■使用质子磁共振波谱的研究揭示了大脑谷氨酸水平的实质性不一致,谷氨酰胺和谷氨酸+谷氨酰胺跨精神分裂症谱系障碍。本系统综述采用定性和定量方法分析谷氨酸能代谢物之间的模式和关系,精神分裂症谱系障碍和大脑区域。
■使用各种数据库进行文献检索,关键词包括谷氨酸,谷氨酰胺,精神分裂症,精神病和质子磁共振波谱学。纳入标准仅限于病例对照研究,这些研究报告了患有精神分裂症谱系障碍的成年患者的谷氨酸能代谢物水平-即首发精神病,精神分裂症,治疗抗性精神分裂症和/或超治疗抗性精神分裂症-使用3T或以上的质子磁共振波谱。汇总研究数据进行综合和分析。
■共有92项研究符合纳入标准,包括2721名健康对照和2822名精神分裂症谱系障碍参与者。基底神经节的Glu水平较高,首发精神病参与者的额叶皮质和内侧前额叶,相比之下,精神分裂症参与者的总体水平较低。对于Gln来说,在基底节区,代谢物水平存在明显差异,背外侧前额叶皮质和额叶皮质,首发精神病在基底神经节显示出明显较高的水平。在谷氨酸+谷氨酰胺中,在精神分裂症谱系障碍组中发现了较高的代谢物水平,特别是在抗治疗精神分裂症参与者的基底神经节和背外侧前额叶皮质。发现代谢物水平和药物状态之间存在显著关系,临床措施和方法学变量。
■该综述强调了整个精神分裂症谱系障碍和特定大脑区域的谷氨酸能代谢异常水平。由于相当多的文献异质性,该综述强调了使用质子磁共振波谱评估谷氨酸能代谢物的标准化未来研究的重要性。
UNASSIGNED: Studies using proton magnetic resonance spectroscopy reveal substantial inconsistencies in the levels of brain
glutamate, glutamine and
glutamate + glutamine across schizophrenia spectrum disorders. This systematic
review employs qualitative and quantitative methods to analyse the patterns and relationships between glutamatergic metabolites, schizophrenia spectrum disorders and brain regions.
UNASSIGNED: A literature search was conducted using various databases with keywords including glutamate, glutamine, schizophrenia, psychosis and proton magnetic resonance spectroscopy. Inclusion criteria were limited to case-control studies that reported glutamatergic metabolite levels in adult patients with a schizophrenia spectrum disorder diagnosis - i.e. first-episode psychosis, schizophrenia, treatment-resistant schizophrenia and/or ultra-treatment-resistant schizophrenia - using proton magnetic resonance spectroscopy at 3 T or above. Pooled study data were synthesized and analysed.
UNASSIGNED: A total of 92 studies met the inclusion criteria, including 2721 healthy controls and 2822 schizophrenia spectrum disorder participants. Glu levels were higher in the basal ganglia, frontal cortex and medial prefrontal of first-episode psychosis participants, contrasting overall lower levels in schizophrenia participants. For Gln, strong differences in metabolite levels were evident in the basal ganglia, dorsolateral prefrontal cortex and frontal cortex, with first-episode psychosis showing significantly higher levels in the basal ganglia. In glutamate + glutamine, higher metabolite levels were found across schizophrenia spectrum disorder groups, particularly in the basal ganglia and dorsolateral prefrontal cortex of treatment-resistant schizophrenia participants. Significant relationships were found between metabolite levels and medication status, clinical measures and methodological variables.
UNASSIGNED: The
review highlights abnormal glutamatergic metabolite levels throughout schizophrenia spectrum disorders and in specific brain regions. The
review underscores the importance of standardized future research assessing glutamatergic metabolites using proton magnetic resonance spectroscopy due to considerable literature heterogeneity.