Document Detail

Anterior cingulate glutamate levels related to clinical status following treatment in first-episode schizophrenia.
MedLine Citation:
PMID:  22763619     Owner:  NLM     Status:  MEDLINE    
Many patients with schizophrenia show a limited symptomatic response to treatment with dopaminergic antipsychotics. This may reflect the additional involvement of non-dopaminergic neurochemical dysfunction in the pathophysiology of the disorder. We tested the hypothesis that brain glutamate levels would differ between patients with first-episode psychosis who were symptomatic compared with those with minimal symptoms following antipsychotic treatment. Proton magnetic resonance spectroscopy (1H-MRS) spectra were acquired at 3 Tesla in the anterior cingulate cortex and left thalamus in 15 patients with first-episode psychosis in symptomatic remission, and 17 patients with first-episode psychosis who were still symptomatic following at least one course of antipsychotic treatment. Metabolite levels were estimated in ratio to creatine (Cr) using LCModel. Levels of glutamate/Cr in the anterior cingulate cortex were significantly higher in patients who were still symptomatic than in those in remission (T(30)=3.02; P=0.005). Across the entire sample, higher levels of glutamate/Cr in the anterior cingulate cortex were associated with a greater severity of negative symptoms (r=0.42; P=0.017) and a lower level of global functioning (r=-0.47; P=0.007). These findings suggest that clinical status following antipsychotic treatment in schizophrenia is linked to glutamate dysfunction. Treatment with compounds acting on the glutamatergic system might therefore be beneficial in patients who respond poorly to dopaminergic antipsychotics.
Alice Egerton; Stefan Brugger; Marie Raffin; Gareth J Barker; David J Lythgoe; Philip K McGuire; James M Stone
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-07-04
Journal Detail:
Title:  Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology     Volume:  37     ISSN:  1740-634X     ISO Abbreviation:  Neuropsychopharmacology     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-17     Completed Date:  2013-02-26     Revised Date:  2013-10-11    
Medline Journal Info:
Nlm Unique ID:  8904907     Medline TA:  Neuropsychopharmacology     Country:  England    
Other Details:
Languages:  eng     Pagination:  2515-21     Citation Subset:  IM    
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
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MeSH Terms
Antipsychotic Agents / pharmacology,  therapeutic use
Creatine / metabolism
Glutamic Acid / metabolism*
Gyrus Cinguli / drug effects,  metabolism*,  radionuclide imaging
Linear Models
Magnetic Resonance Spectroscopy
Mass Spectrometry
Protons / diagnostic use
Psychiatric Status Rating Scales
Schizophrenia / drug therapy,  pathology*
Young Adult
Reg. No./Substance:
0/Antipsychotic Agents; 0/Protons; 56-86-0/Glutamic Acid; 57-00-1/Creatine

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