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Prog Neuropsychopharmacol Biol Psychiatry. 2018 Aug 30;86:340-352. doi: 10.1016/j.pnpbp.2018.03.016. Epub 2018 Mar 23.

Neurometabolite levels in antipsychotic-naïve/free patients with schizophrenia: A systematic review and meta-analysis of 1H-MRS studies.

Author information

1
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, 160-8582 Tokyo, Japan.
2
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, 160-8582 Tokyo, Japan; Geriatric Mental Health Division, Centre for Addiction and Mental Health, 80 Workman Way, M6J 1H4 Toronto, Canada.
3
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.; Institute of Medical Science, University of Toronto, 1 King's College Circle, M5S 1A8 Toronto, Ontario, Canada.
4
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.
5
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Geriatric Mental Health Division, Centre for Addiction and Mental Health, 80 Workman Way, M6J 1H4 Toronto, Canada; Campbell Research Institute, Centre for Addiction and Mental Health, 1001 Queen St. W, M6J 1H4 Toronto, Ontario, Canada.
6
Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, 160-8582 Tokyo, Japan.
7
Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Campbell Research Institute, Centre for Addiction and Mental Health, 1001 Queen St. W, M6J 1H4 Toronto, Ontario, Canada.
8
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, M5T 1R8 Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Geriatric Mental Health Division, Centre for Addiction and Mental Health, 80 Workman Way, M6J 1H4 Toronto, Canada; Campbell Research Institute, Centre for Addiction and Mental Health, 1001 Queen St. W, M6J 1H4 Toronto, Ontario, Canada. Electronic address: ariel_graff@yahoo.com.mx.

Abstract

BACKGROUND:

Studies using proton magnetic resonance spectroscopy (1H-MRS) have reported altered neurometabolite levels in patients with schizophrenia. However, results are possibly confounded by the influence of antipsychotic (AP). Thus, this meta-analysis aimed to examine neurometabolite levels in AP-naïve/free patients with schizophrenia.

METHODS:

A literature search was conducted using Embase, Medline, and PsycINFO to identify studies that compared neurometabolite levels in AP-naïve/free patients with schizophrenia to healthy controls (HCs). Eight neurometabolites (glutamate, glutamine, glutamate + glutamine, N-acetylaspartate [NAA], choline, creatine, myo-inositol, and γ-Aminobutyric acid [GABA]) and seven regions of interest (ROI; medial prefrontal cortex, dorsolateral prefrontal cortex, frontal white matter, occipital lobe, basal ganglia, hippocampus/medial temporal lobe, and thalamus) were examined.

RESULTS:

Twenty-one studies (N = 1281) were included in the analysis. The results showed lower thalamic NAA levels (3 studies, n = 174, effect size = -0.56, P = 0.0005) in the patient group. No group differences were identified for other neurometabolites.

CONCLUSIONS:

Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia.

KEYWORDS:

Antipsychotic-naïve; Proton magnetic resonance spectroscopy; Schizophrenia; Untreated

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