抗精神病药初治/未治精神分裂症患者的神经代谢物水平：磁共振波谱研究的系统评价和荟萃分析。
Neurometabolite levels in antipsychotic-naïve/free patients with schizophrenia: A systematic review and meta-analysis of H-MRS studies.
机构信息
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, 160-8582 Tokyo, Japan.
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, 160-8582 Tokyo, Japan; Geriatric Mental Health Division, Centre for Addiction and Mental Health, 80 Workman Way, M6J 1H4 Toronto, Canada.
出版信息
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Aug 30;86:340-352. doi: 10.1016/j.pnpbp.2018.03.016. Epub 2018 Mar 23.
BACKGROUND
Studies using proton magnetic resonance spectroscopy (H-MRS) have reported altered neurometabolite levels in patients with schizophrenia. However, results are possibly confounded by the influence of antipsychotic (AP). Thus, this meta-analysis aimed to examine neurometabolite levels in AP-naïve/free patients with schizophrenia.
METHODS
A literature search was conducted using Embase, Medline, and PsycINFO to identify studies that compared neurometabolite levels in AP-naïve/free patients with schizophrenia to healthy controls (HCs). Eight neurometabolites (glutamate, glutamine, glutamate + glutamine, N-acetylaspartate [NAA], choline, creatine, myo-inositol, and γ-Aminobutyric acid [GABA]) and seven regions of interest (ROI; medial prefrontal cortex, dorsolateral prefrontal cortex, frontal white matter, occipital lobe, basal ganglia, hippocampus/medial temporal lobe, and thalamus) were examined.
RESULTS
Twenty-one studies (N = 1281) were included in the analysis. The results showed lower thalamic NAA levels (3 studies, n = 174, effect size = -0.56, P = 0.0005) in the patient group. No group differences were identified for other neurometabolites.
CONCLUSIONS
Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia.
背景
使用质子磁共振波谱（H-MRS）的研究报告称，精神分裂症患者的神经代谢物水平发生了改变。然而，这些结果可能受到抗精神病药物（AP）的影响。因此，本荟萃分析旨在检查未经治疗/未使用抗精神病药物的精神分裂症患者的神经代谢物水平。
方法
使用 Embase、Medline 和 PsycINFO 进行文献检索，以确定将未经治疗/未使用抗精神病药物的精神分裂症患者的神经代谢物水平与健康对照组（HCs）进行比较的研究。共检查了 8 种神经代谢物（谷氨酸、谷氨酰胺、谷氨酸+谷氨酰胺、N-乙酰天门冬氨酸[NAA]、胆碱、肌酸、肌醇和γ-氨基丁酸[GABA]）和 7 个感兴趣区（ROI；内侧前额叶皮质、背外侧前额叶皮质、额白质、枕叶、基底节、海马/内侧颞叶和丘脑）。
结果
共纳入 21 项研究（N=1281）进行分析。结果显示，患者组的丘脑 NAA 水平较低（3 项研究，n=174，效应大小=-0.56，P=0.0005）。其他神经代谢物未发现组间差异。
结论
我们的发现表明，丘脑神经元完整性受损可能是精神分裂症早期的一个潜在特征标志物。
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