The British Journal of Psychiatry (2007) 191: 325-334. doi: 10.1192/bjp.bp.106.033670
© 2007 The Royal College of Psychiatrists
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Longitudinal grey-matter and glutamatergic losses in first-episode schizophrenia

JEAN THÉBERGE, PhD

Department of Diagnostic Imaging, St Joseph’s Health Care, Lawson Health Research Institute, Department of Medical Biophysics and Department of Psychiatry, University of Western Ontario, London, Ontario

KATE E. WILLIAMSON, BScH

Lawson Health Research Institute and Department of Psychiatry, University of Western Ontario, London, Ontario

NAOKO AOYAMA, MSc

Lawson Health Research Institute and Department of Medical Biophysics, University of Western Ontario, London, Ontario

DICK J. DROST, PhD

Department of Diagnostic Imaging, St Joseph’s Health Care, Lawson Health Research Institute, Department of Medical Biophysics and Department of Psychiatry, University of Western Ontario, London, Ontario

RAHUL MANCHANDA, MD

Department of Psychiatry, University of Western Ontario, London, Ontario

ASHOK K. MALLA, MBBS

Department of Psychiatry, McGill University, Montreal, Quebec

SANDRA NORTHCOTT, MD

Department of Psychiatry, University of Western Ontario, London, Ontario

RAVI S. MENON, PhD

Departments of Medical Biophysics and Psychiatry, University of Western Ontario and Centre for Functional and Metabolic Mapping, Robarts Research Institute, London, Ontario

RICHARD W. J. NEUFELD, PhD

Departments of Psychology and Psychiatry, University of Western Ontario

NAGALINGAM RAJAKUMAR, PhD

Departments of Medical Biophysics, Psychiatry, and Anatomy and Cell Biology, University of Western Ontario, London, Ontario

WILLIAM PAVLOSKY, MD

Department of Diagnostic Imaging, St Joseph’s Health Care, London, Ontario

MARIA DENSMORE, BSc

Lawson Health Research Institute and Department of Psychiatry, University of Western Ontario

BETSY SCHAEFER, BSc

Department of Psychiatry, University of Western Ontario

PETER C. WILLIAMSON, MD

Lawson Health Research Institute and Departments of Psychiatry and Medical Biophysics, University of Western Ontario, London, Ontario, Canada

Correspondence: Dr Jean Théberge, St Joseph’s Health Care, Nuclear Medicine and MR, Room B5-233, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada. Tel: +1 519 646 6100 (x65635); fax: +1 519 646 6399; e-mail: jtheberge{at}lawsonimaging.ca

Declaration of interest None. Funding detailed in Acknowledgements.

Background Progressive volumetric changes in the brains of people with schizophrenia have been attributed to a number of factors.

Aims To determine whether glutamatergic changes in patients with schizophrenia correlated with grey-matter losses during the first years of illness.

Method Left anterior cingulate and thalamic glutamatergic metabolite levels and grey-matter volumes were examined in 16 patients with first-episode schizophrenia before and after 10 months and 30 months of antipsychotic treatment and in 16 healthy participants on two occasions 30 months apart.

Results Higher than normal glutamine levels were found in the anterior cingulate and thalamus of never-treated patients. Thalamic levels of glutamine were significantly reduced after 30 months. Limited grey-matter reductions were seen in patients at 10 months followed by widespread grey-matter loss at 30 months. Parietal and temporal lobe grey-matter loss was correlated with thalamic glutamine loss.

Conclusions Elevated glutamine levels in never-treated patients followed by decreased thalamic glutamine and grey-matter loss in connected regions could indicate either neurodegeneration or a plastic response to reduced subcortical activity.


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