Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Transl Psychiatry. 2020 Jan 21;10(1):15. doi: 10.1038/s41398-020-0700-6.
Antipsychotic medications are the cornerstone of treatment in schizophrenia spectrum disorders. In first-episode psychosis, the recommended time for an antipsychotic medication trial is up to 16 weeks, but the biological correlates of shorter and longer antipsychotic treatment trials in these cohorts remain largely unknown. We enrolled 29 medication-naive first-episode patients (FEP) and 22 matched healthy controls (HC) in this magnetic resonance spectroscopy (MRS) study, examining the levels of combined glutamate and glutamine (commonly referred to as Glx) in the bilateral medial prefrontal cortex (MPFC) with a PRESS sequence (TR/TE = 2000/80 ms) before initiation of antipsychotic treatment, after 6 and 16 weeks of treatment with risperidone. Data were quantified in 18 HC and 20 FEP at baseline, for 19 HC and 15 FEP at week 6, and for 14 HC and 16 FEP at week 16. At baseline, none of the metabolites differed between groups. Metabolite levels did not change after 6 or 16 weeks of treatment in patients. Our data suggest that metabolite levels do not change after 6 or 16 weeks of treatment with risperidone in FEP. It is possible that our choice of sequence parameters and the limited sample size contributed to negative findings reported here. On the other hand, longer follow-up may be needed to detect treatment-related metabolic changes with MRS. In summary, our study adds to the efforts in better understanding glutamatergic neurometabolism in schizophrenia, especially as it relates to antipsychotic exposure.
抗精神病药物是精神分裂症谱系障碍治疗的基石。在首发精神病中，抗精神病药物试验的推荐时间长达 16 周，但这些队列中较短和较长抗精神病药物试验的生物学相关性在很大程度上仍不清楚。我们在这项磁共振波谱（MRS）研究中招募了 29 名未经药物治疗的首发精神病患者（FEP）和 22 名匹配的健康对照者（HC），使用 PRESS 序列（TR/TE=2000/80ms）在开始抗精神病治疗前、使用利培酮治疗 6 周和 16 周后，分别检测双侧内侧前额叶皮质（MPFC）中谷氨酸和谷氨酰胺（通常称为 Glx）的水平。在基线时，18 名 HC 和 20 名 FEP 进行了数据定量，在第 6 周时，19 名 HC 和 15 名 FEP 进行了数据定量，在第 16 周时，14 名 HC 和 16 名 FEP 进行了数据定量。在基线时，各组之间的代谢物没有差异。在患者中，治疗 6 周或 16 周后，代谢物水平没有变化。我们的数据表明，在 FEP 中，利培酮治疗 6 周或 16 周后，代谢物水平没有变化。可能是我们选择的序列参数和有限的样本量导致了这里报告的阴性结果。另一方面，可能需要更长的随访时间来使用 MRS 检测与治疗相关的代谢变化。总之，我们的研究有助于更好地理解精神分裂症中的谷氨酸能神经代谢，特别是与抗精神病药物暴露有关的代谢。
