title: N-acetyl aspartate concentration in the anterior cingulate cortex in patients with schizophrenia: a study of clinical and neuropsychological correlates and preliminary exploration of cognitive behaviour therapy effects.
abstract: This study investigated the clinical and neuropsychological correlates of N-acetyl aspartate (NAA) concentration in the anterior cingulate cortex (ACC) in schizophrenia, and explored whether ACC NAA concentration is sensitive to symptom change following cognitive behaviour therapy for psychosis (CBTp). Participants comprised 30 patients and 15 healthy controls who underwent magnetic resonance spectroscopy of the ACC and were assessed on frontal lobe based neuropsychological tasks. Twenty-four (of 30) patients were followed-up; 11 subsequently received 8-9 months of CBTp in addition to standard care (CBTp+SC) and 13 received SC only. At baseline (i) NAA and Cr concentrations were lower in patients compared to controls, (ii) in patients, NAA concentration correlated inversely with positive symptoms and general psychopathology (positive symptoms explained 21% of the variance; total variance explained=25%) and Cho concentration correlated inversely with positive symptoms, and (iii) in controls, NAA concentration correlated positively with working and short-term memory and Cr concentration inversely with executive function. NAA concentration tended to increase in CBTp+SC patients at follow-up (n=7 with usable data) concomitant with improvement in positive symptoms. NAA concentration may be more closely associated with symptoms and symptom change than frontal lobe based neuropsychological function in schizophrenia, perhaps because the latter is relatively stable during the long-term illness course.
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Preethi
authors.initials: P
authors.lastname: Premkumar
authors.forename: Vivek A
authors.initials: VA
authors.lastname: Parbhakar
authors.forename: Dominic
authors.initials: D
authors.lastname: Fannon
authors.forename: David
authors.initials: D
authors.lastname: Lythgoe
authors.forename: Steven C
authors.initials: SC
authors.lastname: Williams
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.forename: Veena
authors.initials: V
authors.lastname: Kumari
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D002648:Child; D002794:Choline / Q000378:metabolism; D003072:Cognition Disorders / Q000209:etiology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003401:Creatine / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006179:Gyrus Cinguli / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D009483:Neuropsychological Tests; D012044:Regression Analysis; D012559:Schizophrenia / Q000150:complications / Q000473:pathology* / Q000534:rehabilitation*; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline