Glutamate in Schizophrenia: A Focused Review and Meta-Analysis of 1H-MRS Studies

被引:314
作者
Marsman, Anouk [1 ]
van den Heuvel, Martijn P. [1 ]
Klomp, Dennis W. J. [2 ]
Kahn, Rene S. [1 ]
Luijten, Peter R. [2 ]
Pol, Hilleke E. Hulshoff [1 ]
机构
[1] Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Psychiat, NL-3508 GA Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Dept Radiol, NL-3508 GA Utrecht, Netherlands
关键词
magnetic resonance spectroscopy; glutamatergic system; aging; MAGNETIC-RESONANCE-SPECTROSCOPY; SPATIAL WORKING-MEMORY; NMDA RECEPTOR SUBUNITS; TWIN PAIRS DISCORDANT; MEDIAL TEMPORAL-LOBE; HIGH GENETIC RISK; ANTERIOR CINGULATE; PREFRONTAL CORTEX; 1ST-EPISODE SCHIZOPHRENIA; BRAIN VOLUME;
D O I
10.1093/schbul/sbr069
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Schizophrenia is a severe chronic psychiatric illness, characterized by hallucinations and delusions. Decreased brain volumes have been observed in the disease, although the origin of these changes is unknown. Changes in the n-methyl-d-aspartate (NMDA)-receptor mediated glutamatergic neurotransmission are implicated, since it is hypothesized that NMDA-receptor dysfunction in schizophrenia leads to increased glutamate release, which can have excitotoxic effects. However, the magnitude and extent of changes in glutamatergic metabolites in schizophrenia are not clear. With H-1 magnetic resonance spectroscopy (H-1-MRS), in vivo information about glutamate and glutamine concentrations can be obtained in the brain. A systematic search through the MEDLINE database was conducted to identify relevant H-1-MRS studies that examined differences in glutamate and glutamine concentrations between patients with schizophrenia and healthy control subjects. Twenty-eight studies were identified and included a total of 647 patients with schizophrenia and 608 healthy-control subjects. For each study, Cohen's d was calculated and main effects for group analyses were performed using the random-effects model. Medial frontal region glutamate was decreased and glutamine was increased in patients with schizophrenia as compared with healthy individuals. Group-by-age associations revealed that in patients with schizophrenia, glutamate and glutamine concentrations decreased at a faster rate with age as compared with healthy controls. This could reflect aberrant processes in schizophrenia, such as altered synaptic activity, changed glutamate receptor functioning, abnormal glutamine-glutamate cycling, or dysfunctional glutamate transport.
引用
收藏
页码:120 / 129
页数:10
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