Focal changes in brain energy and phospholipid metabolism in first-episode schizophrenia -: 31P-MRS chemical shift imaging study at 4 Tesla

Background: Membrane phospholipid and high-energy abnormalities measured with phosphorus magnetic resonance spectroscopy (P-31-MRS) have been reported in patients with schizophrenia in several brain regions. Aims: Using improved imaging techniques, previously inaccessible brain regions were examined in patients with first-episode schizophrenia and healthy volunteers with 4.0 T P-31-MRS. Method: Brain spectra were collected in vivo from 15 patients with first-episode schizophrenia and 15 healthy volunteers from 15 cm(3) effective voxels in the thalamus, cerebellum, hippocampus, anterior/posterior cingulate, prefrontal cortex and parieto-occipital cortex. Results: People with first-episode schizophrenia showed increased levels of glycerophosphocholine in the anterior cingulate. Inorganic phosphate, phosphocreatine and adenosine triphosphate concentrations were also increased in the anterior cingulate in this group. Conclusions: The increased phosphodiester and high-energy phosphate levels in the anterior cingulate of brains of people with first-episode schizophrenia may indicate neural overactivity in this region during the early stages of the illness, resulting in increased excitotoxic neural membrane breakdown. Declaration of interest: None. Funding detailed in Acknowledgement.