Magnetic resonance spectroscopy in schizophrenia: Methodological issues and findings - Part II

Magnetic resonance spectroscopy allows investigation of in vivo neurochemic al pathology of schizophrenia, "First generation" studies, focusing on phos phorus and proton magnetic resonance spectroscopy, have suggested alteratio ns in membrane phospholipid metabolism and reductions in N-acetyl aspartate in the frontal and temporal lobes, Some discrepancies remain in the litera ture, perhaps related to the variations in medication status and phase of i llness in the patients examined, as well as in magnetic resonance spectrosc opy methodology; the pathophysiologic significance of the findings also rem ains unclear. Technologic advances in magnetic resonance spectroscopy in re cent years have expanded the potential to measure several other metabolites of interest such as the neurotransmitters glutamate and gamma-aminobutyric acid and macromolecules such as membrane phospholipids and synaptic protei ns. Issues of sensitivity, specificity, measurement reliability, and functi onal significance of the magnetic resonance spectroscopy findings need to b e further clarified. The noninvasive nature of magnetic resonance spectrosc opy allows longitudinal studies of schizophrenia both in its different phas es and among individuals at generic risk for this illness. Future studies a lso need to address confounds of prior treatment and illness chronicity, ta ke advantage of current pathophysiologic models of schizophrenia, and be hy pothesis driven. (C) 2000 Society of Biological Psychiatry.