University of Nottingham, School of Psychology, United Kingdom.
Cambridgeshire Community Services NHS Trust, United Kingdom.
Neurosci Biobehav Rev. 2022 Jan;132:224-247. doi: 10.1016/j.neubiorev.2021.11.010. Epub 2021 Dec 2.
A large proportion of patients with schizophrenia exhibit deficits in cognitive control functions including working memory, processing speed and inhibitory control, which have been associated with frontal brain areas. In this systematic review, we investigated differences between chronic schizophrenia patients, first-episode (FEP) patients and healthy control groups in the neurometabolite levels of GABA, glutamate, glutamine and Glx in frontal brain areas. Additionally, we reviewed correlations between cognitive control functions or negative symptoms and these neurometabolite levels. Several studies reported decreased GABA or glutamate concentrations in frontal lobe areas, particularly in chronic schizophrenia patients, while the results were mixed for FEP patients. Working memory performance and prediction errors have been associated with frontal GABA and glutamate levels, and processing speed with frontomedial GABA levels in chronic patients. The relationship between metabolites and negative symptom severity was somewhat inconsistent. Future studies should take the participants' age, medication status or responsivity, disease stage and precise anatomical location of the voxel into account when comparing neurometabolite levels between schizophrenia patients and healthy controls.
很大一部分精神分裂症患者表现出认知控制功能缺陷，包括工作记忆、加工速度和抑制控制，这些功能与额叶脑区有关。在这项系统评价中，我们研究了慢性精神分裂症患者、首发精神分裂症（FEP）患者和健康对照组在额叶脑区 GABA、谷氨酸、谷氨酰胺和 Glx 神经代谢物水平上的差异。此外，我们还回顾了认知控制功能或阴性症状与这些神经代谢物水平之间的相关性。一些研究报告称，额叶区域的 GABA 或谷氨酸浓度降低，特别是在慢性精神分裂症患者中，而 FEP 患者的结果则各不相同。在慢性患者中，工作记忆表现和预测误差与额叶 GABA 和谷氨酸水平相关，而加工速度与额叶内侧 GABA 水平相关。代谢物与阴性症状严重程度之间的关系有些不一致。未来的研究在比较精神分裂症患者和健康对照组的神经代谢物水平时，应考虑参与者的年龄、用药情况或反应性、疾病阶段和体素的精确解剖位置。
