Proton Magnetic Resonance Spectroscopy Study of Brain Metabolite Changes after Antipsychotic Treatment

Abstract

Our results confirm that antipsychotic medication modifies brain metabolism measured by means of ¹H MRS. The pattern of the changes suggests a neuroprotective action of antipsychotic medication in schizophrenia.

Structural and functional abnormalities in the caudate nucleus of schizophrenic patients with and without obsessive symptoms

“…The NAA/creatine ratio is markedly reduced among schizophrenic patients with OCS and to less extent in schizophrenic patients without OCS than in controls, which is congruent with the results of other researchers [16,17,37,38]. The increase in the choline to NAA ratio in patients with or without OCS in comparison with controls is in agreement with different studies [13,37,39].…”

1H-magnetic resonance spectroscopy in first episode and chronic schizophrenia patients

“…In addition, we did not evaluate glutamate and glutamine levels, which might be differentiated in spectra using MRS protocols with higher magnetic field strength. As previously reported, not excluding the drug effects on brain metabolites is another limitation of our study (13,(71)(72)(73)(74).…”

The Effect of Aripiprazole versus Risperidone on Prefrontal Brain Metabolite Levels and Brain Volume in Psychotic Disorders: An Exploratory Study

“…Other studies did not show a treatment effect on glutamate levels in the prefrontal cortex [32][33][34][35], although in one studies improvement of negative symptoms was related to increased Glx levels [32] and improvement on total PANSS to lower Glx levels [9]. The observed changes by antipsychotics on Glx levels may be caused by their dopaminergic effects on glutamatergic receptor activity and density and modulation of glutamate release [36].…”

“…It has been reported that NAA did initially not decrease after treatment [34], but eventually did after multiple years [33], although the authors could not confirm whether these effects were specific to antipsychotic exposure. There are also studies that have shown that antipsychotics decrease NAA levels at follow-up [35], that strong antagonists did but weak D2 antagonists did not [40], or that NAA levels increased more after atypical than typical treatment [41,42]. These effects may again be caused by differences in sample size or characteristics, follow-up period, or type and dose of antipsychotics.…”