Murray Alex J, Humpston Clara S, Wilson Martin, Rogers Jack C, Zia Ul Haq Katshu Mohammad, Liddle Peter F, Upthegrove Rachel
Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, United Kingdom.
Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Department of Psychology, University of York, York, United Kingdom.
Brain Behav Immun. 2024 Jan;115:3-12. doi: 10.1016/j.bbi.2023.09.017. Epub 2023 Sep 26.
Oxidative stress may contribute to declining course and poor outcomes in psychosis. However, in vivo Magnetic Resonance Spectroscopy studies yield disparate results due to clinical stage, sample demographics, neuroanatomical focus, sample size, and acquisition method variations. We investigated glutathione in brain regions from participants with psychosis, and the relation of glutathione to clinical features and spectroscopy protocols. Meta-analysis comprised 21 studies. Glutathione levels did not differ between total psychosis patients (N = 639) and controls (N = 704) in the Medial Prefrontal region (k = 21, d = -0.09, CI = -0.28 to 0.10, p = 0.37). Patients with stable schizophrenia exhibited a small but significant glutathione reduction compared to controls (k = 14, d = -0.20, CI = -0.40 to -0.00, p = 0.05). Meta-regression showed older studies had greater glutathione reductions, possibly reflecting greater accuracy related to spectroscopy advancements in more recent studies. No significant effects of methodological variables, such as voxel size or echo time were found. Reduced glutathione in patients with stable established schizophrenia may provide novel targets for precision medicine. Standardizing MRS acquisition methods in future studies may help address discrepancies in glutathione levels.
氧化应激可能导致精神病病情恶化和预后不良。然而，由于临床阶段、样本人口统计学特征、神经解剖学重点、样本量和采集方法的差异，体内磁共振波谱研究得出了不同的结果。我们研究了精神病患者脑区中的谷胱甘肽，以及谷胱甘肽与临床特征和波谱分析方案的关系。荟萃分析包括21项研究。在内侧前额叶区域，精神病患者（N = 639）和对照组（N = 704）的谷胱甘肽水平没有差异（k = 21，d = -0.09，CI = -0.28至0.10，p = 0.37）。与对照组相比，病情稳定的精神分裂症患者的谷胱甘肽水平有小幅但显著的降低（k = 14，d = -0.20，CI = -0.40至-0.00，p = 0.05）。荟萃回归显示，较早的研究中谷胱甘肽降低幅度更大，这可能反映了较新研究中与波谱技术进步相关的更高准确性。未发现体素大小或回波时间等方法学变量有显著影响。病情稳定的精神分裂症患者体内谷胱甘肽水平降低可能为精准医学提供新的靶点。在未来研究中标准化磁共振波谱采集方法可能有助于解决谷胱甘肽水平的差异问题。
