phosphocreatine and Psychotic-Disorders

Topics: Adenosine Triphosphate; Adult; Analysis of Variance; Asparagine; Diseases in Twins; Female; Humans; Magnetic Resonance Spectroscopy; Male; Middle Aged; Phosphocreatine; Phosphoric Monoester Hydrolases; Phosphorus Isotopes; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Twins, Monozygotic; Young Adult

Schizophrenia is associated with significant brain abnormalities, including changes in brain metabolites as measured by proton magnetic resonance spectroscopy (MRS). What remains unclear is the extent to which these changes are a consequence of the emergence of psychotic disorders or the result of treatment with antipsychotic medication. We assessed 34 patients with first episode psychosis (15 antipsychotic naïve) and 19 age- and gender-matched controls using short-echo MRS in the medial temporal lobe bilaterally. Overall, there were no differences in any metabolite, regardless of treatment status. However, when the analysis was limited to patients with a diagnosis of schizophrenia, schizophreniform or schizoaffective disorder, significant elevations of creatine/phosphocreatine (Cr/PCr) and myo-inositol (mI) were found in the treated group. These data indicate a relative absence of temporal lobe metabolic abnormalities in first episode psychosis, but suggest that some treatment-related changes in mI might be apparent in patients with schizophrenia-spectrum diagnoses. Seemingly illness-related Cr/PCr elevations were also specific to the diagnosis of schizophrenia-spectrum disorder and seem worthy of future study.

Topics: Adult; Antipsychotic Agents; Aspartic Acid; Choline; Creatine; Female; Frontal Lobe; Functional Laterality; Humans; Image Processing, Computer-Assisted; Inositol; Magnetic Resonance Spectroscopy; Male; Phosphocreatine; Psychotic Disorders; Schizophrenia; Temporal Lobe

Recent magnetic resonance imaging studies have attempted to relate volumetric brain measurements in early schizophrenia to clinical and functional outcome some years later. These studies have generally been negative, perhaps because gray and white matter volumes inaccurately assess the underlying dysfunction that might be predictive of outcome.. To investigate the predictive value of frontal and temporal spectroscopy measures for outcome in patients with first-episode psychoses.. Left prefrontal cortex and left mediotemporal lobe voxels were assessed using proton magnetic resonance spectroscopy to provide the ratio of N-acetylaspartate (NAA) and choline-containing compounds to creatine and phosphocreatine (Cr) (NAA/Cr ratio). These data were used to predict outcome at 18 months after admission, as assessed by a systematic medical record audit.. Early psychosis clinic.. Forty-six patients with first-episode psychosis.. We used regression models that included age at imaging and duration of untreated psychosis to predict outcome scores on the Global Assessment of Functioning Scale, Clinical Global Impression scales, and Social and Occupational Functional Assessment Scale, as well as the number of admissions during the treatment period. We then further considered the contributions of premorbid function and baseline level of negative symptoms.. The only spectroscopic predictor of outcome was the NAA/Cr ratio in the prefrontal cortex. Low scores on this variable were related to poorer outcome on all measures. In addition, the frontal NAA/Cr ratio explained 17% to 30% of the variance in outcome.. Prefrontal neuronal dysfunction is an inconsistent feature of early psychosis; rather, it is an early marker of poor prognosis across the first years of illness. The extent to which this can be used to guide treatment and whether it predicts outcome some years after first presentation are questions for further research.

Topics: Adult; Aspartic Acid; Choline; Creatine; Female; Follow-Up Studies; Functional Laterality; Hippocampus; Humans; Magnetic Resonance Spectroscopy; Male; Outcome Assessment, Health Care; Patient Readmission; Phosphocreatine; Predictive Value of Tests; Prefrontal Cortex; Prognosis; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia; Temporal Lobe

Following the chronic use of methamphetamine, some individuals experience psychosis and anxiety. One reason may be the persistence of metabolite abnormalities in the brain of currently abstinent former methamphetamine users. In this study, N-acetylaspartate (NAA), creatine plus phosphocreatine (Cr+PCr), and choline-containing compound (Cho) levels were measured in the left and right basal ganglia using proton magnetic resonance spectroscopy (MRS) in 13 abstinent methamphetamine users and 11 healthy comparison subjects with no history of illicit drug use. The methamphetamine users showed a significantly reduced Cr+PCr/Cho ratio in the bilateral basal ganglia compared with the healthy comparison subjects. Furthermore, the reduction in the Cr+PCr/Cho ratio was significantly correlated with the duration of methamphetamine use and with the severity of residual psychiatric symptoms. NAA/Cho ratios in the bilateral basal ganglia did not significantly differ between methamphetamine users and comparison subjects. These findings suggest that protracted use of methamphetamine may cause metabolite alterations in the basal ganglia. Furthermore, residual psychiatric symptoms may be attributable to the metabolite alterations in the basal ganglia.

Topics: Adult; Analysis of Variance; Aspartic Acid; Basal Ganglia; Central Nervous System Stimulants; Choline; Female; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Methamphetamine; Phosphocreatine; Psychiatric Status Rating Scales; Psychotic Disorders

The authors measured the ratio of N-acetyl aspartate (a putative neuronal marker) to creatine-phosphocreatine in patients with first-episode psychosis by using proton magnetic resonance spectroscopy (MRS).. Temporal lobe 1H MRS was performed bilaterally on 13 patients with first-episode psychosis and 15 comparison subjects. The N-acetyl aspartate/creatine-phosphocreatine and choline/creatine-phosphocreatine ratios were determined.. The N-acetyl aspartate/creatine-phosphocreatine ratio of the psychotic patients was significantly lower than that of the comparison subjects.. These preliminary data suggest that abnormalities in temporal lobe N-acetyl aspartate concentration are present early in psychotic illness.

Topics: Adult; Aspartic Acid; Choline; Creatinine; Female; Functional Laterality; Humans; Magnetic Resonance Spectroscopy; Male; Phosphocreatine; Psychotic Disorders; Temporal Lobe