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The British Journal of Psychiatry (2004) 184: 409-415
© 2004 The Royal College of Psychiatrists

Focal changes in brain energy and phospholipid metabolism in first-episode schizophrenia

31P–MRS chemical shift imaging study at 4 Tesla

J. Eric Jensen, PhD

Brain Imaging Center, McLean Hospital, Belmont, and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA

Jodi Miller, BSc

Department of Medical Biophysics, University of Western Ontario, and Diagnostic Radiology and Nuclear Medicine, St Joseph’s Health Care, London, Ontario

Peter C. Williamson, MD

Departments of Medical Biophysics and Psychiatry, University of Western Ontario

Richard W. J. Neufeld, PhD

Department of Psychology, University of Western Ontario

Ravi S. Menon, PhD

Department of Medical Biophysics, University of Western Ontario, and Laboratory for Magnetic Resonance Imaging Research, Robarts Research Institute, London, Ontario

Ashok Malla, MD

Douglas Hospital, McGill University, Montreal, Quebec

Rahul Manchanda, MD and Betsy Schaefer, BSc

Department of Psychiatry, University of Western Ontario

Maria Densmore, BSc

Diagnostic Radiology and Nuclear Medicine, St Joseph’s Health Care, London, Ontario

Dick J. Drost, PhD

Departments of Medical Biophysics and Psychiatry, University of Western Ontario, and Diagnostic Radiology and Nuclear Medicine, St Joseph’s Health Care, London, Ontario, Canada

Correspondence: Dr J. Eric Jensen, Room 208,Brain Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478-9106, USA. E-mail: ejensen{at}mclean.harvard.edu

Declaration of interest None. Funding detailed in Acknowledgement.

Background Membrane phospholipid and high-energy abnormalities measured with phosphorus magnetic resonance spectroscopy (31P–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 31P–MRS.

Method Brain spectra were collected in vivo from 15 patients with first-episode schizophrenia and 15 healthy volunteers from 15 cm3 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.


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