title: Elevated brain lactate in schizophrenia: a 7 T magnetic resonance spectroscopy study.
abstract: Various lines of evidence suggest that brain bioenergetics and mitochondrial function may be altered in schizophrenia. On the basis of prior phosphorus-31 (31P)-magnetic resonance spectroscopy (MRS), post-mortem and preclinical studies, this study was designed to test the hypothesis that abnormal glycolysis leads to elevated lactate concentrations in subjects with schizophrenia. The high sensitivity of 7 Tesla proton (1H)-MRS was used to measure brain lactate levels in vivo. Twenty-nine controls and 27 participants with schizophrenia completed the study. MRS scanning was conducted on a Philips 'Achieva' 7T scanner, and spectra were acquired from a voxel in the anterior cingulate cortex. Patients were assessed for psychiatric symptom severity, and all participants completed the MATRICS Consensus Cognitive Battery (MCCB) and University of California, San Diego Performance-Based Skills Assessment (UPSA). The relationship between lactate, psychiatric symptom severity, MCCB and UPSA was examined. Lactate was significantly higher in patients compared with controls (P=0.013). Higher lactate was associated with lower MCCB (r=-0.36, P=0.01) and UPSA total scores (r=-0.43, P=0.001). We believe this is the first study to report elevated in vivo cerebral lactate levels in schizophrenia. Elevated lactate levels in schizophrenia may reflect increased anaerobic glycolysis possibly because of mitochondrial dysfunction. This study also suggests that altered cerebral bioenergetics contribute to cognitive and functional impairments in schizophrenia.
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.|Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Rowland
authors.affiliation: Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Kirby Imaging Center, Kennedy Krieger Institute, Baltimore, MD, USA.
authors.forename: S
authors.initials: S
authors.lastname: Pradhan
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: S
authors.initials: S
authors.lastname: Korenic
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Wijtenburg
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Hong
authors.affiliation: Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Kirby Imaging Center, Kennedy Krieger Institute, Baltimore, MD, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Edden
authors.affiliation: Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Kirby Imaging Center, Kennedy Krieger Institute, Baltimore, MD, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Barker
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000503:physiopathology*; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D019344:Lactic Acid