Treatment effects on neurometabolite levels in schizophrenia: A systematic review and meta-analysis of proton magnetic resonance spectroscopy studies

Although there is growing evidence of alterations in the neurometabolite status associated with the pathophysiology of schizophrenia, how treatments influence these metabolite levels in patients with schizophrenia remains poorly studied. We conducted a literature search using Embase, Medline, and Ps...

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Bibliographic Details
Published in:Schizophrenia research 2020-08, Vol.222, p.122-132
Main Authors: Kubota, Manabu, Moriguchi, Sho, Takahata, Keisuke, Nakajima, Shinichiro, Horita, Nobuyuki
Format: Article
Language:English
Subjects:
Antipsychotic
Aspartic Acid
Glutamate
Glutamic Acid
Glutamine
Humans
MRS
Myo-inositol
N-acetylaspartate
Proton Magnetic Resonance Spectroscopy
Psychosis
Schizophrenia - diagnostic imaging
Schizophrenia - drug therapy
Schizophrenia - metabolism
Thalamus - diagnostic imaging
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Summary:Although there is growing evidence of alterations in the neurometabolite status associated with the pathophysiology of schizophrenia, how treatments influence these metabolite levels in patients with schizophrenia remains poorly studied. We conducted a literature search using Embase, Medline, and PsycINFO to identify proton magnetic resonance spectroscopy studies that compared neurometabolite levels before and after treatment in patients with schizophrenia. Six neurometabolites (glutamate, glutamine, glutamate + glutamine, gamma-aminobutyric acid, N-acetylaspartate, myo-inositol) and six regions of interest (frontal cortex, temporal cortex, parieto-occipital cortex, thalamus, basal ganglia, hippocampus) were investigated. Thirty-two studies (n = 773 at follow-up) were included in our meta-analysis. Our results demonstrated that the frontal glutamate + glutamine level was significantly decreased (14 groups; n = 292 at follow-up; effect size = −0.35, P = 0.0003; I2 = 22%) and the thalamic N-acetylaspartate level was significantly increased (7 groups; n = 184 at follow-up; effect size = 0.47, P < 0.00001; I2 = 0%) after treatment in schizophrenia patients. No significant associations were found between neurometabolite changes and age, gender, duration of illness, duration of treatment, or baseline symptom severity. The current results suggest that glutamatergic neurometabolite levels in the frontal cortex and neuronal integrity in the thalamus in schizophrenia might be modified following treatment.
ISSN:0920-9964
1573-2509
DOI:10.1016/j.schres.2020.03.069