N-acetylaspartate (NAA) levels in selected areas of the brain in patients with chronic schizophrenia treated with typical and atypical neuroleptics: a proton magnetic resonance spectroscopy (1H MRS) study.
BACKGROUND
NAA, marker of neurons integrity and viability, is one of the most important brain metabolites visible in 1H MRS. In most studies of schizophrenia, the decrease of NAA level was observed in the temporal, frontal lobes and in the thalamus. This finding was observed more often among chronic patients, what suggests the influence of disease duration or the effect of neuroleptic treatment. The aim of the present study was the comparison of NAA levels in brain of schizophrenic patients taking typical and atypical neuroleptics.


METHODS
We analyzed the NAA levels in selected brain areas in 58 schizophrenic patients and 21 healthy controls. 10 patients were treated with typical neuroleptics, 10 patients with clozapine, 17 received olanzapine and 21 - risperidone. 1H MRS was performed on a 1,5 MR scanner with PRESS sequence. Voxels of 2x2x2 cm were localized in the left frontal, left temporal lobe and left thalamus.


RESULTS
There were no differences in NAA levels between patients on typical and atypical medications analyzed together and separately (olanzapine, clozapine and risperidone groups). We also did not find any differences between patients taking selected atypical neuroleptics and controls. The NAA level in the thalamus in the group of patients receiving typical antipsychotics was the lowest among all groups and differed significantly from healthy controls.


CONCLUSIONS
The results of our study suggest that atypical neuroleptics may have favorable effect on NAA concentration in brain of schizophrenic patients. Decrease in NAA level in patients taking typical medication may be caused by the progression of the disease or by the direct action of these drugs.
Szulc
Agata
A
Department of Psychiatry, Medical University of Białystok, Białystok, Poland. agataszulc@poczta.onet.pl <agataszulc@poczta.onet.pl>
Galińska
Beata
B
Tarasów
Eugeniusz
E
Kubas
Bozena
B
Dzienis
Wojciech
W
Konarzewska
Beata
B
Poplawska
Regina
R
Tomczak
Anna A
AA
Czernikiewicz
Andrzej
A
Walecki
Jerzy
J
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001921:Brain / Q000033:anatomy & histology* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology
D014150:Antipsychotic Agents; D001224:Aspartic Acid; C000179:N-acetylaspartate