title: Hypo-metabolism of the rostral anterior cingulate cortex associated with working memory impairment in 18 cases of schizophrenia.
abstract: Working memory (Work-Mem), the capacity to hold and manipulate information, activates the anterior cingulate cortex (ACC), especially its caudal subregion. Impaired Work-Mem and structural and functional abnormalities of the ACC are reported in schizophrenia. This study aims to elucidate the pathogenesis of Work-Mem dysfunction in schizophrenia by comparing metabolite concentrations across ACC subregions. This retrospective study of 18 schizophrenia cases and 10 matched controls used proton magnetic resonance spectroscopic imaging ((1)H-MRSI, TR/TE = 1800/35 ms, 0.5 cm(3) spatial resolution) to test whether the Work-Mem Index of the Wechsler Adult Intelligence Scale, third edition is associated with differences in the rostral to caudal ACC ratios of N-acetylaspartate (NAA) and creatine (Cr). Higher caudal:rostral ACC Cr (but not NAA) concentrations were associated with decreased Work-Mem Index in cases (r = -0.6, p = 0.02), with a similar trend in controls (r = -0.56, p = 0.10), although caudal:rostral ACC Cr correlated with NAA in cases and controls (r = 0.67 and 0.62, p < 0.05 for both). NAA and Cr ratios did not correlate with myo-inositol, excluding gliosis as the underlying process. Subjects' sex and age had no effects on these relationships. The findings suggest that rostral ACC energy hypo-metabolism, possibly arising from neurodevelopmental processes, is associated with working memory impairment in schizophrenia. Changes in the rostral (not the expected caudal) subregion underscore the interconnections between the ACC subregions and may offer laboratory markers for treatment trials, etiology studies, and perhaps even enhanced identification of prodromal "at risk" subjects.
authors: Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA.|Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA.
authors: Robert
authors: R
authors: Mazgaj
authors: Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY, 10016, USA.
authors: Assaf
authors: A
authors: Tal
authors: Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA.
authors: Raymond
authors: R
authors: Goetz
authors: Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY, 10016, USA.
authors: Mariana
authors: M
authors: Lazar
authors: Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA.|Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA.
authors: Karen
authors: K
authors: Rothman
authors: Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA.|Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA.|Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA.
authors: Julie Walsh
authors: JW
authors: Messinger
authors: Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA. Dolores.Malaspina@nyumc.org.|Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA. Dolores.Malaspina@nyumc.org.
authors: Dolores
authors: D
authors: Malaspina
authors: Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY, 10016, USA.
authors: Oded
authors: O
authors: Gonen
mesh_terms: D000328:Adult; D000375:Aging / Q000378:metabolism; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D005911:Gliosis / Q000378:metabolism; D006179:Gyrus Cinguli / Q000378:metabolism*; D006801:Humans; D007294:Inositol / Q000378:metabolism; D007361:Intelligence Tests; D008297:Male; D008569:Memory Disorders / Q000378:metabolism*; D008570:Memory, Short-Term / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D066244:Proton Magnetic Resonance Spectroscopy; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy / Q000378:metabolism*; D012565:Schizophrenic Psychology; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine
keywords: Anterior cingulate cortex; Creatine; Energy metabolism; Proton magnetic resonance spectroscopic imaging; Schizophrenia; Working memory