OBSERVATION OF METABOLIC CHANGES IN CHRONIC-SCHIZOPHRENIA AFTER NEUROLEPTIC TREATMENT BY IN-VIVO HYDROGEN MAGNETIC-RESONANCE SPECTROSCOPY

RATIONALE AND OBJECTIVES. The authors investigate: (1) whether there i s a lateral effect of hydrogen (H-1) magnetic resonance (MR) spectrosc opy observable metabolite ratios between the right and the left prefro ntal lobe in chronic schizophrenia; (2) whether there is a change of p roton metabolite ratios in chronic schizophrenia after neuroleptic tre atment; (3) whether there is a relation between changes in H-1 MR spec tra and the clinical assessment of Brief Psychiatric Rating Scale (BPR S); and (4) to investigate a hypofrontality hypothesis in schizophreni a in terms of neurochemical aspects. METHODS. Localized in vivo H-1 MR spectroscopy was used to measure the metabolite levels in the prefron tal lobes of control persons (n = 20) and of chronic patients before a nd after neuroleptic treatment (n = 34), The MR spectra of 8 cm(3) vox els were compared with clinical assessment of BPRS in each subject. RE SULTS. No significant metabolic lateral effect was established in both schizophrenia and control groups (P > 0.05), After neuroleptic treatm ent, chronic schizophrenic patients generally demonstrated a decrease of the complex of gamma-aminobutyric acid (GABA) and glutamate (Gin) c ontaining (GABA + Glu)/creatine (Cr) ratio. CONCLUSIONS. The current f ollow-up H-1 MR spectroscopy study shows a significant correlation bet ween alterations of (GABA + Glu)/Cr ratio and BPRS, and supports a hyp ofrontality hypothesis in chronic schizophrenia, The reduction of (GAB A + Glu)/Cr ratio after neuroleptic treatment may implicate the recove ry of normal neuronal function in neurotransmitters, In vivo H-1 MR sp ectroscopy may be a useful modality in follow-up evaluation of neurole ptic treatment in chronic schizophrenia.