- Email: [email protected]
Proton magnetic resonance spectroscopy and schizophrenia
100
only modest finding thus far. Failure to observe robust PME decrements may reflect illness chronicity, medication-effects, or other potential confounds. This work was supported by the Stanley Foundation.
PROTON
MAGNETIC
SPECTROSCOPY
RESONANCE
AND SCHIZOPHRENIA
P. Delamillieure ~, J.M. Constans ~2, J. Fernandez ~'2, P. Brazo ~, T. VasseL P. Courth6oux 2, M. PetitL S. Dollfus x
Groupe de recherche ( UPRES JE2014) et Programme Hospitalier de Recherche Clinique (P. H. R. C. ) (S. Dol([us, CHU de Caen, M. Petit, UniversitO de Rouen, France), 2Centre IRM, CHU de Caen, France The aim: of this preliminary study was to test the relationship between clinical characteristics and spectroscopic data using Proton Magnetic Resonance Spectroscopy (~H MRS). Methods." Proton spectra in the regions of the right and left thalamus, prefrontal cortex and temporal lobes were studied in 17 schizophrenic patients (DSM-IV), mean age 31 (SD=6) and 14 healthy subjects, mean age 30 ( S D - 6 ) . Patients were assessed by Positive And Negative Syndrome Scale (PANSS: Kay et al., 1987). Results." A decrease of N-Acetyl Aspartate-glutamate/ Creatine (NAAg/CRE) in thalamus ( p - 0 . 0 2 ) and in increase of N-Acetyl Aspartate-glutamate/Choline (NAA/CHO) in temporal lobes (p=0.01) were found. NAA/CHO was negatively correlated with the age in control subjects in thalamus (r= 0.65; p=0.01). Positive correlations between CHO/CRE and delusion were found in thalamus and prefrontal cortex in schizophrenics (r=0.48; p=0.05). Furthermore, NAA/CRE and NAA/CHO were negatively correlated with age of onset of illness. Conclusion: These findings suggest, first, a role for the existence of the glutamatergic system in schizophrenia and second, the existence of a neurodegenerative subtype of schizophrenia with late onset of illness.
THE NEUROBIOLOGY OF SEVERE AND REPETETIVE VIOLENCE: A tHMRS STUDY OF FRONTAL
LOBE
D. Robertson, H. Critchley, E. Daly, T. Van Amelsvoort, K. Xenitidis, D. M u r p h y
Department ~]' Psyehological Medicine, Institute ~)]Psyehiato,, King's College Sehool o/Medicine, London, SE5 8AF, UK Background." Schizophrenia is associated with a significantly increased prevalence of violent crime and this is associated with
a high socio-economic cost and social morbidity. However, the neurobiology of violence is poorly understood, and it is unknown if violent behaviour is related to abnormalities in frontal neural integrity in schizophrenia. Thus, we used 1HMRS in people with a history of severe and repetitive violence and non-violent controls to investigate the neurobiological correlates of violent behaviour, and if abnormalities in neural integrity relate to the frequency of violence. Method. We studied 7 repetitively violent inpatients, and 7 non-violent age and IQ matched controls. Frontal ~HMRS was obtained with a 1.5 T GE Signa NMR system, using a PRESS sequence (TR/TE 2000/136 ms) after CHESS water suppression. The voxel was 2 cm 3, positioned in the right dorsomedial frontal lobe according to a standard protocol. Spectra were processed and analysed using SAGE/IDL software. Results. Compared to controls, violent patients had significantly decreased absolute concentrations of frontal creatine (Cr) (p<0.05) and N-acetylaspartate (NAA) (p<0.05). Moreover, number of violent episodes/month was negatively correlated with concentrations of NAA (p<0.008) and Cr (p<0.02). ('onclusion. NAA is a marker for neuronal density, and Cr provides a measure of cellular metabolic turnover. Thus, repetitive violence is associated with abnormalities in neural integrity of frontal lobe, a brain region implicated in the neurobiology of schizophrenia. We hypothesise that patients with schizophrenia who are violent will differ from those who are not in the neural integrity of the frontal lobes.
PROTON
MAGNETIC
SPECTROSCOPY
RESONANCE
(1H-MRS) OF PUTAMEN
IN SCHIZOPHRENIC WITHOUT TARDIVE
PATIENTS WITH AND DYSKINESIA
T. Sigmundsson, H. Wilson, K.R. Chaudhuri, S . C R . Williams, A. Simmons, P.N. Leigh, B.K. Toone
Department of Psychological Medie#~e, The Institute ~! Psychiato,, De Crespiglo~ Park, Denmark Hill, London, SE5 8AF, UK Tardive dyskinesia (TD), is a serious side-effect of chronic neuroleptic treatment in schizophrenia, with a reported prevalence of around 20%. Dyskinesia and other abnormal involuntary movements have also been reported to have a higher prevalance in never-treated schizophrenic patients. Pre-existing basal ganglia pathology as part of the disease process in some schizophrenic patients has been put forward to account for this. This may explain why only some but not all patients on neuroleptic drugs suffer TD. To study this we used proton magnetic resonance spectroscopy (~H-MRS) centered on the putamen (2.88cm 3 voxel) in two groups of schizophrenic patients, with (n=7) and without TD (n=8), compared with age and sex matched healthy comparison subjects (n=8). N-acetyl-aspartate (NAA), a metabolite only found in neurones and believed to reflect neuronal density, was found to be
only modest finding thus far. Failure to observe robust PME decrements may reflect illness chronicity, medication-effects, or other potential confounds. This work was supported by the Stanley Foundation.
PROTON
MAGNETIC
SPECTROSCOPY
RESONANCE
AND SCHIZOPHRENIA
P. Delamillieure ~, J.M. Constans ~2, J. Fernandez ~'2, P. Brazo ~, T. VasseL P. Courth6oux 2, M. PetitL S. Dollfus x
Groupe de recherche ( UPRES JE2014) et Programme Hospitalier de Recherche Clinique (P. H. R. C. ) (S. Dol([us, CHU de Caen, M. Petit, UniversitO de Rouen, France), 2Centre IRM, CHU de Caen, France The aim: of this preliminary study was to test the relationship between clinical characteristics and spectroscopic data using Proton Magnetic Resonance Spectroscopy (~H MRS). Methods." Proton spectra in the regions of the right and left thalamus, prefrontal cortex and temporal lobes were studied in 17 schizophrenic patients (DSM-IV), mean age 31 (SD=6) and 14 healthy subjects, mean age 30 ( S D - 6 ) . Patients were assessed by Positive And Negative Syndrome Scale (PANSS: Kay et al., 1987). Results." A decrease of N-Acetyl Aspartate-glutamate/ Creatine (NAAg/CRE) in thalamus ( p - 0 . 0 2 ) and in increase of N-Acetyl Aspartate-glutamate/Choline (NAA/CHO) in temporal lobes (p=0.01) were found. NAA/CHO was negatively correlated with the age in control subjects in thalamus (r= 0.65; p=0.01). Positive correlations between CHO/CRE and delusion were found in thalamus and prefrontal cortex in schizophrenics (r=0.48; p=0.05). Furthermore, NAA/CRE and NAA/CHO were negatively correlated with age of onset of illness. Conclusion: These findings suggest, first, a role for the existence of the glutamatergic system in schizophrenia and second, the existence of a neurodegenerative subtype of schizophrenia with late onset of illness.
THE NEUROBIOLOGY OF SEVERE AND REPETETIVE VIOLENCE: A tHMRS STUDY OF FRONTAL
LOBE
D. Robertson, H. Critchley, E. Daly, T. Van Amelsvoort, K. Xenitidis, D. M u r p h y
Department ~]' Psyehological Medicine, Institute ~)]Psyehiato,, King's College Sehool o/Medicine, London, SE5 8AF, UK Background." Schizophrenia is associated with a significantly increased prevalence of violent crime and this is associated with
a high socio-economic cost and social morbidity. However, the neurobiology of violence is poorly understood, and it is unknown if violent behaviour is related to abnormalities in frontal neural integrity in schizophrenia. Thus, we used 1HMRS in people with a history of severe and repetitive violence and non-violent controls to investigate the neurobiological correlates of violent behaviour, and if abnormalities in neural integrity relate to the frequency of violence. Method. We studied 7 repetitively violent inpatients, and 7 non-violent age and IQ matched controls. Frontal ~HMRS was obtained with a 1.5 T GE Signa NMR system, using a PRESS sequence (TR/TE 2000/136 ms) after CHESS water suppression. The voxel was 2 cm 3, positioned in the right dorsomedial frontal lobe according to a standard protocol. Spectra were processed and analysed using SAGE/IDL software. Results. Compared to controls, violent patients had significantly decreased absolute concentrations of frontal creatine (Cr) (p<0.05) and N-acetylaspartate (NAA) (p<0.05). Moreover, number of violent episodes/month was negatively correlated with concentrations of NAA (p<0.008) and Cr (p<0.02). ('onclusion. NAA is a marker for neuronal density, and Cr provides a measure of cellular metabolic turnover. Thus, repetitive violence is associated with abnormalities in neural integrity of frontal lobe, a brain region implicated in the neurobiology of schizophrenia. We hypothesise that patients with schizophrenia who are violent will differ from those who are not in the neural integrity of the frontal lobes.
PROTON
MAGNETIC
SPECTROSCOPY
RESONANCE
(1H-MRS) OF PUTAMEN
IN SCHIZOPHRENIC WITHOUT TARDIVE
PATIENTS WITH AND DYSKINESIA
T. Sigmundsson, H. Wilson, K.R. Chaudhuri, S . C R . Williams, A. Simmons, P.N. Leigh, B.K. Toone
Department of Psychological Medie#~e, The Institute ~! Psychiato,, De Crespiglo~ Park, Denmark Hill, London, SE5 8AF, UK Tardive dyskinesia (TD), is a serious side-effect of chronic neuroleptic treatment in schizophrenia, with a reported prevalence of around 20%. Dyskinesia and other abnormal involuntary movements have also been reported to have a higher prevalance in never-treated schizophrenic patients. Pre-existing basal ganglia pathology as part of the disease process in some schizophrenic patients has been put forward to account for this. This may explain why only some but not all patients on neuroleptic drugs suffer TD. To study this we used proton magnetic resonance spectroscopy (~H-MRS) centered on the putamen (2.88cm 3 voxel) in two groups of schizophrenic patients, with (n=7) and without TD (n=8), compared with age and sex matched healthy comparison subjects (n=8). N-acetyl-aspartate (NAA), a metabolite only found in neurones and believed to reflect neuronal density, was found to be