title: Metabolic Abnormalities in the Hippocampus of Patients with Schizophrenia: A 3D Multivoxel MR Spectroscopic Imaging Study at 3T.
abstract: Schizophrenia is well-known to be associated with hippocampal structural abnormalities. We used1H-MR spectroscopy to test the hypothesis that these abnormalities are accompanied by NAA deficits, reflecting neuronal dysfunction, in patients compared with healthy controls.
  
  
  
  Nineteen patients with schizophrenia (11 men; mean age, 40.6 ± 10.1 years; mean disease duration, 19.5 ± 10.5 years) and 11 matched healthy controls (5 men; mean age, 33.7 ± 10.1 years) underwent MR imaging and multivoxel point-resolved spectroscopy (TE/TR, 35/1400 ms)1H-MRS at 3T to obtain their hippocampal GM absolute NAA, Cr, Cho, and mIns concentrations. Unequal variance t tests and ANCOVA were used to compare patients with controls. Bilateral volumes from manually outlined hippocampal masks were compared by using unequal variance t tests.
  
  
  
  Patients' average hippocampal GM Cr concentrations were 19% higher than that of controls, 8.7 ± 2.2 versus 7.4 ± 1.2 mmol/L (P < .05); showing no differences, concentrations in NAA were 8.8 ± 1.6 versus 8.7 ± 1.2 mmol/L; in Cho, 2.3 ± 0.7 versus 2.1 ± 0.3 mmol/L; and in mIns, 6.1 ± 1.5 versus 5.2 ± 0.9 (all P > .1). There was a positive correlation between mIns and Cr in patients (r = 0.57, P = .05) but not in controls. The mean bilateral hippocampal volume was ∼10% lower in patients: 7.5 ± 0.9 versus 8.4 ± 0.7 cm3(P < .05).
  
  
  
  These findings suggest that the hippocampal volume deficit in schizophrenia is not due to net loss of neurons, in agreement with histopathology studies but not with prior1H-MR spectroscopy reports. Elevated Cr is consistent with hippocampal hypermetabolism, and its correlation with mIns may also suggest an inflammatory process affecting some cases; these findings may suggest treatment targets and markers to monitor them.
authors.affiliation: From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging.
authors.forename: E J
authors.identifier: 0000-0002-9717-8707
authors.initials: EJ
authors.lastname: Meyer
authors.affiliation: From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging.
authors.forename: I I
authors.identifier: 0000-0001-5641-8578
authors.initials: II
authors.lastname: Kirov
authors.affiliation: Department of Chemical Physics (A.T.), Weizmann Institute of Science, Rehovot, Israel.
authors.forename: A
authors.identifier: 0000-0001-6718-6522
authors.initials: A
authors.lastname: Tal
authors.affiliation: From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging.
authors.forename: M S
authors.identifier: 0000-0002-9029-5222
authors.initials: MS
authors.lastname: Davitz
authors.affiliation: From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging.
authors.forename: J S
authors.identifier: 0000-0003-1798-1186
authors.initials: JS
authors.lastname: Babb
authors.affiliation: From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging.
authors.forename: M
authors.identifier: 0000-0001-9285-8124
authors.initials: M
authors.lastname: Lazar
authors.affiliation: Department of Psychiatry (D.M.), Institute for Social and Psychiatric Initiatives, New York University School of Medicine, New York, New York.
authors.forename: D
authors.identifier: 0000-0002-5599-5151
authors.initials: D
authors.lastname: Malaspina
authors.affiliation: From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging oded.gonen@med.nyu.edu.
authors.forename: O
authors.identifier: 0000-0002-3148-2028
authors.initials: O
authors.lastname: Gonen
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000378:metabolism; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology
chemical_list: D001224:Aspartic Acid; D003401:Creatine; D002794:Choline