Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada.
Br J Psychiatry. 2011 Jun;198(6):448-56. doi: 10.1192/bjp.bp.110.079608.
Thalamic glutamine loss and grey matter reduction suggest neurodegeneration in first-episode schizophrenia, but the duration is unknown.
To observe glutamine and glutamate levels, grey matter volumes and social functioning in patients with schizophrenia followed to 80 months after diagnosis.
Grey matter volumes and proton magnetic resonance spectroscopy metabolites in left anterior cingulate and left thalamus were measured in 17 patients with schizophrenia before medication and 10 and 80 months after diagnosis. Social functioning was assessed with the Life Skills Profile Rating Scale (LSPRS) at 80 months.
The sum of thalamic glutamate and glutamine levels decreased over 80 months, and correlated inversely with the LSPRS. Thalamic glutamine and grey matter loss were significantly correlated in frontal, parietal, temporal and limbic regions.
Brain metabolite loss is correlated with deteriorated social functioning and grey matter losses in schizophrenia, consistent with neurodegeneration.
首次发作精神分裂症患者的丘脑谷氨酰胺丢失和灰质减少提示存在神经退行性变，但持续时间尚不清楚。
观察诊断后 80 个月内首发精神分裂症患者的谷氨酰胺和谷氨酸水平、灰质体积和社会功能。
对 17 例未经药物治疗的精神分裂症患者，在诊断前、诊断后 10 个月和 80 个月时，测量左前扣带回和左丘脑的灰质体积和质子磁共振波谱代谢物。在 80 个月时使用生活技能评定量表（LSPRS）评估社会功能。
80 个月内，丘脑谷氨酸和谷氨酰胺水平的总和下降，与 LSPRS 呈负相关。丘脑谷氨酰胺和灰质丢失与额叶、顶叶、颞叶和边缘区域的灰质丢失呈显著相关。
脑代谢物丢失与精神分裂症社会功能恶化和灰质丢失相关，提示存在神经退行性变。
