Functional magnetic resonance imaging and magnetic resonance spectroscopy in schizophrenia

Studies published since July 1998 will be reviewed. In fMRI studies, the 'b ottom up' approach was applied, i.e. symptoms or neuropsychological dysfunc tions in schizophrenia, were related to specific areas of abnormal activati on. One study showed that Heschl's gyrus is activated during acoustic hallu cinations. Other studies suggested that during speech-related tasks activat ion is attenuated in the inferior frontal gyrus, during induced sad affects in the amygdala and during standardised motor tasks in the sensory motor c ortex. Whereas typical neuroleptics further reduced the activation in this area, atypical compounds did not, which is of high clinical relevance. In f uture studies 'top-down' approaches should also be persued in which complex models of the disease can be tested. With respect to magnetic resonance sp ectroscopy (MRS), the most consistent finding of H-1-MRS is a decrease of N -aspertylaspertate, often considered to be a neuronal marker, in various br ain areas. Other promising, yet preliminary findings, suggest an alteration of glutamate in schizophrenia. According to P-31-MRS studies the phospholi pid metabolism and energy-demanding processes can also seem to be altered. Findings, however, are not always unanimous. In the future, technical devel opments can be expected that will enhance the sensitivity of the determinat ion of compounds, Curr Opin Psychiatry 13:21-26. (C) 2000 Lippincott Willia ms & Wilkins.