title: Neuroprotective Effect of Modified Electroconvulsive Therapy for Schizophrenia: A Proton Magnetic Resonance Spectroscopy Study.
abstract: The underlying mechanism of modified electroconvulsive therapy (MECT) treatment for drug-resistant and catatonic schizophrenia remains unclear. Here, we aim to investigate whether MECT exerts its antipsychotic effects through elevating N-acetylaspartate (NAA) concentration measured by proton magnetic resonance spectroscopy (H-MRS). Multiple-voxel H-MRS was acquired in the bilateral prefrontal cortex (PFC) and thalamus to obtain measures of neurochemistry in 32 MECT, 34 atypical antipsychotic-treated schizophrenic patients, and 34 healthy controls. We found that both MECT and atypical antipsychotic treatments showed significant antipsychotic efficacy. MECT and atypical antipsychotic treatments reversed the reduced NAA/creatine ratio (NAA/Cr) in the left PFC and left thalamus in schizophrenic patients compared with healthy controls. Furthermore, the NAA/Cr ratio after treatments was significant higher in the MECT group, but not in the medication group. Our findings demonstrate that eight times of MECT elevated the relative NAA concentration to display neuroprotective effect, which may be the underlying mechanism of rapid antipsychotic efficacy.
authors.affiliation: *Mental Diseases Prevention and Treatment Institute of Chinese PLA; and †Center for Medical Imaging, Jiaozuo, PR China.
authors.forename: Jing-Li
authors.initials: JL
authors.lastname: Gan
authors.forename: Hui-Feng
authors.initials: HF
authors.lastname: Duan
authors.forename: Zheng-Xiang
authors.initials: ZX
authors.lastname: Cheng
authors.forename: Jia-Ming
authors.initials: JM
authors.lastname: Yang
authors.forename: Xi-Quan
authors.initials: XQ
authors.lastname: Zhu
authors.forename: Cun-You
authors.initials: CY
authors.lastname: Gao
authors.forename: Lan-Min
authors.initials: LM
authors.lastname: Zhao
authors.forename: Xue-Jun
authors.initials: XJ
authors.lastname: Liang
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D000066829:Neuroprotection / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000378:metabolism*; D066244:Proton Magnetic Resonance Spectroscopy; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000628:therapy*; D013788:Thalamus / Q000000981:diagnostic imaging / Q000378:metabolism*; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine