Jayakumar Perumbava N, Gangadhar Bangalore N, Subbakrishna Doddaballapur K, Janakiramaiah Nimmagadda, Srinivas Jakka S, Keshavan Matcheri S
Department of Neuroimaging and Interventional Neuroradiology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Biol Psychiatry. 2003 Aug 15;54(4):491-4. doi: 10.1016/s0006-3223(02)01829-2.
Studies in schizophrenia using in vivo (31)P magnetic resonance spectroscopy (MRS) have mostly focused on the association cortices, including the frontal and temporal lobes. Striatum has also been implicated in schizophrenia, although neuroleptic exposure in the patients is a potential confound limiting interpretation of earlier studies. We examined membrane phospholipid abnormality in the basal ganglia using (31)P MRS in neuroleptic-naive schizophrenia patients.
Never-treated, DSM-IV schizophrenia patients (n=20) and age- and gender-matched healthy control subjects (n=30) underwent in vivo 1-D 31P MRS of both basal ganglia using an image-selected technique on a 1.5-T magnetic resonance imaging scanner. A neuroradiologist blind to clinical data measured the phosphomonoester (PME) and phosphodiester (PDE) from the spectra.
The schizophrenia patients showed significantly and bilaterally elevated levels of PME/PDE ratios in basal ganglia as compared with control subjects. There were no significant differences in the ratios between the two sides in either patient or control groups. Phosphomonoester/phosphodiester ratio did not correlate with illness duration. Lower Positive and Negative Syndrome Scale scores were associated with lower PME/PDE ratio.
The basal ganglia of never-treated schizophrenia patients show features suggestive of reduced breakdown and/or increased synthesis of membrane phospholipids. Lack of correlation between illness duration and the membrane phosphorus moiety ratio may be consistent with a nonprogressive, possibly neurodevelopmental etiopathogenesis.
利用活体（31）P磁共振波谱（MRS）对精神分裂症进行的研究大多聚焦于联合皮质，包括额叶和颞叶。纹状体也与精神分裂症有关，尽管患者接受抗精神病药物治疗是一个潜在的混杂因素，限制了对早期研究的解读。我们使用（31）P MRS对未接受过抗精神病药物治疗的精神分裂症患者的基底神经节膜磷脂异常进行了研究。
从未接受过治疗的DSM-IV精神分裂症患者（n = 20）以及年龄和性别匹配的健康对照者（n = 30），在1.5-T磁共振成像扫描仪上采用图像选择技术对双侧基底神经节进行活体一维31P MRS检查。一名对临床数据不知情的神经放射科医生从波谱中测量磷酸单酯（PME）和磷酸二酯（PDE）。
与对照组相比，精神分裂症患者基底神经节的PME/PDE比值显著双侧升高。患者组和对照组两侧的比值均无显著差异。磷酸单酯/磷酸二酯比值与病程无关。阳性和阴性症状量表得分较低与PME/PDE比值较低相关。
未接受过治疗的精神分裂症患者的基底神经节表现出提示膜磷脂分解减少和/或合成增加的特征。病程与膜磷部分比值之间缺乏相关性可能与非进行性、可能是神经发育性的病因发病机制一致。
