Das Tushar Kanti, Dey Avyarthana, Sabesan Priyadharshini, Javadzadeh Alborz, Théberge Jean, Radua Joaquim, Palaniyappan Lena
Department of Psychiatry, University of Western Ontario, London, ON, Canada.
Robarts Research Institute, London, ON, Canada.
Front Psychiatry. 2018 Sep 21;9:438. doi: 10.3389/fpsyt.2018.00438. eCollection 2018.
Several lines of evidence support a role for astroglial pathology in schizophrenia. Myo-inositol is particularly abundant in astroglia. Many small sized studies have reported on myo-inositol concentration in schizophrenia, but to date these have not been pooled to estimate a collective effect size. We reviewed all proton magnetic resonance spectroscopy (1H-MRS) studies reporting myo-inositol values for patients satisfying DSM or ICD based criteria for schizophrenia in comparison to a healthy controls group in the medial prefrontal cortex published until February 2018. A random-effects model was used to calculate the pooled effect size using package. A meta-regression analysis of moderator variables was also undertaken. The literature search identified 19 studies published with a total sample size of 585 controls, 561 patients with schizophrenia. Patients with schizophrenia had significantly reduced medial prefrontal myo-inositol compared to controls (RFX standardized mean difference = 0.19, 95% CI [0.05-0.32], = 2.72, = 0.0067; heterogeneity = 0.09). Studies with more female patients reported more notable schizophrenia-related reduction in myo-inositol ( = 2.53, = 0.011). We report a small, but significant reduction in myo-inositol concentration in the medial prefrontal cortex in schizophrenia. The size of the reported effect indicates that the biological pathways affecting the astroglia are likely to operate only in a subset of patients with schizophrenia. MRS myo-inositol could be a useful tool to stratify and investigate such patients.
多项证据支持星形胶质细胞病理学在精神分裂症中所起的作用。肌醇在星形胶质细胞中含量尤为丰富。许多小规模研究报告了精神分裂症患者的肌醇浓度，但迄今为止，尚未对这些研究进行汇总以估计总体效应量。我们回顾了所有质子磁共振波谱（1H-MRS）研究，这些研究报告了符合DSM或ICD精神分裂症标准的患者与健康对照组相比，在内侧前额叶皮质中的肌醇值，这些研究发表于2018年2月之前。使用随机效应模型通过软件包计算汇总效应量。还对调节变量进行了元回归分析。文献检索确定了19项已发表的研究，总样本量为585名对照、561名精神分裂症患者。与对照组相比，精神分裂症患者内侧前额叶的肌醇显著降低（随机效应模型标准化平均差=0.19，95%可信区间[0.05 - 0.32]，Z = 2.72，P = 0.0067；异质性I² = 0.09）。女性患者较多的研究报告了与精神分裂症相关的更显著的肌醇降低（Z = 2.53，P = 0.011）。我们报告精神分裂症患者内侧前额叶皮质中的肌醇浓度有小幅但显著的降低。所报告效应的大小表明，影响星形胶质细胞的生物学途径可能仅在一部分精神分裂症患者中起作用。MRS肌醇可能是对这类患者进行分层和研究的有用工具。
