Specific metabolites in the medial prefrontal cortex are associated with the neurocognitive deficits in schizophrenia: a preliminary study

We measured brain metabolites in the medial prefrontal cortex of 19 schizophrenic patients and 18 healthy controls by 3 T proton magnetic resonance spectroscopy ((1)H MRS), and examined the relationship between prefrontal cortex-related neurocognitive functions and brain metabolites in the medial prefrontal cortex. The patients with schizophrenia exhibited deficits on the verbal fluency, Wisconsin card sorting test (WCST), trail making test, Stroop test and digit span distraction test (DSDT), but not on the Iowa gambling test. The patients showed statistical significant changes in the ratio of glutamine/glutamate, the ratio of N-acetyl-l-aspartate (NAA)/glycerophosphorylcholine plus phosphorylcholine (GPC+PC) and the levels of taurine in the medial prefrontal cortex compared with normal controls. Furthermore, we found significant correlations of the ratio of glutamine/glutamate with WCST and DSDT scores, the ratio of NAA/(GPC+PC) with verbal fluency and WCST scores, and the levels of taurine with scores on the Stroop test and Trail making test A among the participants. The ratios of NAA/(GPC+PC) and (GPC+PC)/(Cr+PCr) had significant relationships with the duration of untreated psychosis of the schizophrenic patients. The glutamine/glutamate ratio and levels of taurine were significantly related to the duration of illness of the patients. These data suggest that specific metabolites of the medial prefrontal cortex are associated with the neurocognitive deficits in schizophrenia.

Negative correlation between brain glutathione level and negative symptoms in schizophrenia: a 3T 1H-MRS study

Background

Glutathione (GSH), a major intracellular antioxidant, plays a role in NMDA receptor-mediated neurotransmission, which is involved in the pathophysiology of schizophrenia. In the present study, we aimed to investigate whether GSH levels are altered in the posterior medial frontal cortex of schizophrenic patients. Furthermore, we examined correlations between GSH levels and clinical variables in patients.

Methods and Findings

Twenty schizophrenia patients and 16 age- and gender-matched normal controls were enrolled to examine the levels of GSH in the posterior medial frontal cortex by using 3T SIGNA EXCITE ¹H-MRS with the spectral editing technique, MEGA-PRESS. Clinical variables of patients were assessed by the Global Assessment of Functioning (GAF), Scale for the Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), Drug-Induced Extra-Pyramidal Symptoms Scale (DIEPSS), and five cognitive performance tests (Word Fluency Test, Stroop Test, Trail Making Test, Wisconsin Card Sorting Test and Digit Span Distractibility Test). Levels of GSH in the posterior medial frontal cortex of schizophrenic patients were not different from those of normal controls. However, we found a significant negative correlation between GSH levels and the severity of negative symptoms (SANS total score and negative symptom subscore on BPRS) in patients. There were no correlations between brain GSH levels and scores on any cognitive performance test except Trail Making Test part A.

Conclusion

These results suggest that GSH levels in the posterior medial frontal cortex may be related to negative symptoms in schizophrenic patients. Therefore, agents that increase GSH levels in the brain could be potential therapeutic drugs for negative symptoms in schizophrenia.

Quantitative magnetic resonance spectroscopy of schizophrenia: relationship between decreased N-acetylaspartate and frontal lobe dysfunction

Numerous studies using proton magnetic resonance spectroscopy (1H-MRS) have detected signal changes in schizophrenia. However, most studies investigated relative concentrations such as N-acetylaspartate/creatine plus phosphocreatine (NAA/Cre) and choline-containing compounds/creatine plus phosphocreatine (Cho/Cre), and individual metabolite concentrations have not been clarified. Using absolute quantification measurement of 1H-MRS, the aim of the present paper was to demonstrate the changes in metabolite concentrations in the frontal lobe of patients with chronic schizophrenia. The 1H-MRS was performed in the left frontal lobe in 14 patients with schizophrenia and in 13 healthy comparison subjects. Individual MRS peak concentration was quantified based on a frequency-domain fitting program: LCModel. The scores on the Positive and Negative Symptoms Scale and Wisconsin Card Sorting Test were used for clinical assessment. The NAA concentration was reduced in schizophrenic patients (average, 7.94 mmol/L, t=2.28, P<0.05) compared with healthy subjects (average=8.45 mmol/L) while choline, creatine or NAA/Cre ratio did not show any differences. The reduction in NAA concentration had a significant correlation with the severity of negative symptoms (r=-0.536, P<0.05) and poor performance in Wisconsin Card Sorting Test (r=-0.544, P<0.05). Using quantitative MRS, decreased NAA concentration was confirmed in the left frontal lobe of schizophrenic patients and was demonstrated to be correlated with negative symptoms and cognitive dysfunction in schizophrenia.

Development of a dielectric equivalent gel for better impedance matching for human skin

It would be useful to develop a tissue equivalent gel to improve the uniformity of the electromagnetic field in the human body, and for making a tissue equivalent dielectric human phantom. In this study, solid type, water based gelatin-honey gels were developed which have the electrical characteristics of skin tissue. It was demonstrated that a stable and homogeneous gel, with a relative dielectric constant epsilon ' chosen from desired ranges found in skin, can be made for 200-400 MHz.

Brain N-acetylaspartate is elevated in Pelizaeus-Merzbacher disease with PLP1 duplication

OBJECTIVE

To assess alterations in brain metabolites of patients with Pelizaeus-Merzbacher disease (PMD) with the proteolipid protein gene 1 (PLP1) duplications using quantitative proton MRS.

METHODS

Five unrelated male Japanese patients with PMD with PLP1 duplications were analyzed using automated proton brain examination with the point resolved spectroscopy technique (repetition and echo time of 5,000 and 30 msec). Localized spectra in the posterior portion of the centrum semiovale were acquired, and absolute metabolite concentrations were calculated using the LCModel.

RESULTS

Absolute concentrations of N-acetylaspartate (NAA), creatine (Cr), and myoinositol (MI) were increased by 16% (p < 0.01), 43% (p < 0.001), and 31% (p < 0.01) in patients with PMD as compared with age-matched controls. There was no statistical difference in choline concentration.

CONCLUSION

The increased concentration of NAA, which could not be detected by previous relative quantitation methods, suggests two possibilities: axonal involvement secondary to dysmyelination, or increased cell population of oligodendrocyte progenitors. Elevated Cr and MI concentrations may reflect the reactive astrocytic gliosis. Our study thus emphasizes the importance of absolute quantitation of metabolites to investigate the disease mechanism of the dysmyelinating disorders of the CNS.

Measurement of the electrical properties of human skin and the variation among subjects with certain skin conditions

In this study the dielectric properties are reported for human skin tissues over the frequency range 1-450 MHz at 36 degrees C. Healthy volunteers, collagen disease patients and dialysis patients are studied in order to investigate, primarily, the variability among (1) different regions of one individual, (2) the same region among different individuals and (3) skin conditions due to diseases. Considerable differences exist among the skin dielectric properties obtained from different regions of one individual body. Although region dependence is observed, larger variability is found even in the same skin region among individuals.

An asymmetric slice profile: spatial alteration of flow signal response in 3D time-of-flight NMR angiography

We introduce an asymmetric slice profile technique, which alters the spatial response of the flow signal in 3D time-of-flight NMR angiography. By gradually increasing the flip angle from the inflow to the outflow portions of the slab, the inflow refreshment effect is distributed over a wide slab thickness. The asymmetric slice profile is simply produced by using a Gaussian RF excitation with an overlapping presaturation. The spatial distribution of steady flow signal in a phantom study demonstrated an essential agreement with a numerical simulation. 3D time-of-flight NMR angiography of volunteers' heads using this technique provided a smooth vascular depiction over a wide slab thickness.

Influence of matrix size, vessel shape, vascular diameter, flow velocity, course of vessels on MR angiography

Basic experiments were done to examine the influence of the extent of curve, direction of flow, vascular diameter, velocity of flow, and course of vessels on MR angiography. In the first experiment, two phantoms were constructed of vinyl tubing, a hairpin type and one with tubes bent to varying degrees. These phantoms were imaged in two matrices, different FOV, and of various velocities with a 1.5 Tesla system. Images of a normal volunteer were also obtained. In studies of the hairpin phantoms, a low intensity artifact appeared at the curve position, and the edge became fuzzy when the flow was perpendicular to the phase encoding direction. These phenomena were more apparent with a smaller matrix, smaller FOV, more gentle angle, larger diameter, and faster flow; in other words the component along the direction was dominant. In the phantom that used bent tubes, another low intensity artifact appeared on the medial side of the outflow portion. The results obtained from the volunteer corresponded well to those from the basic experiments. It was thought that the profile of flow was not well demonstrated due to the coarse matrix. In the second experiment, water flowed at various speeds through three-dimensional phantoms that were made of vinyl tubes of various diameters and directions. The phantoms were imaged with two- and three-dimensional time of flight and phase contrast angiography. The lower limits of detection of the phase contrast method were almost the same. In the coronal plane, the lower limit decreased to 2.5 mm for arteries and 9.5 mm for veins.(ABSTRACT TRUNCATED AT 250 WORDS)

[Dynamic motion study of the cervical spine using ultra-fast gradient echo with RF-spoiled GRASS--evaluation of cervical instability]

In order to assess the instability of the cervical spine, ten patients with cervical spondylosis were studied by dynamic MRI using Ultra-Fast RF-Spoiled GRASS which is capable of subsecond imaging. Dynamic MRI has proved to be useful in the evaluation of cervical instability, especially in detecting the transient abnormal mobility of cervical spines which cannot be identified on conventional radiography.

Multiple echo SSFP sequences

We report a new type of SSFP imaging sequences for acquiring higher-order echoes. Spins excited during a cycle have, in a sense, a phase memory such that they can be refocused several cycles down the line, and since the spins are pulsed under a steady-state condition, the resulting echoes have very complicated T1 and T2 dependencies. A steady-state equation, which describes the T1 and T2 dependencies for the higher-order echoes, is presented, and the intensity of each echo is calculated and compared with the experimental results. Although the signal intensity of the higher-order echoes are weaker than the FID or the CE-FAST echo, these echoes may be used to obtain images with different contrast dependencies previously unobtainable with either of the two signals.

Time-resolved magnetic resonance angiography

A time-resolved phase contrast magnetic resonance angiography technique is described. This technique provides a series of angiograms obtained at different phases of the cardiac cycle. Such a series of angiograms can be used to evaluate blood flow dynamics. For example, turbulent flow in the regions of vessel bifurcations is easily demonstrated and followed during systole and diastole. Retrograde flow can also be observed. Dynamic angiography can be particularly useful in distinguishing transient image features, such as signal voids due to turbulent flow, from static features arising from vessel morphology.