Singh Ujjwal, Das Basudeb, Khanra Sourav, Roy Chandramouli
Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Indian J Psychiatry. 2024 Jan;66(1):82-89. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_621_23. Epub 2024 Jan 25.
Research on glutamate (Glu) in schizophrenia has so far been inconclusive. Based on preclinical studies on Glu lactate interaction, researchers have now focused on brain lactate level as a sign of major pathology, including cognitive dysfunctions in the brain. Our study aimed to examine changes at resting and activated states in brain lactate and Glu-glutamine (Glx) at the anterior cingulate cortex (ACC) in schizophrenia.
A hospital-based prospective study was conducted with twenty-two male cases of schizophrenia and matched healthy controls (HCs). Positive and Negative Syndrome Scale (PANSS), Montreal Cognitive Assessment (MoCA), and Stroop tasks were administered among patients. Brain lactate and Glx at ACC were measured at resting state and during the Stroop test with proton magnetic resonance spectroscopy (1H-MRS) both at baseline and at remission and once among HC.
Though MoCA scores improved significantly ( < 0.001) at remission from baseline among cases, repeated-measures analysis of variance (RM-ANOVA) did not find a significant time effect for Glx ( = 0.82) and lactate ( = 0.30) among cases from baseline to remission. Glx and lactate changed differently from baseline to remission.
Our study did not find significant differences in Glx and lactate between schizophrenia patients and HC. No significant time effect on Glx and lactate was observed from baseline to remission among schizophrenia cases. Different changes observed in Glx and lactate from baseline to remission require replication in future studies with larger sample size, longer follow-up period, and multivoxel MR assessment.
迄今为止，关于精神分裂症中谷氨酸（Glu）的研究尚无定论。基于对Glu与乳酸相互作用的临床前研究，研究人员现在将重点放在脑乳酸水平上，将其作为主要病理状态的一个指标，包括大脑中的认知功能障碍。我们的研究旨在检查精神分裂症患者前扣带回皮质（ACC）在静息和激活状态下脑乳酸和Glu-谷氨酰胺（Glx）的变化。
进行了一项基于医院的前瞻性研究，纳入22例男性精神分裂症患者及匹配的健康对照（HCs）。对患者进行阳性和阴性症状量表（PANSS）、蒙特利尔认知评估（MoCA）和斯特鲁普任务测试。在基线、缓解期以及对HCs进行一次测试时，使用质子磁共振波谱（1H-MRS）在静息状态和斯特鲁普测试期间测量ACC的脑乳酸和Glx。
尽管病例组从基线到缓解期MoCA评分显著改善（<0.001），但重复测量方差分析（RM-ANOVA）未发现病例组从基线到缓解期Glx（=0.82）和乳酸（=0.30）有显著的时间效应。从基线到缓解期，Glx和乳酸的变化不同。
我们的研究未发现精神分裂症患者与HCs之间Glx和乳酸有显著差异。在精神分裂症病例中，从基线到缓解期未观察到Glx和乳酸有显著的时间效应。从基线到缓解期Glx和乳酸观察到的不同变化需要在未来更大样本量、更长随访期和多体素磁共振评估的研究中进行重复验证。
