Glx metabolism within the same GM region.
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14
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Mason NL, Theunissen EL, Hutten NR, Tse DH, Toennes SW, Jansen JF, Stiers P, Ramaekers JG. Reduced responsiveness of the reward system is associated with tolerance to cannabis impairment in chronic users. Addict Biol 2021; 26:e12870. [PMID: 31865628 PMCID: PMC7757162 DOI: 10.1111/adb.12870] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 12/20/2022]
Abstract
Cannabis is the most commonly used illicit drug in the world. However, because of a changing legal landscape and rising interest in therapeutic utility, there is an increasing trend in (long‐term) use and possibly cannabis impairment. Importantly, a growing body of evidence suggests that regular cannabis users develop tolerance to the impairing, as well as the rewarding, effects of the drug. However, the neuroadaptations that may underlie cannabis tolerance remain unclear. Therefore, this double‐blind, randomized, placebo‐controlled, cross‐over study assessed the acute influence of cannabis on the brain and behavioral outcomes in two distinct cannabis user groups. Twelve occasional and 12 chronic cannabis users received acute doses of cannabis (300‐μg/kg delta‐9‐tetrahydrocannabinol) and placebo and underwent ultrahigh field functional magnetic resonance imaging and magnetic resonance spectroscopy. In occasional users, cannabis induced significant neurometabolic alterations in reward circuitry, namely, decrements in functional connectivity and increments in striatal glutamate concentrations, which were associated with increases in subjective high and decreases in performance on a sustained attention task. Such changes were absent in chronic users. The finding that cannabis altered circuitry and distorted behavior in occasional, but not chronic users, suggests reduced responsiveness of the reward circuitry to cannabis intoxication in chronic users. Taken together, the results suggest a pharmacodynamic mechanism for the development of tolerance to cannabis impairment, of which is important to understand in the context of the long‐term therapeutic use of cannabis‐based medications, as well as in the context of public health and safety of cannabis use when performing day‐to‐day operations.
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Affiliation(s)
- Natasha L. Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
| | - Eef L. Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
| | - Nadia R.P.W. Hutten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
| | - Desmond H.Y. Tse
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
| | - Stefan W. Toennes
- Institute of Legal Medicine University of Frankfurt Frankfurt/Main Germany
| | - Jacobus F.A. Jansen
- Department of Radiology and Nuclear Medicine Maastricht University Medical Center+ (MUMC+) Maastricht The Netherlands
- School for Mental Health and Neuroscience Maastricht University Medical Center Maastricht The Netherlands
| | - Peter Stiers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
| | - Johannes G. Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
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15
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Zink CF, Barker PB, Sawa A, Weinberger DR, Wang M, Quillian H, Ulrich WS, Chen Q, Jaffe AE, Kleinman JE, Hyde TM, Prettyman GE, Giegerich M, Carta K, van Ginkel M, Bigos KL. Association of Missense Mutation in FOLH1 With Decreased NAAG Levels and Impaired Working Memory Circuitry and Cognition. Am J Psychiatry 2020; 177:1129-1139. [PMID: 33256444 DOI: 10.1176/appi.ajp.2020.19111152] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Altering the metabotropic glutamate receptor 3 (mGluR3) by pharmacology or genetics is associated with differences in learning and memory in animals and humans. GRM3 (the gene coding for mGluR3) is also genome-wide associated with risk for schizophrenia. The neurotransmitter N-acetyl-aspartyl-glutamate (NAAG) is the selective endogenous agonist of mGluR3, and increasing NAAG may improve cognition. Glutamate carboxypeptidase II (GCPII), coded by the gene folate hydrolase 1 (FOLH1), regulates the amount of NAAG in the synapse. The goal of this study was to determine the relationship between FOLH1, NAAG levels, measures of human cognition, and neural activity associated with cognition. METHODS The effects of genetic variation in FOLH1 on mRNA expression in human brain and NAAG levels using 7-T magnetic resonance spectroscopy (MRS) were measured. NAAG levels and FOLH1 genetic variation were correlated with measures of cognition in subjects with psychosis and unaffected subjects. Additionally, FOLH1 genetic variation was correlated with neural activity during working memory, as measured by functional MRI (fMRI). RESULTS A missense mutation in FOLH1 (rs202676 G allele) was associated with increased FOLH1 mRNA in the dorsolateral prefrontal cortex of brains from unaffected subjects and schizophrenia patients. This FOLH1 variant was associated with decreased NAAG levels in unaffected subjects and patients with psychosis. NAAG levels were positively correlated with visual memory performance. Carriers of the FOLH1 variant associated with lower NAAG levels had lower IQ scores. Carriers of this FOLH1 variant had less efficient cortical activity during working memory. CONCLUSIONS These data show that higher NAAG levels are associated with better cognition, suggesting that increasing NAAG levels through FOLH1/GCPII inhibition may improve cognition. Additionally, NAAG levels measured by MRS and cortical efficiency during working memory measured by fMRI have the potential to be neuroimaging biomarkers for future clinical trials.
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Affiliation(s)
- Caroline F Zink
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Peter B Barker
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Akira Sawa
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Daniel R Weinberger
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Min Wang
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Henry Quillian
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - William S Ulrich
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Qiang Chen
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Andrew E Jaffe
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Joel E Kleinman
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Thomas M Hyde
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Greer E Prettyman
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Mellissa Giegerich
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Kayla Carta
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Marcus van Ginkel
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Kristin L Bigos
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
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16
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Proton Magnetic Resonance Spectroscopy of N-acetyl Aspartate in Chronic Schizophrenia, First Episode of Psychosis and High-Risk of Psychosis: A Systematic Review and Meta-Analysis. Neurosci Biobehav Rev 2020; 119:255-267. [PMID: 33068555 DOI: 10.1016/j.neubiorev.2020.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/01/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023]
Abstract
N-acetyl-aspartate (NAA) is a readily measured marker of neuronal metabolism. Previous analyses in schizophrenia have shown NAA levels are low in frontal, temporal and thalamic regions, but may be underpowered to detect effects in other regions, in high-risk states and in first episode psychosis. We searched for magnetic resonance spectroscopy studies comparing NAA in chronic schizophrenia, first episode psychosis and high risk of psychosis to controls. 182 studies were included and meta-analysed using a random-effects model for each region and illness stage. NAA levels were significantly lower than controls in the frontal lobe [Hedge's g = -0.36, p < 0.001], hippocampus [-0.52, p < 0.001], temporal lobe [-0.35, p = 0.031], thalamus [-0.32, p = 0.012] and parietal lobe [-0.25, p = 0.028] in chronic schizophrenia, and lower than controls in the frontal lobe [-0.26, p = 0.002], anterior cingulate cortex [-0.24, p = 0.016] and thalamus [-0.28, p = 0.028] in first episode psychosis. NAA was lower in high-risk of psychosis in the hippocampus [-0.20, p = 0.049]. In schizophrenia, NAA alterations appear to begin in hippocampus, frontal cortex and thalamus, and extend later to many other regions.
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17
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Candidate metabolic biomarkers for schizophrenia in CNS and periphery: Do any possible associations exist? Schizophr Res 2020; 226:95-110. [PMID: 30935700 DOI: 10.1016/j.schres.2019.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 02/07/2023]
Abstract
Due to the limitations of analytical techniques and the complicity of schizophrenia, nowadays it is still a challenge to diagnose and stratify schizophrenia patients accurately. Many attempts have been made to identify and validate available biomarkers for schizophrenia from CSF and/or peripheral blood in clinical studies with consideration to disease stages, antipsychotic effects and even gender differences. However, conflicting results handicap the validation and application of biomarkers for schizophrenia. In view of availability and feasibility, peripheral biomarkers have superior advantages over biomarkers in CNS. Meanwhile, schizophrenia is considered to be a devastating neuropsychiatric disease mainly taking place in CNS featured by widespread defects in multiple metabolic pathways whose dynamic interactions, until recently, have been difficult to difficult to investigate. Evidence for these alterations has been collected piecemeal, limiting the potential to inform our understanding of the interactions among relevant biochemical pathways. Taken these points together, it will be interesting to investigate possible associations of biomarkers between CNS and periphery. Numerous studies have suggested putative correlations within peripheral and CNS systems especially for dopaminergic and glutamatergic metabolic biomarkers. In addition, it has been demonstrated that blood concentrations of BDNF protein can also reflect its changes in the nervous system. In turn, BDNF also interacts with glutamatergic, dopaminergic and serotonergic systems. Therefore, this review will summarize metabolic biomarkers identified both in the CNS (brain tissues and CSF) and peripheral blood. Further, more attentions will be paid to discussing possible physical and functional associations between CNS and periphery, especially with respect to BDNF.
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18
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Li W, Xiang Q, Liu D, Li Y. Disrupted Coupling Between NAA and Functional Connectivity in Ventromedial Prefrontal Cortex of Drug-Naïve First-Episode Psychosis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:1738-1741. [PMID: 33018333 DOI: 10.1109/embc44109.2020.9176293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Ventromedial prefrontal cortex (vmPFC) is an important brain region involved in many psychological functions. Previous neuroimaging studies have shown disrupted function and altered metabolic level within vmPFC of schizophrenia (SCZ) patients. However, the linkage between the functional connectivity and its underlying neurobiological mechanism in SCZ remains unclear. In this study, we aimed to investigate the altered relationship between the functional connectivity strength (FCS) and metabolic concentrations within vmPFC in drug-naïve first-episode psychosis (FEP) patients using a combined functional magnetic resonance imaging (fMRI) and single-voxel proton magnetic resonance spectroscopy (1H- MRS) technique. There were 26 drug-naïve FEP patients and 27 matched healthy controls participated this study. We have found altered correlation between FCS and N-acetylaspartate (NAA) in drug-naïve FEP patients. In addition, the glutamate and glutamine compounds (Glx) and NAA concentrations were positively correlated with Positive and Negative Symptoms Scale (PANSS) total scores. Our findings revealed the disrupted functional-metabolic coupling within vmPFC in drug-naïve FEP patients and provided useful insights in understanding the etiology of SCZ.
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19
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Menshchikov P, Ivantsova A, Manzhurtsev A, Ublinskiy M, Yakovlev A, Melnikov I, Kupriyanov D, Akhadov T, Semenova N. Separate N-acetyl aspartyl glutamate, N-acetyl aspartate, aspartate, and glutamate quantification after pediatric mild traumatic brain injury in the acute phase. Magn Reson Med 2020; 84:2918-2931. [PMID: 32544309 DOI: 10.1002/mrm.28332] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/27/2020] [Accepted: 05/01/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To separately measure N-acetyl aspartul glutamate (NAAG), N-acetyl aspartate (NAA), aspartate (Asp), and glutamate (Glu) concentrations in white matter (WM) using J-editing techniques in patients with mild traumatic brain injury (mTBI) in the acute phase. METHODS Twenty-four patients with closed concussive head injury and 29 healthy volunteers were enrolled in the current study. For extended 1 H MRS examination, patients and controls were equally divided into two subgroups. In subgroup 1 (12 patients/15 controls), NAAG and NAA concentrations were measured in WM separately with MEGA-PRESS (echo time/repetition time [TE/TR] = 140/2000 ms; δ ON NAA / δ OFF NAA = 4.84/4.38 ppm, δ ON NAAG / δ OFF NAAG = 4.61/4.15 ppm). In subgroup 2 (12 patients/14 controls), Asp and Glu concentrations were acquired with MEGA-PRESS (TE/TR = 90/2000 ms; δ ON Asp / δ OFF Asp = 3.89/5.21 ppm) and TE-averaged PRESS (TE from 35 ms to 185 ms with 2.5-ms increments; TR = 2000 ms) pulse sequences, respectively. RESULTS tNAA and NAAG concentrations were found to be reduced, while NAA concentrations were unchanged, after mild mTBI. Reduced Asp and elevated myo-inositol (mI) concentrations were also found. CONCLUSION The main finding of the study is that the tNAA signal reduction in WM after mTBI is associated with a decrease in the NAAG concentration rather than a decrease in the NAA concentration, as was thought previously. This finding highlights the importance of separating these signals, at least for WM studies, to avoid misinterpretation of the results. NAAG plays an important role in selectively activating mGluR3 receptors, thus providing neuroprotective and neuroreparative functions immediately after mTBI. NAAG shows potential for the development of new therapeutic strategies for patients with injuries of varying severity.
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Affiliation(s)
- Petr Menshchikov
- Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
| | - Anna Ivantsova
- Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
| | - Andrei Manzhurtsev
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
| | - Maxim Ublinskiy
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
| | - Alexey Yakovlev
- Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
| | - Ilya Melnikov
- Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
| | | | - Tolib Akhadov
- Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
| | - Natalia Semenova
- Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation.,Clinical and Research Institute of Emergency Paediatric Surgery and Traumatology, Moscow, Russian Federation
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20
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Hippocampal Metabolite Profiles in Two Rat Models of Autism: NMR-Based Metabolomics Studies. Mol Neurobiol 2020; 57:3089-3105. [PMID: 32468248 PMCID: PMC7320041 DOI: 10.1007/s12035-020-01935-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/13/2020] [Indexed: 12/22/2022]
Abstract
Autism spectrum disorders (ASDs) are increasingly being diagnosed. Hypotheses link ASD to genetic, epigenetic, or environmental factors. The role of oxidative stress and the imbalance between excitatory and inhibitory neurotransmission in the pathogenesis of ASD has been suggested. Rats in which ASD symptoms are induced by valproate (VPA) or thalidomide (THAL) application in utero are useful models in ASD studies. Our study investigated whether rats in ASD models show changes in metabolite levels in the brain consistent with the hypothetical pathomechanisms of ASD. Female rats were fed one dose of 800 mg/kg VPA or 500 mg/kg THAL orally on the 11th day of gestation, and 1-month offspring were used for the experiments. Metabolic profiles from proton nuclear magnetic resonance spectroscopy of hydrophilic and hydrophobic extracts of rat hippocampi were subjected to OPLS-DA statistical analysis. Large differences between both models in the content of several metabolites in the rat hippocampus were noticed. The following metabolic pathways were identified as being disturbed in both ASD models: steroid hormone biosynthesis; fatty acid biosynthesis; the synthesis and degradation of ketone bodies; glycerophospholipid metabolism; cholesterol metabolism; purine metabolism; arginine and proline metabolism; valine, leucine, and isoleucine biosynthesis and degradation. These results indicate disorders of energy metabolism, altered structure of cell membranes, changes in neurotransmission, and the induction of oxidative stress in the hippocampus. Our data, consistent with hypotheses of ASD pathomechanisms, may be useful in future ASD studies, especially for the interpretation of the results of metabolomics analysis of body fluids in rat ASD models.
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21
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Kirov II, Tal A. Potential clinical impact of multiparametric quantitative MR spectroscopy in neurological disorders: A review and analysis. Magn Reson Med 2020; 83:22-44. [PMID: 31393032 PMCID: PMC6814297 DOI: 10.1002/mrm.27912] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/06/2019] [Accepted: 06/29/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Unlike conventional MR spectroscopy (MRS), which only measures metabolite concentrations, multiparametric MRS also quantifies their longitudinal (T1 ) and transverse (T2 ) relaxation times, as well as the radiofrequency transmitter inhomogeneity (B1+ ). To test whether knowledge of these additional parameters can improve the clinical utility of brain MRS, we compare the conventional and multiparametric approaches in terms of expected classification accuracy in differentiating controls from patients with neurological disorders. THEORY AND METHODS A literature review was conducted to compile metabolic concentrations and relaxation times in a wide range of neuropathologies and regions of interest. Simulations were performed to construct receiver operating characteristic curves and compute the associated areas (area under the curve) to examine the sensitivity and specificity of MRS for detecting each pathology in each region. Classification accuracy was assessed using metabolite concentrations corrected using population-averages for T1 , T2 , and B1+ (conventional MRS); using metabolite concentrations corrected using per-subject values (multiparametric MRS); and using an optimal linear multiparametric estimator comprised of the metabolites' concentrations and relaxation constants (multiparametric MRS). Additional simulations were conducted to find the minimal intra-subject precision needed for each parameter. RESULTS Compared with conventional MRS, multiparametric approaches yielded area under the curve improvements for almost all neuropathologies and regions of interest. The median area under the curve increased by 0.14 over the entire dataset, and by 0.24 over the 10 instances with the largest individual increases. CONCLUSIONS Multiparametric MRS can substantially improve the clinical utility of MRS in diagnosing and assessing brain pathology, motivating the design and use of novel multiparametric sequences.
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Affiliation(s)
- Ivan I. Kirov
- Center for Advanced Imaging Innovation and Research (CAIR), Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, Department of Radiology, 660 1 Avenue, New York, NY 10016, United States of America
| | - Assaf Tal
- Department of Chemical and Biological Physics, Weizmann Institute of Science, 234 Herzel St., Rehovot 7610001, Israel
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22
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Guerin AA, Bonomo Y, Lawrence AJ, Baune BT, Nestler EJ, Rossell SL, Kim JH. Cognition and Related Neural Findings on Methamphetamine Use Disorder: Insights and Treatment Implications From Schizophrenia Research. Front Psychiatry 2019; 10:880. [PMID: 31920743 PMCID: PMC6928591 DOI: 10.3389/fpsyt.2019.00880] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022] Open
Abstract
Despite the prevalence of methamphetamine (meth) use disorder, research on meth is disproportionately scarce compared to research on other illicit drugs. Existing evidence highlights cognitive deficits as an impediment against daily function and treatment of chronic meth use. Similar deficits are also observed in schizophrenia, and this review therefore draws on schizophrenia research by examining similarities and differences between the two disorders on cognition and related neural findings. While meth use disorder and schizophrenia are two distinct disorders, they are highly co-morbid and share impairments in similar cognitive domains and altered brain structure/function. This narrative review specifically identifies overlapping features such as deficits in learning and memory, social cognition, working memory and inhibitory/impulse control. We report that while working memory deficits are a core feature of schizophrenia, such deficits are inconsistently observed following chronic meth use. Similar structural and functional abnormalities are also observed in cortical and limbic regions between the two disorders, except for cingulate activity where differences are observed. There is growing evidence that targeting cognitive symptoms may improve functional outcome in schizophrenia, with evidence of normalized abnormal brain activity in regions associated with cognition. Considering the overlap between meth use disorder and schizophrenia, targeting cognitive symptoms in people with meth use disorder may also improve treatment outcome and daily function.
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Affiliation(s)
- Alexandre A. Guerin
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Yvonne Bonomo
- Department of Addiction Medicine, St Vincent’s Hospital, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
- Women’s Alcohol and Drug Service, Royal Women’s Hospital, Melbourne, VIC, Australia
| | - Andrew John Lawrence
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | | | - Eric J. Nestler
- Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Susan L. Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
| | - Jee Hyun Kim
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Wood PL. Targeted lipidomics and metabolomics evaluations of cortical neuronal stress in schizophrenia. Schizophr Res 2019; 212:107-112. [PMID: 31434624 DOI: 10.1016/j.schres.2019.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/02/2019] [Accepted: 08/03/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cortical neuronal dysfunction has been proposed to underlie the psychopathology and cognitive dysfunction of schizophrenia. Previously we have reported altered sphingolipid and N-acylphosphatidylserine (NAPS) metabolism in the frontal cortex in schizophrenia. We continue to expand these investigations to define the biochemical basis for these critical neuropathologies. METHODS We undertook a targeted high resolution mass spectrometric analysis to validate our previous reports of elevated sphingolipids and NAPS in the frontal cortex of a new cohort of schizophrenia subjects. Furthermore we expanded these analyses to include ceramides, N-acylphosphatidylethanolamines (NAPE), and N-acylethanolamines (NAE). In the same tissue samples we examined N-acetylaspartylglutamate (NAAG), a modulator of excitatory amino acid transmission, hypothesized to be involved in the pathology of schizophrenia. RESULTS We repeated our observations of elevated sulfatides in the frontal cortex in schizophrenia. An in-depth analysis of other sphingolipids revealed decrements in ceramide levels and increased levels of lactosylceramides. NAPS also were found to be augmented in schizophrenia as we previously reported. In addition, levels of NAPES, established biomarkers of neuronal stress, were elevated while their metabolites, NAEs were decreased. With regard to excitatory amino acid neurotransmission, NAAG levels were decreased by 50% while the metabolic precursor, N-acetylaspartate was unaltered. CONCLUSIONS Our data support the concept of cortical neuronal dysfunction in schizophrenia as indicated by altered metabolism of structural sphingolipids and NAAG, a modulator of excitatory amino acid neurotransmission.
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Affiliation(s)
- Paul L Wood
- Metabolomics Unit, College of Veterinary Medicine, Lincoln Memorial University, 6965 Cumberland Gap Pkwy., Harrogate, TN 37752, United States of America.
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Elucidating the glutamatergic processes underlying mismatch negativity deficits in early stage bipolar disorder and schizophrenia: A combined 1H-MRS and EEG study. J Psychiatr Res 2019; 113:83-89. [PMID: 30921632 DOI: 10.1016/j.jpsychires.2019.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 02/01/2019] [Accepted: 03/20/2019] [Indexed: 01/31/2023]
Abstract
Impairments in mismatch negativity (MMN) in schizophrenia are well-established; these findings have been extended to show impairments at early illness stages and in bipolar disorder. A substantial literature supports MMN as an index of NMDA receptor output, however, few studies have conducted in vivo assessments to elucidate the neurochemical underpinnings of MMN. Sixty young (16-33 years) participants with bipolar disorder (n = 47) or schizophrenia (n = 13) underwent 1H-MRS and MMN assessment. Glutamate over creatine (Glu/Cr) levels in the anterior cingulate cortex (ACC) and hippocampus were determined and MMN was measured frontally and temporally. Correlational analyses assessed the relationship between MMN amplitudes and Glu/Cr. Any significant relationships were assessed for specificity with a follow up correlation analysis of MMN and n-acetyleaspartate (NAA/Cr). No associations between frontal or temporal MMN and ACC or hippocampal Glu/Cr were noted in the bipolar group. In the schizophrenia group, frontal and right temporal MMN amplitudes corresponded with increased ACC Glu/Cr at the trend-level. Right temporal MMN was similarly significantly associated with NAA/Cr. MMN was not associated with hippocampal Glu/Cr. This work provides in vivo evidence that glutamatergic processes may underlie MMN generation in early stage schizophrenia but not in early stage bipolar disorder suggesting differences in the MMN mechanism in these groups. The negative association between ACC Glu/Cr and MMN is consistent with findings of reduced MMN and increased in vivo glutamatergic neurometabolite levels in early stage schizophrenia. Furthermore, these results indicate that examining in vivo NAA/Cr may have provide additional insights into the MMN mechanism in schizophrenia.
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Hollinger KR, Alt J, Rais R, Kaplin AI, Slusher BS. The NAAG’ing Concerns of Modeling Human Alzheimer’s Disease in Mice. J Alzheimers Dis 2019; 68:939-945. [DOI: 10.3233/jad-181251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Kristen R. Hollinger
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA
| | - Jesse Alt
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA
| | - Rana Rais
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA
| | - Adam I. Kaplin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Barbara S. Slusher
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Drug Discovery, Johns Hopkins University, Baltimore, MD, USA
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26
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Goryunova AV, Shevchenko YS, Goryunov AV. Cogitum in children's neurology and psychiatry (experience in the practical use). Zh Nevrol Psikhiatr Im S S Korsakova 2019. [DOI: 10.17116/jnevro201911907258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Wang X, Zhao J, Hu Y, Jiao Z, Lu Y, Ding M, Kou Y, Li B, Meng F, Zhao H, Li H, Li W, Yang Y, Lv L. Sodium nitroprusside treatment for psychotic symptoms and cognitive deficits of schizophrenia: A randomized, double-blind, placebo-controlled trial. Psychiatry Res 2018; 269:271-277. [PMID: 30170285 DOI: 10.1016/j.psychres.2018.08.079] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 07/07/2018] [Accepted: 08/19/2018] [Indexed: 11/24/2022]
Abstract
Schizophrenia presents with a broad range of negative, positive, and cognitive symptoms, and comprehensive treatment is still a challenge. Sodium nitroprusside (SNP) has been reported to rapidly reduce psychotic symptoms and improve cognitive functions in patients with schizophrenia, providing a new possible direction for treatment. In this study, we tested whether SNP can improve psychotic symptoms and cognitive function in schizophrenia patients with longer disease history. This was a randomized, double-blind, placebo-controlled trial conducted between May 2016 and April 2017. Forty-two schizophrenia patients aged 18-45 years were recruited from Henan Province Mental Hospital. Baseline psychiatric symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), and baseline cognitive functions were measured using the Wechsler Adult Intelligence Scale. Patients received two SNP or placebo infusions (0.5 μg/kg per min for 4 h) at a one-week interval. We reassessed psychiatric symptoms and cognitive functions using the same tests shortly after the first and second infusions and 4 weeks after the second infusion. We did not find any significant effect of SNP over placebo on psychotic symptoms or cognitive functions, although SNP was relatively well tolerated with a good safety profile.
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Affiliation(s)
- Xiujuan Wang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Jingyuan Zhao
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - YunQing Hu
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Zhiqiang Jiao
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yanli Lu
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Minli Ding
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yanna Kou
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Benliang Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Fancui Meng
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Hongzu Zhao
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Hong Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Wenqiang Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China.
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Thomas EH, Bozaoglu K, Rossell SL, Gurvich C. The influence of the glutamatergic system on cognition in schizophrenia: A systematic review. Neurosci Biobehav Rev 2017; 77:369-387. [DOI: 10.1016/j.neubiorev.2017.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/24/2017] [Accepted: 04/06/2017] [Indexed: 12/22/2022]
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Schubert F, Kühn S, Gallinat J, Mekle R, Ittermann B. Towards a neurochemical profile of the amygdala using short-TE 1 H magnetic resonance spectroscopy at 3 T. NMR IN BIOMEDICINE 2017; 30:e3685. [PMID: 28058747 DOI: 10.1002/nbm.3685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 10/21/2016] [Accepted: 11/18/2016] [Indexed: 06/06/2023]
Abstract
The amygdala plays a key role in emotional learning and in the processing of emotions. As disturbed amygdala function has been linked to several psychiatric conditions, a knowledge of its biochemistry, especially neurotransmitter levels, is highly desirable. The spin echo full intensity acquired localized (SPECIAL) sequence, together with a transmit/receive coil, was used to perform very short-TE magnetic resonance spectroscopy at 3 T to determine the neurochemical profile in a spectroscopic voxel containing the amygdala in 21 healthy adult subjects. For spectral analysis, advanced data processing was applied in combination with a macromolecule baseline measured in the anterior cingulate for spectral fitting. The concentrations of total N-acetylaspartate, total creatine, total choline, myo-inositol and, for the first time, glutamate were quantified with high reliability (uncertainties far below 10%). For these metabolites, the inter-individual variability, reflected by the relative standard deviations for the cohort studied, varied between 12% (glutamate) and 22% (myo-inositol). Glutamine and glutathione could also be determined, albeit with lower precision. Retest on four subjects showed good reproducibility. The devised method allows the determination of metabolite concentrations in the amygdala voxel, including glutamate, provides an estimation of glutamine and glutathione, and may help in the study of disturbed amygdala metabolism in pathologies such as anxiety disorder, autism and major depression.
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Affiliation(s)
- Florian Schubert
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Simone Kühn
- Max Planck Institute for Human Development, Center for Lifespan Psychology, Berlin, Germany
- Universitätsklinikum Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
| | - Jürgen Gallinat
- Universitätsklinikum Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
| | - Ralf Mekle
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
- Charité-Universitätsmedizin Berlin, Center for Stroke Research Berlin (CSB), Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
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30
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Combination of volume and perfusion parameters reveals different types of grey matter changes in schizophrenia. Sci Rep 2017; 7:435. [PMID: 28348393 PMCID: PMC5428274 DOI: 10.1038/s41598-017-00352-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/22/2017] [Indexed: 01/10/2023] Open
Abstract
Diverse brain structural and functional changes have been reported in schizophrenia. Identifying different types of brain changes may help to understand the neural mechanisms and to develop reliable biomarkers in schizophrenia. We aimed to categorize different grey matter changes in schizophrenia based on grey matter volume (GMV) and cerebral blood flow (CBF). Structural and perfusion magnetic resonance imaging data were acquired in 100 schizophrenia patients and 95 healthy comparison subjects. Voxel-based GMV comparison was used to show structural changes, CBF analysis was used to demonstrate functional changes. We identified three types of grey matter changes in schizophrenia: structural and functional impairments in the anterior cingulate cortex and insular cortex, displaying reduction in both GMV and CBF; structural impairment with preserved function in the frontal and temporal cortices, demonstrating decreased GMV with normal CBF; pure functional abnormality in the anterior cingulate cortex and lateral prefrontal cortex and putamen, showing altered CBF with normal GMV. By combination of GMV and CBF, we identified three types of grey matter changes in schizophrenia. These findings may help to understand the complex manifestations and to develop reliable biomarkers in schizophrenia.
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31
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7T Proton Magnetic Resonance Spectroscopy of Gamma-Aminobutyric Acid, Glutamate, and Glutamine Reveals Altered Concentrations in Patients With Schizophrenia and Healthy Siblings. Biol Psychiatry 2017; 81:525-535. [PMID: 27316853 DOI: 10.1016/j.biopsych.2016.04.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 04/08/2016] [Accepted: 04/11/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND The N-methyl-D-aspartate receptor hypofunction model of schizophrenia predicts dysfunction in both glutamatergic and gamma-aminobutyric acidergic (GABAergic) transmission. We addressed this hypothesis by measuring GABA, glutamate, glutamine, and the sum of glutamine plus glutamate concentrations in vivo in patients with schizophrenia using proton magnetic resonance spectroscopy at 7T, which allows separation of metabolites that would otherwise overlap at lower field strengths. In addition, we investigated whether altered levels of GABA, glutamate, glutamine, and the sum of glutamine plus glutamate reflect genetic vulnerability to schizophrenia by including healthy first-degree relatives. METHODS Proton magnetic resonance spectroscopy at 7T was performed in 21 patients with chronic schizophrenia who were taking medication, 23 healthy first-degree relatives of patients with schizophrenia, and 24 healthy nonrelatives. Glutamate, glutamine, and GABA were measured cortically and subcortically in bilateral basal ganglia and occipital cortex. RESULTS Patients with schizophrenia had reduced cortical GABA compared with healthy relatives and the combined sample of healthy relatives and healthy nonrelatives, suggesting that altered GABAergic systems in schizophrenia are associated with either disease state or medication effects. Reduced cortical glutamine relative to healthy control subjects was observed in patients with schizophrenia and the combined sample of healthy relatives and patients with schizophrenia, suggesting that altered glutamatergic metabolite levels are associated with illness liability. No group differences were found in the basal ganglia. CONCLUSIONS Taken together, these findings are consistent with alterations in GABAergic and glutamatergic systems in patients with schizophrenia and provide novel insights into these systems in healthy relatives.
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Ward SE, Beswick P, Calcinaghi N, Dawson LA, Gartlon J, Graziani F, Jones DNC, Lacroix L, Selina Mok MH, Oliosi B, Pardoe J, Starr K, Woolley ML, Harries MH. Pharmacological characterization of N-[(2S)-5-(6-fluoro-3-pyridinyl)-2, 3-dihydro-1H-inden-2-yl]-2-propanesulfonamide: a novel, clinical AMPA receptor positive allosteric modulator. Br J Pharmacol 2017; 174:370-385. [PMID: 28009436 DOI: 10.1111/bph.13696] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/28/2016] [Accepted: 12/11/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE AMPA receptor positive allosteric modulators represent a potential therapeutic strategy to improve cognition in people with schizophrenia. These studies collectively constitute the preclinical pharmacology data package used to build confidence in the pharmacology of this molecule and enable a clinical trial application. EXPERIMENTAL APPROACH [N-[(2S)-5-(6-fluoro-3-pyridinyl)-2,3-dihydro 1H-inden-2-yl]-2-propanesulfonamide] (UoS12258) was profiled in a number of in vitro and in vivo studies to highlight its suitability as a novel therapeutic agent. KEY RESULTS We demonstrated that UoS12258 is a selective, positive allosteric modulator of the AMPA receptor. At rat native hetero-oligomeric AMPA receptors, UoS12258 displayed a minimum effective concentration of approximately 10 nM in vitro and enhanced AMPA receptor-mediated synaptic transmission at an estimated free brain concentration of approximately 15 nM in vivo. UoS12258 reversed a delay-induced deficit in novel object recognition in rats after both acute and sub-chronic dosing. Sub-chronic dosing reduced the minimum effective dose from 0.3 to 0.03 mg·kg-1 . UoS12258 was also effective at improving performance in two other cognition models, passive avoidance in scopolamine-impaired rats and water maze learning and retention in aged rats. In side-effect profiling studies, UoS12258 did not produce significant changes in the maximal electroshock threshold test at doses below 10 mg·kg-1 . CONCLUSION AND IMPLICATIONS We conclude that UoS12258 is a potent and selective AMPA receptor modulator exhibiting cognition enhancing properties in several rat behavioural models superior to other molecules that have previously entered clinical evaluation.
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Affiliation(s)
- Simon E Ward
- University of Sussex, Brighton, UK.,Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | | | - Novella Calcinaghi
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline Medicines Research Centre, Verona, Italy
| | - Lee A Dawson
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | - Jane Gartlon
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | - Francesca Graziani
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline Medicines Research Centre, Verona, Italy
| | - Declan N C Jones
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | - Laurent Lacroix
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK.,Health Sciences Research Center, Whiteland's College, University of Roehampton, London, UK
| | - M H Selina Mok
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | - Beatrice Oliosi
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline Medicines Research Centre, Verona, Italy
| | - Joanne Pardoe
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | - Kathryn Starr
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | - Marie L Woolley
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
| | - Mark H Harries
- Neurosciences Centre of Excellence for Drug Discovery, GlaxoSmithKline, Harlow, UK
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Miscevic F, Foong J, Schmitt B, Blaser S, Brudno M, Schulze A. An MRspec database query and visualization engine with applications as a clinical diagnostic and research tool. Mol Genet Metab 2016; 119:300-306. [PMID: 27847299 DOI: 10.1016/j.ymgme.2016.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Proton magnetic resonance spectroscopy (MRspec), one of the very few techniques for in vivo assessment of neuro-metabolic profiles, is often complicated by lack of standard population norms and paucity of computational tools. METHODS 7035 scans and clinical information from 4430 pediatric patients were collected from 2008 to 2014. Scans were conducted using a 1.5T (n=3664) or 3T scanner (n=3371), and with either a long (144ms, n=5559) or short echo time (35ms, n=1476). 3055 of these scans were localized in the basal ganglia (BG), 1211 in parieto-occipital white matter (WM). 34 metabolites were quantified using LCModel. A web application using MySQL, Python and Flask was developed to facilitate the exploration of the data set. RESULTS Already piloting the application revealed numerous insights. (1), N-acetylaspartate (NAA) increased throughout all ages. During early infancy, total choline was highly varied and myo-inositol demonstrated a downward trend. (2), Total creatine (tCr) and creatine increased throughout childhood and adolescence, though phosphocreatine (PCr) remained constant beyond 200days. (3), tCr was higher in BG than WM. (4), No obvious gender-related differences were observed. (5), Field strength affects quantification using LCModel for some metabolites, most prominently for tCr and total NAA. (6), Outlier analysis identified patients treated with vigabatrin through elevated γ-aminobutyrate, and patients with Klippel-Feil syndrome, Leigh disease and L2-hydroxyglutaric aciduria through low choline in BG. CONCLUSIONS We have established the largest MRSpec database and developed a robust and flexible computational tool for facilitating the exploration of vast metabolite datasets that proved its value for discovering neurochemical trends for clinical diagnosis, treatment monitoring, and research. Open access will lead to its widespread use, improving the diagnostic yield and contributing to better understanding of metabolic processes and conditions in the brain.
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Affiliation(s)
- Filip Miscevic
- Centre for Computational Medicine, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, Canada; Department of Computer Science, University of Toronto, Toronto, Canada
| | - Justin Foong
- Centre for Computational Medicine, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Benjamin Schmitt
- Department of Paediatrics, University of Toronto, Toronto, Canada; Siemens Healthcare, Sydney, Australia; Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Susan Blaser
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Michael Brudno
- Centre for Computational Medicine, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, Canada; Department of Computer Science, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Andreas Schulze
- Department of Paediatrics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, Canada; Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada.
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Xu H, Zhang H, Zhang J, Huang Q, Shen Z, Wu R. Evaluation of neuron-glia integrity by in vivo proton magnetic resonance spectroscopy: Implications for psychiatric disorders. Neurosci Biobehav Rev 2016; 71:563-577. [PMID: 27702600 DOI: 10.1016/j.neubiorev.2016.09.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 09/18/2016] [Accepted: 09/26/2016] [Indexed: 02/05/2023]
Abstract
Proton magnetic resonance spectroscopy (1H-MRS) has been widely applied in human studies. There is now a large literature describing findings of brain MRS studies with mental disorder patients including schizophrenia, bipolar disorder, major depressive disorder, and anxiety disorders. However, the findings are mixed and cannot be reconciled by any of the existing interpretations. Here we proposed the new theory of neuron-glia integrity to explain the findings of brain 1H-MRS stuies. It proposed the neurochemical correlates of neuron-astrocyte integrity and axon-myelin integrity on the basis of update of neurobiological knowledge about neuron-glia communication and of experimental MRS evidence for impairments in neuron-glia integrity from the authors and the other investigators. Following the neuron-glia integrity theories, this review collected evidence showing that glutamate/glutamine change is a good marker for impaired neuron-astrocyte integrity and that changes in N-acetylaspartate and lipid precursors reflect impaired myelination. Moreover, this new theory enables us to explain the differences between MRS findings in neuropsychiatric and neurodegenerative disorders.
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Affiliation(s)
- Haiyun Xu
- The Mental Health Center, Shantou University Medical College, China.
| | - Handi Zhang
- The Mental Health Center, Shantou University Medical College, China
| | - Jie Zhang
- The Mental Health Center, Shantou University Medical College, China
| | - Qingjun Huang
- The Mental Health Center, Shantou University Medical College, China
| | - Zhiwei Shen
- The Department of Radiology, the second affiliated hospital, Shantou University Medical College, China
| | - Renhua Wu
- The Department of Radiology, the second affiliated hospital, Shantou University Medical College, China
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Yoo CH, Song KH, Lim SI, Lee DW, Woo DC, Choe BY. Effects of repeated dizocilpine treatment on glutamatergic activity in the prefrontal cortex in an animal model of schizophrenia: An in vivo proton magnetic resonance spectroscopy study at 9.4T. Neurosci Lett 2016; 637:57-63. [PMID: 27894920 DOI: 10.1016/j.neulet.2016.11.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 11/24/2016] [Accepted: 11/24/2016] [Indexed: 12/30/2022]
Abstract
Repeated exposure to dizocilpine (MK-801) can be used as a model of schizophrenia that incorporates disease progression. Proton magnetic resonance spectroscopy (1H MRS) has been widely used to investigate schizophrenia-related alterations in glutamate (Glu). The purpose of this study was to investigate metabolic alterations in the prefrontal cortex (PFC) in an animal model of schizophrenia by using in vivo 1H MRS. Because of the spectral overlap of Glu and glutamine (Gln), high-field 1H MRS with short echo time (TE) was used. A point-resolved spectroscopy sequence was used to measure the levels of Glu and Gln, and the brain metabolites in a volume of interest (22.5μL) located in the PFC region of rats (n=13) before and after 6days of MK-801 (0.5mg/kg) treatment. Analysis of the spectra showed that the cross-contamination of Glu and Gln can be considered to comparably low. No metabolic parameters were altered (p>0.05). However, differences in Glu and N-acetylaspartate (NAA) levels between two times were significantly correlated (p<0.01). The results showed both decreased (in 6 of the 13 rats) and increased (7 of the 13 rats) levels of Glu and NAA, which suggested that these opposite metabolic alterations reflect two stage of disease progression. The results suggest that high-field and short TE in vivo 1H MRS can quantify Glu and Gln with reliably low level of cross-contamination and that repeated exposure to MK-801 induces the progressive development of schizophrenia.
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Affiliation(s)
- Chi-Hyeon Yoo
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Kyu-Ho Song
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea
| | - Song-I Lim
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Do-Wan Lee
- Ehwa Brain Institute, Ehwa Womans University, Seoul, Republic of Korea
| | - Dong-Cheol Woo
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Bo-Young Choe
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea.
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Bernier D, Bartha R, McAllindon D, Hanstock CC, Marchand Y, Dillen KNH, Gallant M, Good KP, Tibbo PG. Illness versus substance use effects on the frontal white matter in early phase schizophrenia: A 4Tesla (1)H-MRS study. Schizophr Res 2016; 175:4-11. [PMID: 27161760 DOI: 10.1016/j.schres.2016.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Young adults with early phase schizophrenia often report a past or current pattern of illicit substance use and/or alcohol misuse. Still, little is known about the cumulative and separate effects of each stressor on white matter tissue, at this vulnerable period of brain development. METHODS Participants involved 24 healthy controls with a past or current history of sustained illicit drug use and/or alcohol misuse (users), 23 healthy controls without such history (normative data), and 27 users with early phase schizophrenia. (1)H-MRS data were acquired from a large frontal volume encompassing 95% of white matter, using a 4Tesla scanner (LASER sequence, TR/TE 3200/46ms). RESULTS Reduced levels of choline-containing compounds (Cho) were specific to the effect of illness (Cohen's d=0.68), with 22% of the variance in Cho levels accounted for by duration of illness. Reduced levels of myoInositol (d=1.10) and creatine plus phosphocreatine (d=1.07) were specific to the effects of illness plus substance use. Effect of substance use on its own was revealed by reductions in levels of glutamate plus glutamine (d=0.83) in control users relative to normative data. CONCLUSIONS The specific effect of illness on white matter might indicate a decreased synthesis of membrane phospholipids or alternatively, reduced membrane cellular density. In terms of limitations, this study did not include patients without a lifetime history of substance use (non-users), and the specific effect of each substance used could not be studied separately.
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Affiliation(s)
- Denise Bernier
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Robert Bartha
- Robarts Research Institute, University of Western Ontario, Ontario, Canada
| | - David McAllindon
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada; Biomedical Translational Imaging Centre, Halifax, Nova Scotia, Canada
| | | | - Yannick Marchand
- Faculty of Computer Science, Department of Psychology and Neuroscience, Dalhousie University, Nova Scotia, Canada
| | - Kim N H Dillen
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Michelle Gallant
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Kimberly P Good
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada.
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Still NAAG’ing After All These Years. NEUROPSYCHOPHARMACOLOGY: A TRIBUTE TO JOSEPH T. COYLE 2016; 76:215-55. [DOI: 10.1016/bs.apha.2016.01.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Comparison of Metabolite Concentrations in the Left Dorsolateral Prefrontal Cortex, the Left Frontal White Matter, and the Left Hippocampus in Patients in Stable Schizophrenia Treated with Antipsychotics with or without Antidepressants. ¹H-NMR Spectroscopy Study. Int J Mol Sci 2015; 16:24387-402. [PMID: 26501256 PMCID: PMC4632756 DOI: 10.3390/ijms161024387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/15/2015] [Accepted: 09/15/2015] [Indexed: 02/01/2023] Open
Abstract
Managing affective, negative, and cognitive symptoms remains the most difficult therapeutic problem in stable phase of schizophrenia. Efforts include administration of antidepressants. Drugs effects on brain metabolic parameters can be evaluated by means of proton nuclear magnetic resonance (¹H-NMR) spectroscopy. We compared spectroscopic parameters in the left prefrontal cortex (DLPFC), the left frontal white matter (WM) and the left hippocampus and assessed the relationship between treatment and the spectroscopic parameters in both groups. We recruited 25 patients diagnosed with schizophrenia (DSM-IV-TR), with dominant negative symptoms and in stable clinical condition, who were treated with antipsychotic and antidepressive medication for minimum of three months. A group of 25 patients with schizophrenia, who were taking antipsychotic drugs but not antidepressants, was matched. We compared metabolic parameters (N-acetylaspartate (NAA), myo-inositol (mI), glutamatergic parameters (Glx), choline (Cho), and creatine (Cr)) between the two groups. All patients were also assessed with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). In patients receiving antidepressants we observed significantly higher NAA/Cr and NAA/Cho ratios within the DLPFC, as well as significantly higher mI/Cr within the frontal WM. Moreover, we noted significantly lower values of parameters associated with the glutamatergic transmission--Glx/Cr and Glx/Cho in the hippocampus. Doses of antipsychotic drugs in the group treated with antidepressants were also significantly lower in the patients showing similar severity of psychopathology.
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Roberts RC, Barksdale KA, Roche JK, Lahti AC. Decreased synaptic and mitochondrial density in the postmortem anterior cingulate cortex in schizophrenia. Schizophr Res 2015; 168:543-53. [PMID: 26210550 PMCID: PMC4591176 DOI: 10.1016/j.schres.2015.07.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 07/07/2015] [Accepted: 07/10/2015] [Indexed: 12/24/2022]
Abstract
Schizophrenia (SZ) is a mental illness characterized by psychosis, negative symptoms, and cognitive deficits. The anterior cingulate cortex (ACC), a structurally and functionally diverse region, is one of several brain regions that is abnormal in SZ. The present study compared synaptic organization and mitochondrial number and morphology in postmortem ACC in SZ versus normal control (NC). Total synaptic density in the combined ACC was decreased in SZ, to 72% of normal controls (NCs), due to selective decreases in axospinous synapses, both asymmetric (excitatory) and symmetric (inhibitory). These changes were present in layers 3 and 5/6. The density of mitochondria in all axon terminals combined in SZ was decreased to 64% of NC. In layer 3, mitochondrial density was decreased only in terminals forming asymmetric synapses with spines, while in layers 5/6 mitochondrial density was decreased in terminals forming symmetric synapses with spines and dendrites. The proportion of terminals making symmetric synapses that contained mitochondria was significantly lower in SZ than in NCs, especially for symmetric axospinous synapses. The number of mitochondria per neuronal somata was decreased in the ACC in SZ compared to NCs; this finding was present in layers 5-6. The size of mitochondria in neuronal somata and throughout the neuropil was similar in SZ and NCs. Our results, though preliminary, are well supported by the literature, and support an anatomical substrate for some of the altered executive functions found in SZ.
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Affiliation(s)
- R C Roberts
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States.
| | - K A Barksdale
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States
| | - J K Roche
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States
| | - A C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL 35294, United States
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Kinoshita K, Arai K, Kawaura K, Hiyoshi T, Yamaguchi JI. Development, validation, and application of a surrogate analyte method for determining N-acetyl-l-aspartyl-l-glutamic acid levels in rat brain, plasma, and cerebrospinal fluid. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 1003:1-11. [DOI: 10.1016/j.jchromb.2015.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/04/2015] [Accepted: 09/05/2015] [Indexed: 01/10/2023]
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McClay JL, Vunck SA, Batman AM, Crowley JJ, Vann RE, Beardsley PM, van den Oord EJ. Neurochemical Metabolomics Reveals Disruption to Sphingolipid Metabolism Following Chronic Haloperidol Administration. J Neuroimmune Pharmacol 2015; 10:425-34. [PMID: 25850894 DOI: 10.1007/s11481-015-9605-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
Haloperidol is an effective antipsychotic drug for treatment of schizophrenia, but prolonged use can lead to debilitating side effects. To better understand the effects of long-term administration, we measured global metabolic changes in mouse brain following 3 mg/kg/day haloperidol for 28 days. These conditions lead to movement-related side effects in mice akin to those observed in patients after prolonged use. Brain tissue was collected following microwave tissue fixation to arrest metabolism and extracted metabolites were assessed using both liquid and gas chromatography mass spectrometry (MS). Over 300 unique compounds were identified across MS platforms. Haloperidol was found to be present in all test samples and not in controls, indicating experimental validity. Twenty-one compounds differed significantly between test and control groups at the p < 0.05 level. Top compounds were robust to analytical method, also being identified via partial least squares discriminant analysis. Four compounds (sphinganine, N-acetylornithine, leucine and adenosine diphosphate) survived correction for multiple testing in a non-parametric analysis using false discovery rate threshold < 0.1. Pathway analysis of nominally significant compounds (p < 0.05) revealed significant findings for sphingolipid metabolism (p = 0.015) and protein biosynthesis (p = 0.024). Altered sphingolipid metabolism is suggestive of disruptions to myelin. This interpretation is supported by our observation of elevated N-acetyl-aspartyl-glutamate in the haloperidol-treated mice (p = 0.004), a marker previously associated with demyelination. This study further demonstrates the utility of murine neurochemical metabolomics as a method to advance understanding of CNS drug effects.
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Affiliation(s)
- Joseph L McClay
- Center for Biomarker Research and Personalized Medicine, Virginia Commonwealth University, McGuire Hall, 1112 East Clay Street, Richmond, VA, 23298, USA,
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Wijtenburg SA, Yang S, Fischer BA, Rowland LM. In vivo assessment of neurotransmitters and modulators with magnetic resonance spectroscopy: application to schizophrenia. Neurosci Biobehav Rev 2015; 51:276-95. [PMID: 25614132 PMCID: PMC4427237 DOI: 10.1016/j.neubiorev.2015.01.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 01/02/2015] [Accepted: 01/08/2015] [Indexed: 12/28/2022]
Abstract
In vivo measurement of neurotransmitters and modulators is now feasible with advanced proton magnetic resonance spectroscopy ((1)H MRS) techniques. This review provides a basic tutorial of MRS, describes the methods available to measure brain glutamate, glutamine, γ-aminobutyric acid, glutathione, N-acetylaspartylglutamate, glycine, and serine at magnetic field strengths of 3T or higher, and summarizes the neurochemical findings in schizophrenia. Overall, (1)H MRS holds great promise for producing biomarkers that can serve as treatment targets, prediction of disease onset, or illness exacerbation in schizophrenia and other brain diseases.
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Affiliation(s)
- S Andrea Wijtenburg
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD 21228, USA.
| | - Shaolin Yang
- Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor Street, Suite 512, Chicago, IL 60612, USA; Department of Radiology, University of Illinois at Chicago, 1601 W. Taylor Street, Suite 512, Chicago, IL 60612, USA; Department of Bioengineering, University of Illinois at Chicago, 1601 W. Taylor Street, Suite 512, Chicago, IL 60612, USA
| | - Bernard A Fischer
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD 21228, USA; Veterans Affairs Capital Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, 10 N. Greene Street, Baltimore, MD 21201, USA
| | - Laura M Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD 21228, USA; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA; Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21228, USA
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Baymeeva NV, Miroshnichenko II. N-acetylaspartate is a biomarker of psychiatric and neurological disorders. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:94-98. [DOI: 10.17116/jnevro20151158194-98] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Brand SJ, Moller M, Harvey BH. A Review of Biomarkers in Mood and Psychotic Disorders: A Dissection of Clinical vs. Preclinical Correlates. Curr Neuropharmacol 2015; 13:324-68. [PMID: 26411964 PMCID: PMC4812797 DOI: 10.2174/1570159x13666150307004545] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 02/04/2015] [Accepted: 03/06/2015] [Indexed: 11/23/2022] Open
Abstract
Despite significant research efforts aimed at understanding the neurobiological underpinnings of mood (depression, bipolar disorder) and psychotic disorders, the diagnosis and evaluation of treatment of these disorders are still based solely on relatively subjective assessment of symptoms as well as psychometric evaluations. Therefore, biological markers aimed at improving the current classification of psychotic and mood-related disorders, and that will enable patients to be stratified on a biological basis into more homogeneous clinically distinct subgroups, are urgently needed. The attainment of this goal can be facilitated by identifying biomarkers that accurately reflect pathophysiologic processes in these disorders. This review postulates that the field of psychotic and mood disorder research has advanced sufficiently to develop biochemical hypotheses of the etiopathology of the particular illness and to target the same for more effective disease modifying therapy. This implies that a "one-size fits all" paradigm in the treatment of psychotic and mood disorders is not a viable approach, but that a customized regime based on individual biological abnormalities would pave the way forward to more effective treatment. In reviewing the clinical and preclinical literature, this paper discusses the most highly regarded pathophysiologic processes in mood and psychotic disorders, thereby providing a scaffold for the selection of suitable biomarkers for future studies in this field, to develope biomarker panels, as well as to improve diagnosis and to customize treatment regimens for better therapeutic outcomes.
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Affiliation(s)
| | | | - Brian H Harvey
- Division of Pharmacology and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University, Potchefstroom, South Africa.
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An L, Li S, Wood ET, Reich DS, Shen J. N-acetyl-aspartyl-glutamate detection in the human brain at 7 Tesla by echo time optimization and improved Wiener filtering. Magn Reson Med 2014; 72:903-12. [PMID: 24243344 PMCID: PMC4020995 DOI: 10.1002/mrm.25007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 09/27/2013] [Accepted: 09/30/2013] [Indexed: 11/09/2022]
Abstract
PURPOSE To report enhanced signal detection for measuring N-acetyl-aspartyl-glutamate (NAAG) in the human brain at 7 Tesla by echo time (TE) -optimized point-resolved spectroscopy (PRESS) and improved Wiener filtering. METHODS Using a highly efficient in-house developed numerical simulation program, a PRESS sequence with (TE1 , TE2 ) = (26, 72) ms was found to maximize the NAAG signals relative to the overlapping Glu signals. A new Wiener filtering water reference deconvolution method was developed to reduce broadening and distortions of metabolite peaks caused by B0 inhomogeneity and eddy currents. RESULTS Monte Carlo simulation results demonstrated that the new Wiener filtering method offered higher spectral resolution, reduced spectral artifacts, and higher accuracy in NAAG quantification compared with the original Wiener filtering method. In vivo spectra and point spread functions of signal distortion confirmed that the new Wiener filtering method lead to improved spectral resolution and reduced spectral artifacts. CONCLUSION TE-optimized PRESS in combination with a new Wiener filtering method made it possible to fully use both the NAAG singlet signal at 2.05 ppm and the NAAG multiplet signal at 2.18 ppm in the quantification of NAAG. A more accurate characterization of lineshape distortion for Wiener filtering needs B0 field maps and segmented anatomical images to exclude contribution from cerebral spinal fluid.
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Affiliation(s)
- Li An
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Shizhe Li
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Emily T Wood
- NeuroImmunology Branch (NINDS), National Institutes of Health, Bethesda, MD
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Daniel S Reich
- NeuroImmunology Branch (NINDS), National Institutes of Health, Bethesda, MD
| | - Jun Shen
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD
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Xuan Y, Yan G, Peng H, Wu R, Xu H. Concurrent changes in ¹H MRS metabolites and antioxidant enzymes in the brain of C57BL/6 mouse short-termly exposed to cuprizone: possible implications for schizophrenia. Neurochem Int 2014; 69:20-7. [PMID: 24613425 DOI: 10.1016/j.neuint.2014.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 02/13/2014] [Accepted: 02/20/2014] [Indexed: 02/05/2023]
Abstract
Cuprizone (CPZ) is a copper chelating agent able to selectively insult mature oligodendrocytes (OLs) in brains of rodents. The CPZ-exposed mice show behavioral changes and have been employed to examine a putative role of altered OLs in the pathophysiology of schizophrenia. The aims of this study were to examine the brain metabolites in the CPZ-exposed mice during the early stage and to measure some antioxidant enzymes, lipid peroxidation and hydrogen peroxide (H2O2) in brain tissue. C57BL/6 mice were fed normal or CPZ-containing diet for 7 days. On days 7 and 8, mice were subjected to behavioral tests. On days 9 and 10, mice were subjected to (1)H MRS procedure. On day 10 mice were sacrificed and their brain tissue was processed for biochemical analyses. CPZ-exposure for 7 days caused an anxiety-like behavior, but had no effect on the social interaction and spatial working memory in C57BL/6 mice. The treatment significantly decreased levels of GPC+PCh, ml, NAA, NAA+NAAG, and PCr in the thalamus and hippocampus. It impaired the activities of some antioxidant enzymes, but did not increase levels of MDA and H2O2. This first (1)H MRS study with CPZ-exposed mice provided neurochemical evidence for mitochondrial dysfunction in brain cells of living mice during the early stage of CPZ-exposure. The results are of relevance to the pathophysiology of schizophrenia in which mitochondrial dysfunction of neural cells and altered OLs are two important players.
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Affiliation(s)
- Yinghua Xuan
- The Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Department of Anatomy, Shantou University Medical College, Shantou, Guangdong, China
| | - Gen Yan
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China
| | - Hui Peng
- Department of Anatomy, Shantou University Medical College, Shantou, Guangdong, China
| | - Renhua Wu
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China
| | - Haiyun Xu
- The Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Department of Anatomy, Shantou University Medical College, Shantou, Guangdong, China.
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Bernier D, Cookey J, McAllindon D, Bartha R, Hanstock CC, Newman AJ, Stewart SH, Tibbo PG. Multimodal neuroimaging of frontal white matter microstructure in early phase schizophrenia: the impact of early adolescent cannabis use. BMC Psychiatry 2013; 13:264. [PMID: 24131511 PMCID: PMC3852698 DOI: 10.1186/1471-244x-13-264] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 10/14/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A disturbance in connectivity between different brain regions, rather than abnormalities within the separate regions themselves, could be responsible for the clinical symptoms and cognitive dysfunctions observed in schizophrenia. White matter, which comprises axons and their myelin sheaths, provides the physical foundation for functional connectivity in the brain. Myelin sheaths are located around the axons and provide insulation through the lipid membranes of oligodendrocytes. Empirical data suggests oligodendroglial dysfunction in schizophrenia, based on findings of abnormal myelin maintenance and repair in regions of deep white matter. The aim of this in vivo neuroimaging project is to assess the impact of early adolescent onset of regular cannabis use on brain white matter tissue integrity, and to differentiate this impact from the white matter abnormalities associated with schizophrenia. The ultimate goal is to determine the liability of early adolescent use of cannabis on brain white matter, in a vulnerable brain. METHODS/DESIGN Young adults with schizophrenia at the early stage of the illness (less than 5 years since diagnosis) will be the focus of this project. Four magnetic resonance imaging measurements will be used to assess different cellular aspects of white matter: a) diffusion tensor imaging, b) localized proton magnetic resonance spectroscopy with a focus on the neurochemical N-acetylaspartate, c) the transverse relaxation time constants of regional tissue water, d) and of N-acetylaspartate. These four neuroimaging indices will be assessed within the same brain region of interest, that is, a large white matter fibre bundle located in the frontal region, the left superior longitudinal fasciculus. DISCUSSION We will expand our knowledge regarding current theoretical models of schizophrenia with a more comprehensive multimodal neuroimaging approach to studying the underlying cellular abnormalities of white matter, while taking into consideration the important confounding variable of early adolescent onset of regular cannabis use.
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Affiliation(s)
- Denise Bernier
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J, Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada.
| | - Jacob Cookey
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada
| | - David McAllindon
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, 100 Perth Drive, London N6A 5K8, Ontario, Canada
| | - Christopher C Hanstock
- Department of Biomedical Engineering, University of Alberta, 8308-114 Street, Edmonton T6G 2V2, Alberta, Canada
| | - Aaron J Newman
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
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Abstract
NAAG (N-acetylaspartylglutamate) is an abundant neuropeptide in the vertebrate nervous system. It is released from synaptic terminals in a calcium-dependent manner and has been shown to act as an agonist at the type II metabotropic glutamate receptor mGluR3. It has been proposed that NAAG may also be released from axons. So far, however, it has remained unclear how NAAG is transported into synaptic or other vesicles before it is secreted. In the present study, we demonstrate that uptake of NAAG and the related peptide NAAG2 (N-acetylaspartylglutamylglutamate) into vesicles depends on the sialic acid transporter sialin (SLC17A5). This was demonstrated using cell lines expressing a cell surface variant of sialin and by functional reconstitution of sialin in liposomes. NAAG uptake into sialin-containing proteoliposomes was detectable in the presence of an active H+-ATPase or valinomycin, indicating that transport is driven by membrane potential rather than H+ gradient. We also show that sialin is most probably the major and possibly only vesicular transporter for NAAG and NAAG2, because ATP-dependent transport of both peptides was not detectable in vesicles isolated from sialin-deficient mice.
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Schwerk A, Alves FDS, Pouwels PJW, van Amelsvoort T. Metabolic alterations associated with schizophrenia: a critical evaluation of proton magnetic resonance spectroscopy studies. J Neurochem 2013; 128:1-87. [DOI: 10.1111/jnc.12398] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 07/31/2013] [Accepted: 08/03/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Anne Schwerk
- Department of Neurology; Charité - University Medicine; Berlin Germany
| | - Fabiana D. S. Alves
- Department of Psychiatry; Academic Medical Centre; Amsterdam The Netherlands
| | - Petra J. W. Pouwels
- Department of Physics& Medical Technology; VU University Medical Centre; Amsterdam The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Psychology; Maastricht University; Maastricht The Netherlands
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Neural substrates underlying effort computation in schizophrenia. Neurosci Biobehav Rev 2013; 37:2649-65. [PMID: 24035741 DOI: 10.1016/j.neubiorev.2013.09.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/16/2013] [Accepted: 09/03/2013] [Indexed: 11/23/2022]
Abstract
The lack of initiative, drive or effort in patients with schizophrenia is linked to marked functional impairments. However, our assessment of effort and motivation is crude, relying on clinical rating scales based largely on patient recall. In order to better understand the neurobiology of effort in schizophrenia, we need more rigorous measurements of this construct. In the behavioural neuroscience literature, decades of work has been carried out developing various paradigms to examine the neural underpinnings of an animal's willingness to expend effort for a reward. Here, we shall review this literature on the nature of paradigms used in rodents to assess effort, as well as those used in humans. Next, the neurobiology of these effort-based decisions will be discussed. We shall then review what is known about effort in schizophrenia, and what might be inferred from experiments done in other human populations. Lastly, we shall discuss future directions of research that may assist in shedding light on the neurobiology of effort cost computations in schizophrenia.
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