Proton Magnetic Resonance Spectroscopy and Illness Stage in Schizophrenia—A Systematic Review and Meta-Analysis
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Background It is not known whether regional brain N-acetyl aspartate (NAA) changes in the progression from prodrome to chronic schizophrenia. We used effect size meta-analysis to determine which brain regions show the most robust reductions in NAA first episode and chronic schizophrenia as measured by proton magnetic resonance spectroscopy and to determine whether these changes are present in individuals at high risk of developing schizophrenia. Methods We identified 131 articles, of which 97 met inclusion criteria. Data were separated by stage of illness (at risk, first episode schizophrenia, chronic schizophrenia) and by brain region. For each region, mean and SD of the NAA measure was extracted. Results Significant reductions in NAA levels were found in frontal lobe, temporal lobe, and thalamus in both patient groups (effect size > .3; p < .01). In individuals at high risk of schizophrenia (of whom approximately 20% would be expected to undergo transition to psychosis), significant NAA reductions were present in thalamus (effect size = .78; p < .05), with reductions at trend level only in temporal lobe (effect size = .32; p < .1), and no reductions in frontal lobe (effect size = .05; p = .5). Conclusions These data suggest that schizophrenia is associated with loss of neuronal integrity in frontal and temporal cortices and in the thalamus and suggest that these changes in the frontal and temporal lobe might occur in the transition between the at-risk phase and the first episode.
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Changes in cortical glutamate levels may vary with the age and treatment history of the patients.
“although it is worth noting that changes in cortical glutamate levels may vary with the age and treatment history of the patients 67 .”
From Developmental timing and critical windows for the treatment of psychiatric disorders (2016) · cites this paper as [67]
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- Authors
- Brugger, S., Davis, J. M., Leucht, S., & Stone, J. M.
- Affiliations
- St George's, University of London (GB)
- University of Maryland, Baltimore (US)
- Technical University of Munich (DE)
- King's College London (GB)
- Corresponding author
- Stone, James M.
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 69
- Issue
- 5
- Pages
- 495-503
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W1983956215
- Cited by
- 131
- References
- 133
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 6 · 2022: 2 · 2021: 4 · 2020: 9 · 2019: 14 · 2018: 6 · 2017: 6 · 2016: 7 · 2015: 14 · 2014: 16 · 2013: 15 · 2012: 17
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Funders
- Eli Lilly
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- schizophrenia, N-acetylaspartate, 1H NMR, disease stage, prodromal schizophrenia, first-episode schizophrenia, chronic schizophrenia, clinical high risk for psychosis, thalamus, frontal lobe, temporal lobe, neuronal integrity, brain metabolites
- MeSH terms
- Aspartic Acid, Data Interpretation, Statistical, Frontal Lobe, Humans, Magnetic Resonance Spectroscopy, Regression Analysis, Risk, Schizophrenia, Schizophrenic Psychology, Temporal Lobe, Thalamus, Publication Bias, Disease Progression
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