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Glutamate levels in the anterior cingulate cortex in un-medicated first episode psychosis: a proton magnetic resonance spectroscopy study

Research output: Contribution to journalArticle

Original languageEnglish
Article number8685
Number of pages1
JournalScientific Reports
Volume9
Issue number1
Early online date2 Jul 2019
DOIs
Accepted/In press22 May 2019
E-pub ahead of print2 Jul 2019
Published2 Jul 2019

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King's Authors

Abstract

Background: Converging lines of evidence suggest that glutamatergic dysfunction may contribute to the pathophysiology of first episode psychosis. We aimed to investigate whether first episode psychosis patients free from all pharmacological treatments and illicit substances show cortical glutamatergic alterations.
Method: One-hundred and eleven volunteers including 65 healthy volunteers and 46 first episode psychosis patients free from all pharmacological treatments (28 drug naïve) underwent a proton magnetic resonance spectroscopy scan measuring glutamate levels in the bilateral anterior cingulate cortex. Symptom severity was measured using the Positive and Negative Syndrome Scale (PANSS) and cognition was measured using the Wechsler Adult Intelligence Scale (WAIS) digit symbol test.
Results: There were no differences between patients and controls for glutamate (F(1,109)=0.171, p=0.680), glutamine (F(1,50)=0.267, p=0.608),GLX (F(1,110)=1.923, p=0.168) or NAA (F(1,106)=0.950, p=0.332). These findings remained unchanged when adjusting for the effects of age, sex and ethnicity or when restricting the analyses to patients who were both medication naïve to all pharmacological treatments and illicit substances. There were no relationships between glutamate levels and symptom severity or cognitive function.
Conclusions: Relative to healthy volunteers, drug-free first episode psychosis patients free from illicit substances show no evidence of metabolite alterations in the anterior cingulate cortex. These findings remained unchanged when investigating patients who were medication naïve to all pharmacological treatments. Whilst these findings do not preclude glutamatergic alterations in first episode psychosis, methodological advances are needed to investigate whether patients show alterations in other aspects of glutamate function, such as pre-synaptic glutamate or release.

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