Howells Fleur M, Uhlmann Anne, Temmingh Henk, Sinclair Heidi, Meintjes Ernesta, Wilson Don, Stein Dan J
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa.
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa.
Schizophr Res. 2014 Mar;153(1-3):122-8. doi: 10.1016/j.schres.2014.01.029. Epub 2014 Feb 12.
Methamphetamine (MA) use has been shown to decrease n-acetyl-aspartate (NAA), a marker of neuronal integrity and viability, on (1)H magnetic resonance spectroscopy ((1)H-MRS). However, little work has compared (1)H-MRS in MA dependent individuals and MA dependent individuals with MA induced psychotic disorder (MAP).
Twenty six participants with MA dependence (sixteen without psychosis, ten with psychosis - MAP) and nineteen healthy controls underwent 2D-chemical shift imaging (1)H-MRS, which included voxels in the anterior cingulate cortices (ACC), dorsolateral prefrontal cortices (DLPFC), and frontal white matter. We compared metabolite concentrations relative to phosphocreatine+creatine (PCr+Cr) for n-acetyl-aspartate (NAA), n-acetyl-aspartate+n-acetyl-aspartyl-glutamate (NAA+NAAG), glutamate (Glu), glutamate+glutamine (Glu+Gln), myo-inositol, and glycerophosphocholine+phosphocholine (GPC+PCh) across groups.
The MA groups showed significantly decreased relative NAA metabolite concentrations for right ACC and right DLPFC, compared with control group. The MA dependent group only showed significantly decreased choline metabolites for right DLPFC, compared with control group. The MAP group's relative NAA metabolite concentrations were significantly correlated with age of initial use and duration of MA use, these correlates were not apparent in MA dependent group.
MA use is associated with decreased neuronal integrity and viability, specifically in the right ACC and right DLPFC. MA dependence showed active neurodegeneration in the right DLPFC, this was not apparent in the MAP group and may be related to the use of antipsychotic medication in the MAP group. The effects of MA use in MAP suggest that age of initial use presents a mismatch of neuronal plasticity, in frontal white vs. gray matter and duration of use relates to decreased neuronal integrity and viability. Further study is warranted from this initial study of (1)H-MRS in MAP, in particular longitudinal assessment of these individuals both neurobiologically ((1)H-MRS) and clinically - to determine disease progression.
甲基苯丙胺(MA)使用已被证明会降低N-乙酰天门冬氨酸(NAA),这是一种通过氢磁共振波谱((1)H-MRS)检测神经元完整性和活力的标志物。然而,很少有研究比较MA依赖个体与患有MA所致精神障碍(MAP)的MA依赖个体的(1)H-MRS。
26名MA依赖参与者(16名无精神病,10名有精神病-MAP)和19名健康对照者接受了二维化学位移成像(1)H-MRS检查,其中包括前扣带回皮质(ACC)、背外侧前额叶皮质(DLPFC)和额叶白质中的体素。我们比较了各组中相对于磷酸肌酸+肌酸(PCr+Cr)的N-乙酰天门冬氨酸(NAA)、N-乙酰天门冬氨酸+N-乙酰天门冬氨酰谷氨酸(NAA+NAAG)、谷氨酸(Glu)、谷氨酸+谷氨酰胺(Glu+Gln)、肌醇以及甘油磷酸胆碱+磷酸胆碱(GPC+PCh)的代谢物浓度。
与对照组相比,MA组右侧ACC和右侧DLPFC的相对NAA代谢物浓度显著降低。与对照组相比,MA依赖组仅右侧DLPFC的胆碱代谢物显著降低。MAP组的相对NAA代谢物浓度与首次使用年龄和MA使用持续时间显著相关,这些相关性在MA依赖组中不明显。
MA使用与神经元完整性和活力降低有关,特别是在右侧ACC和右侧DLPFC。MA依赖在右侧DLPFC显示出活跃的神经变性,这在MAP组中不明显,可能与MAP组使用抗精神病药物有关。MA在MAP中的使用效果表明,首次使用年龄在额叶白质与灰质中呈现神经元可塑性的不匹配,而使用持续时间与神经元完整性和活力降低有关。鉴于对MAP进行的这项初步(1)H-MRS研究,有必要进行进一步研究,特别是对这些个体进行神经生物学((1)H-MRS)和临床方面纵向评估,以确定疾病进展。