Department of Psychiatry, Medical University of Białystok, Plac Brodowicza 1, 16-070 Choroszcz, Poland.
Department of Statistics and Medical Informatics, Medical University of Białystok, ul. Szpitalna 37, 15-295 Białystok, Poland.
Dis Markers. 2018 Nov 25;2018:3654894. doi: 10.1155/2018/3654894. eCollection 2018.
Modern neuroimaging techniques allow investigating brain structures and substances involved in the pathophysiology of mental disorders, trying to find new markers of these disorders. To better understanding of the pathophysiology and differential diagnosis of schizophrenia and bipolar disorder, this study was conducted to assess the neurochemical alterations in the frontal and temporal lobes in hospitalized patients with schizophrenia and bipolar disorder.
Twenty-one subjects with schizophrenia (paranoid and differentiated types), 16 subjects with bipolar I disorder (manic, depressive, and mixed episode), and 20 healthy subjects were studied. Magnetic resonance (MR) imaging and proton resonance magnetic spectroscopy (H MRS) were performed on a 1.5 T scanner. Voxels of 8 cm were positioned in the left frontal and left temporal lobes.
Glx/HO (GABA, glutamine, and glutamate/nonsuppressed water signal) ratios were significantly increased in the left temporal lobe in schizophrenia, but not in bipolar disorder, compared with controls. Cho/HO (choline/nonsuppressed water signal) ratios in the left frontal lobe had a tendency to increase in bipolar disorder and schizophrenia, relative to controls. A lower temporal lobe NAA/HO ratio in mixed than in manic and depressive episode of bipolar patients was also found. No other significant differences were found among three studied groups as regards NAA, Cr, and mI ratios.
Our results partially confirm the role of a glutamatergic system in schizophrenia, however, only in a temporal lobe. We also point to the importance of the choline-containing compounds (marker of cellular density) in the frontal lobe of patients suffering from bipolar disorder and schizophrenia. We also found the deleterious effect of mixed bipolar episode on the integrity and functioning of the temporal lobe. Glutamatergic left temporal spectroscopic changes may potentially help in differential diagnosis of schizophrenia from bipolar disorder.
现代神经影像学技术可用于研究精神障碍病理生理学相关的脑结构和物质，以寻找这些疾病的新标志物。为了更好地理解精神分裂症和双相情感障碍的病理生理学和鉴别诊断，本研究旨在评估精神分裂症和双相情感障碍住院患者额叶和颞叶的神经化学变化。
研究共纳入 21 例精神分裂症（偏执型和未分化型）患者、16 例双相情感障碍 I 型（躁狂、抑郁和混合发作）患者和 20 例健康对照者。采用 1.5T 磁共振扫描仪进行磁共振成像和质子磁共振波谱分析。在左侧额叶和左侧颞叶定位 8cm³的体素。
与对照组相比，精神分裂症患者左侧颞叶 Glx/HO（GABA、谷氨酰胺和谷氨酸/未受抑制水信号）比值显著升高，但双相情感障碍患者未见此改变。左侧额叶 Cho/HO（胆碱/未受抑制水信号）比值在双相情感障碍和精神分裂症患者中呈升高趋势，与对照组相比。混合相双相情感障碍患者的颞叶 NAA/HO 比值低于躁狂和抑郁相。三组研究对象之间的 NAA、Cr 和 mI 比值无显著差异。
我们的研究结果部分证实了谷氨酸能系统在精神分裂症中的作用，但仅局限于颞叶。我们还指出，胆碱类化合物（细胞密度标志物）在双相情感障碍和精神分裂症患者额叶中的重要性。我们还发现混合相双相情感障碍对颞叶完整性和功能的有害影响。左侧颞叶的谷氨酸能神经影像学变化可能有助于精神分裂症和双相情感障碍的鉴别诊断。
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