title: Neurometabolites in schizophrenia and bipolar disorder - a systematic review and meta-analysis.
abstract: This meta-analysis evaluates alterations of neurometabolites in schizophrenia and bipolar disorder. PubMed was searched to find controlled studies evaluating N-acetylaspartate (NAA), Choline (Cho) and Creatine (Cr) assessed with ((1))H-MRS (proton magnetic resonance spectroscopy) in patients with schizophrenia and bipolar disorder up to September 2010. Random effects meta-analyses were conducted to estimate pooled standardized mean differences. The statistic was used to quantify inconsistencies. Subgroup analyses were conducted to explore potential explanations for inconsistencies. The systematic review included 146 studies with 5643 participants. NAA levels were affected in schizophrenia and bipolar disorder. Decreased levels in the basal ganglia and frontal lobe were the most consistent findings in schizophrenia; decreased levels in the basal ganglia were the most consistent findings in bipolar disorder. Cho and Cr levels were not altered in either disorder. Findings for Cr were most consistent in the thalamus, frontal lobe and dorsolateral prefrontal cortex in schizophrenia and the basal ganglia and frontal lobe in bipolar disorder. Findings for Cho were most consistent in the thalamus, frontal lobe and anterior cingulate cortex in schizophrenia and basal ganglia in bipolar disorder. Large, carefully designed studies are needed to better estimate the extent of alterations in neurometabolites.
authors.affiliation: Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, AL, USA. nkraguljac@uab.edu
authors.forename: Nina Vanessa
authors.initials: NV
authors.lastname: Kraguljac
authors.forename: Meredith
authors.initials: M
authors.lastname: Reid
authors.forename: David
authors.initials: D
authors.lastname: White
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jones
authors.forename: Jan
authors.initials: J
authors.lastname: den Hollander
authors.forename: Deborah
authors.initials: D
authors.lastname: Lowman
authors.forename: Adrienne Carol
authors.initials: AC
authors.lastname: Lahti
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001479:Basal Ganglia / Q000378:metabolism; D001714:Bipolar Disorder / Q000378:metabolism* / Q000523:psychology; D002794:Choline / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D017397:Prefrontal Cortex; D012016:Reference Values; D012559:Schizophrenia / Q000378:metabolism*; D012565:Schizophrenic Psychology; D013788:Thalamus / Q000378:metabolism
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline