Romeo Bruno, Petillion Amelie, Martelli Catherine, Benyamina Amine
APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche, PSYCOMADD Université Paris Sud - AP-HP, Université Paris Saclay, France.
APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche, PSYCOMADD Université Paris Sud - AP-HP, Université Paris Saclay, France.
J Psychiatr Res. 2020 Jun;125:52-65. doi: 10.1016/j.jpsychires.2020.03.006. Epub 2020 Mar 16.
Even though anomalies on brain metabolites have been found in schizophrenia, researches about subjects with high risk (HR) show heterogeneous results. Thus, this meta-analysis aims to characterize the metabolic profile of HR subjects, first, compared to controls (HC) and then compared to people with schizophrenia.
After a systematic database search, means and standard deviations were extracted to calculate standardized mean differences (SMD). Cerebral metabolites levels were compared between HR subjects and HC or patients with schizophrenia in all regions of interest investigated in included studies. Meta-regressions were performed to explore the influence of demographic and clinical variables on metabolites level's SMDs.
Thirty-nine studies were included in this meta-analysis. A higher level of glutamine + glutamate (Glx) was found in the medial prefrontal cortex (mPFC) (p < 0.01) and potentially in the basal ganglia (p = 0,05) as well as a higher level of myo-inositol (mI) in the dorsolateral prefrontal cortex (DLPFC) (p = 0.04) in HR subjects compared to HC. A higher level of choline (Cho) was found in people with schizophrenia compared to HR subjects in the DLPFC (p < 0.001) and the medial temporal lobe (p = 0.02). Meta-regression analyses showed negative associations between SMD for Cho concentration, the percentage of females or the age (p = 0.01).
The present meta-analysis provides evidence that some brain metabolites concentrations are disrupted before the transition to psychosis and could be considered like a vulnerability.
尽管在精神分裂症患者中已发现脑代谢物异常，但关于高危（HR）受试者的研究结果却参差不齐。因此，本荟萃分析旨在首先描述HR受试者与对照组（HC）相比，然后与精神分裂症患者相比的代谢特征。
在对数据库进行系统检索后，提取均值和标准差以计算标准化均值差（SMD）。在纳入研究中所调查的所有感兴趣区域，比较HR受试者与HC或精神分裂症患者之间的脑代谢物水平。进行荟萃回归以探讨人口统计学和临床变量对代谢物水平SMD的影响。
本荟萃分析纳入了39项研究。与HC相比，HR受试者在内侧前额叶皮质（mPFC）中谷氨酰胺+谷氨酸（Glx）水平较高（p<0.01），在基底神经节中可能也较高（p = 0.05），在背外侧前额叶皮质（DLPFC）中肌醇（mI）水平较高（p = 0.04）。与HR受试者相比，精神分裂症患者在DLPFC（p<0.001）和内侧颞叶（p = 0.02）中胆碱（Cho）水平较高。荟萃回归分析显示，Cho浓度的SMD与女性百分比或年龄之间存在负相关（p = 0.01）。
本荟萃分析提供了证据，表明在向精神病转变之前，一些脑代谢物浓度就已受到破坏，可被视为一种易感性。
