Egerton Alice, Stone James M, Chaddock Christopher A, Barker Gareth J, Bonoldi Ilaria, Howard Rachel M, Merritt Kate, Allen Paul, Howes Oliver D, Murray Robin M, McLean Mary A, Lythgoe David J, O'Gorman Ruth L, McGuire Philip K
Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK.
1] Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK [2] Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College London, London, UK.
Neuropsychopharmacology. 2014 Nov;39(12):2891-9. doi: 10.1038/npp.2014.143. Epub 2014 Jun 11.
Alterations in brain glutamate levels may be associated with psychosis risk, but the relationship to clinical outcome in at-risk individuals is unknown. Glutamate concentration was measured in the left thalamus and anterior cingulate cortex (ACC) using 3-Tesla proton magnetic resonance spectroscopy in 75 participants at ultra high risk (UHR) of psychosis and 56 healthy controls. The severity of attenuated positive symptoms and overall functioning were assessed. Measures were repeated in 51 UHR and 33 Control subjects after a mean of 18 months. UHR subjects were allocated to either remission (no longer meeting UHR criteria) or non-remission (meeting UHR or psychosis criteria) status on follow-up assessment. Thalamic glutamate levels at presentation were lower in the UHR non-remission (N=29) compared with the remission group (N=22) (t(49)=3.03; P=0.004), and were associated with an increase in the severity of total positive symptoms over time (r=-0.33; df=47; P=0.02), most notably abnormal thought content (r=-0.442; df=47; P=0.003). In the UHR group, ACC glutamate levels were lower at follow-up compared with baseline (F(80)=4.28; P=0.04). These findings suggest that measures of brain glutamate function may be useful as predictors of clinical outcome in individuals at high risk of psychosis.
大脑谷氨酸水平的改变可能与精神病风险相关，但与高危个体临床结局的关系尚不清楚。在75名超高危（UHR）精神病患者和56名健康对照者中，使用3特斯拉质子磁共振波谱测量左侧丘脑和前扣带回皮质（ACC）的谷氨酸浓度。评估了减弱的阳性症状的严重程度和整体功能。在平均18个月后，对51名UHR受试者和33名对照受试者重复进行测量。在随访评估中，将UHR受试者分为缓解（不再符合UHR标准）或未缓解（符合UHR或精神病标准）状态。与缓解组（N = 22）相比，UHR未缓解组（N = 29）在就诊时的丘脑谷氨酸水平较低（t(49)=3.03；P = 0.004），并且与随着时间推移总阳性症状严重程度的增加相关（r = -0.33；自由度 = 47；P = 0.02），最明显的是异常思维内容（r = -0.442；自由度 = 47；P = 0.003）。在UHR组中，随访时ACC谷氨酸水平低于基线（F(80)=4.28；P = 0.04）。这些发现表明，大脑谷氨酸功能的测量可能有助于预测精神病高危个体的临床结局。
