Comparison of Metabolite Concentrations in the Left Dorsolateral Prefrontal Cortex, the Left Frontal White Matter, and the Left Hippocampus in Patients in Stable Schizophrenia Treated with Antipsychotics with or without Antidepressants. ¹H-NMR Spectroscopy Study.
Managing affective, negative, and cognitive symptoms remains the most difficult therapeutic problem in stable phase of schizophrenia. Efforts include administration of antidepressants. Drugs effects on brain metabolic parameters can be evaluated by means of proton nuclear magnetic resonance (¹H-NMR) spectroscopy. We compared spectroscopic parameters in the left prefrontal cortex (DLPFC), the left frontal white matter (WM) and the left hippocampus and assessed the relationship between treatment and the spectroscopic parameters in both groups. We recruited 25 patients diagnosed with schizophrenia (DSM-IV-TR), with dominant negative symptoms and in stable clinical condition, who were treated with antipsychotic and antidepressive medication for minimum of three months. A group of 25 patients with schizophrenia, who were taking antipsychotic drugs but not antidepressants, was matched. We compared metabolic parameters (N-acetylaspartate (NAA), myo-inositol (mI), glutamatergic parameters (Glx), choline (Cho), and creatine (Cr)) between the two groups. All patients were also assessed with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). In patients receiving antidepressants we observed significantly higher NAA/Cr and NAA/Cho ratios within the DLPFC, as well as significantly higher mI/Cr within the frontal WM. Moreover, we noted significantly lower values of parameters associated with the glutamatergic transmission--Glx/Cr and Glx/Cho in the hippocampus. Doses of antipsychotic drugs in the group treated with antidepressants were also significantly lower in the patients showing similar severity of psychopathology.
Department of Affective and Psychotic Disorders, Medical University of Łódź, Central Clinical Hospital, Łódź 92-213, Poland. dominik.strzelecki@umed.lodz.pl.
Dominik
D
Strzelecki
Department of Radiology-Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No. 1, Łódź 90-153, Poland. piotr.grzelak@umed.lodz.pl.
Piotr
P
Grzelak
Department of Radiology-Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No. 1, Łódź 90-153, Poland. chilam@tlen.pl.
Michał
M
Podgórski
Department of Affective and Psychotic Disorders, Medical University of Łódź, Central Clinical Hospital, Łódź 92-213, Poland. okaluzynska@gmail.com.
Olga
O
Kałużyńska
Department of Radiology-Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No. 1, Łódź 90-153, Poland. ludomir.stefanczyk@umed.lodz.pl.
Ludomir
L
Stefańczyk
Department of Affective and Psychotic Disorders, Medical University of Łódź, Central Clinical Hospital, Łódź 92-213, Poland. magdalena.kotlicka-antczak@umed.lodz.pl.
Magdalena
M
Kotlicka-Antczak
Department of Adolescent Psychiatry, Medical University of Łódź, Central Clinical Hospital, Łódź 92-213, Poland. agnieszka.gmitrowicz@umed.lodz.pl.
Agnieszka
A
Gmitrowicz
D000328:Adult; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006624:Hippocampus / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D008297:Male; D055442:Metabolome / Q000187:drug effects; D017397:Prefrontal Cortex / Q000187:drug effects / Q000378:metabolism*; D066244:Proton Magnetic Resonance Spectroscopy; D012044:Regression Analysis; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism; D066127:White Matter / Q000378:metabolism*
D000928:Antidepressive Agents; D014150:Antipsychotic Agents
1H-NMR spectroscopy; SNRI; SSRI; dorso-lateral prefrontal cortex; frontal white matter; hippocampus; schizophrenia