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MR Spectroscopic Studies of the Brain in Psychiatric Disorders.
MR Spectroscopic Studies of the Brain in Psychiatric Disorders.
Curr Top Behav Neurosci. 2012 Feb 1;
Authors: Maddock RJ, Buonocore MH
Abstract
The measurement of brain metabolites with magnetic resonance spectroscopy (MRS) provides a unique perspective on the brain bases of neuropsychiatric disorders. As a context for interpreting MRS studies of neuropsychiatric disorders, we review the characteristic MRS signals, the metabolic dynamics, and the neurobiological significance of the major brain metabolites that can be measured using clinical MRS systems. These metabolites include N-acetylaspartate (NAA), creatine, choline-containing compounds, myo-inositol, glutamate and glutamine, lactate, and gamma-amino butyric acid (GABA). For the major adult neuropsychiatric disorders (schizophrenia, bipolar disorder, major depression, and the anxiety disorders), we highlight the most consistent MRS findings, with an emphasis on those with potential clinical or translational significance. Reduced NAA in specific brain regions in schizophrenia, bipolar disorder, post-traumatic stress disorder, and obsessive-compulsive disorder corroborate findings of reduced brain volumes in the same regions. Future MRS studies may help determine the extent to which the neuronal dysfunction suggested by these findings is reversible in these disorders. Elevated glutamate and glutamine (Glx) in patients with bipolar disorder and reduced Glx in patients with unipolar major depression support models of increased and decreased glutamatergic function, respectively, in those conditions. Reduced phosphomonoesters and intracellular pH in bipolar disorder and elevated dynamic lactate responses in panic disorder are consistent with metabolic models of pathogenesis in those disorders. Preliminary findings of an increased glutamine/glutamate ratio and decreased GABA in patients with schizophrenia are consistent with a model of NMDA hypofunction in that disorder. As MRS methods continue to improve, future studies may further advance our understanding of the natural history of psychiatric illnesses, improve our ability to test translational models of pathogenesis, clarify therapeutic mechanisms of action, and allow clinical monitoring of the effects of interventions on brain metabolic markers.
PMID: 22294088 [PubMed - as supplied by publisher]
Depression: a cultural panic attack.
Depression: a cultural panic attack.
Br J Psychiatry. 2011 Dec;199(6):512-3; author reply 513
Authors: Shepherd A
PMID: 22130751 [PubMed - indexed for MEDLINE]
Depression: a cultural panic attack.
Depression: a cultural panic attack.
Br J Psychiatry. 2011 Dec;199(6):512; author reply 513
Authors: Geaney DP
PMID: 22130750 [PubMed - indexed for MEDLINE]
