Abnormal neurobiochemical metabolites in the first- episode schizophrenia and clinical high-risk population.

OBJECTIVES

To explore the metabolite characteristics in medial prefrontal cortex (mPFC) by 1H magnetic resonance spectroscopy (1H-MRS) in the first-episode schizophrenia (FES) and clinical high-risk (CHR) people.

METHODS

A total of 46 patients with the first-episode schizophrenia (FES), 49 people with clinical high risk (CHR), 61 people with genetic high risk (GHR), and 58 healthy controls (HC) were enrolled. The levels of N-acetylaspartylglutamate+N-acetylaspartate (tNAA), choline-containing compounds (Cho) and myo-inositol (MI), glutamate+glutamine (Glx) in medial prefrontal cortex were measured by single-voxel 1H-MRS. The clinical symptoms were evaluated in the FES group and the CHR group. Continuous performance test (CPT) were carried out to assess the visual and auditory accuracy and reaction time in the 4 groups.

RESULTS

There were significant differences in Glx, tNAA, and MI concentrations among 4 groups (all P<0.05). Compared with the HC group, the FES group showed lower level of MI and Glx. The levels of Glx and tNAA in the CHR group were significantly lower than those in the GHR group (all P<0.05). The visual and auditory accuracies of CPT in the FES group were significantly lower than those in the HC group (P<0.05). In the FES group, Glx was negatively correlated with the reaction time of vision (r=-0.41, P=0.05).

CONCLUSIONS

The decreased levels of MI and Glx in the FES patients suggest that there may be glial functional damage and glutamatergic transmitter dysfunction in the early stage of the disease. The compensatory increase of metabolites may be a protective factor for schizophrenia in the genetic individuals.