Zahid Uzma, McCutcheon Robert A, Borgan Faith, Jauhar Sameer, Pepper Fiona, Nour Matthew M, Rogdaki Maria, Osugo Martin, Murray Graham K, Hathway Pamela, Murray Robin M, Egerton Alice, Howes Oliver D
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Front Psychiatry. 2022 Aug 11;13:967941. doi: 10.3389/fpsyt.2022.967941. eCollection 2022.
Glutamatergic dysfunction is implicated in the pathophysiology of schizophrenia. It is unclear whether glutamatergic dysfunction predicts response to treatment or if antipsychotic treatment influences glutamate levels. We investigated the effect of antipsychotic treatment on glutamatergic levels in the anterior cingulate cortex (ACC), and whether there is a relationship between baseline glutamatergic levels and clinical response after antipsychotic treatment in people with first episode psychosis (FEP).
The sample comprised 25 FEP patients; 22 completed magnetic resonance spectroscopy scans at both timepoints. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS).
There was no significant change in glutamate [baseline 13.23 ± 2.33; follow-up 13.89 ± 1.74; t(21) = -1.158, = 0.260], or Glx levels [baseline 19.64 ± 3.26; follow-up 19.66 ± 2.65; t(21) = -0.034, = 0.973]. There was no significant association between glutamate or Glx levels at baseline and the change in PANSS positive (Glu = 0.061, = 0.777, Glx = -0.152, = 0.477), negative (Glu = 0.144, = 0.502, Glx = 0.052, = 0.811), general (Glu = 0.110, = 0.607, Glx = -0.212, = 0.320), or total scores (Glu = 0.078, = 0.719 Glx = -0.155, = 0.470).
These findings indicate that treatment response is unlikely to be associated with baseline glutamatergic metabolites prior to antipsychotic treatment, and there is no major effect of antipsychotic treatment on glutamatergic metabolites in the ACC.
谷氨酸能功能障碍与精神分裂症的病理生理学有关。目前尚不清楚谷氨酸能功能障碍是否能预测治疗反应，或者抗精神病药物治疗是否会影响谷氨酸水平。我们研究了抗精神病药物治疗对前扣带回皮质（ACC）谷氨酸能水平的影响，以及首发精神病（FEP）患者基线谷氨酸能水平与抗精神病药物治疗后临床反应之间是否存在关联。
样本包括25例FEP患者；22例在两个时间点均完成了磁共振波谱扫描。使用阳性和阴性症状量表（PANSS）评估症状。
谷氨酸水平[基线13.23±2.33；随访13.89±1.74；t(21)=-1.158，P=0.260]或Glx水平[基线19.64±3.26；随访19.66±2.65；t(21)=-0.034，P=0.973]无显著变化。基线时谷氨酸或Glx水平与PANSS阳性（谷氨酸：r=0.061，P=0.777，Glx：r=-0.152，P=0.477）、阴性（谷氨酸：r=0.144，P=0.502，Glx：r=0.052，P=0.811）、一般（谷氨酸：r=0.110，P=0.607，Glx：r=-0.212，P=0.320）或总分（谷氨酸：r=0.078，P=0.719，Glx：r=-0.155，P=0.470）的变化之间无显著关联。
这些发现表明，治疗反应不太可能与抗精神病药物治疗前的基线谷氨酸能代谢物相关，且抗精神病药物治疗对ACC中的谷氨酸能代谢物无重大影响。
