Study on neural biochemical metabolites of adolescent patients with first-episode schizophrenia / 中华实用儿科临床杂志

ABSTRACT

Objective To study the features of treatment on neurochemical metabolites in prefrontal lobe and thalamus by proton magnetic resonance spectroscopy (1H-MRS) in first-episode drug-naive patients with early-onset schizophrenia (EOS).Methods Forty-two EOS (study group) met with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) were recruited.Prefrontal lobe and thalamus were evaluated by multi-voxel 1H-MRS before and 4-week after treatment with a single atypical antipsychotic.The levels of N-acetylaspartate (NAA),creatine compounds (Cr) and choline-containing compounds (Cho) were measured.The patients also received Positive and Negative Syndrome Scale (PANSS).Forty normal controls (normal control group) underwent the same 1H-MRS detection.Results Before treatment,the NAA/Cr ratios in left prefrontal lobe,right prefrontal lobe and lefi thalamus in study group were lower than those in normal control group (1.45 ± 0.26 vs 1.60 ± 0.34,t =2.251,P =0.027;1.43 ±0.26 vs 1.60 ±0.35,t =2.505,P=0.014;1.48 ±0.27 vs 1.65 ±0.35,t =2.470,P =0.016).After 4-week treatment,the NAA/Cr ratios in both left prefrontal lobe and left thalamus of study group were significantly increased compared with those before treatment (1.58 ± 0.30 vs 1.45 ± 0.26,t =2.122,P =0.037;1.62 ± 0.32 vs 1.48 ± 0.27,t =2.167,P =0.033).After 4-week treatment in study group,the total score,positive symptom score,negative symptom score and general pathologic score of PANSS,and the total score of Clinical Global Impression (CGI) were significantly lower compared with those before treatment (59.1 ± 10.2 vs 82.0 ± 13.2,t =8.896,P=0.000;15.3 ±5.1 vs 22.9 ±7.1,t =5.634,P =0.000;16.4 ±5.2 vs 21.1 ±7.8,t =3.249,P =0.002;27.4 ±7.6 vs 38.1 ± 8.8,t =5.963,P =0.000;3.6 ± 0.4 vs 4.4 ± 0.5,t =8.097,P =0.000).There was no correlation between the changes of neurochemical metabolite levels such as NAA/Cr and Cho/Cr both in prefrontal lobe and left thalamus,and the clinical symptoms changes,such as total score and every score of PANSS,the total score of CGI in study group after treatment (all P ＞ 0.05).Conclusions The ratios of NAA/Cr are decreased not only in bilateral prefrontal lobe,but also in left thalamus,and the ratios may increase both in left prefrontal lobe and left thalamus after 4 weeks' treatment with atypical antipsychotics in EOS.The treatment outcomes of NAA/Cr do not agree with the improvement of the clinical symptoms.