Striatal neurometabolite levels in patients with schizophrenia undergoing long-term antipsychotic treatment: A proton magnetic resonance spectroscopy and reliability study

Psychiatry Res Neuroimaging. 2018 Mar 30;273:16-24. doi: 10.1016/j.pscychresns.2018.01.004. Epub 2018 Jan 31.


Previous proton magnetic resonance spectroscopy (1H-MRS) studies have reported disrupted levels of various neurometabolites in patients with schizophrenia. An area of particular interest within this patient population is the striatum, which is highly implicated in the pathophysiology of schizophrenia. The present study examined neurometabolite levels in the striatum of 12 patients with schizophrenia receiving antipsychotic treatment for at least 1 year and 11 healthy controls using 3-Tesla 1H-MRS (PRESS, TE = 35 ms). Glutamate, glutamate+glutamine (Glx), myo-inositol, choline, N-acetylaspartate, and creatine levels were estimated using LCModel, and corrected for fraction of cerebrospinal fluid in the 1H-MRS voxel. Striatal neurometabolite levels were compared between groups. Multiple study visits permitted a reliability assessment for neurometabolite levels (days between paired 1H-MRS acquisitions: average = 90.33; range = 7-306). Striatal neurometabolite levels did not differ between groups. Within the whole sample, intraclass correlation coefficients for glutamate, Glx, myo-inositol, choline, and N-acetylaspartate were fair to excellent (0.576-0.847). The similarity in striatal neurometabolite levels between groups implies a marked difference from the antipsychotic-naïve first-episode state, especially in terms of glutamatergic neurometabolites, and might provide insight regarding illness progression and the influence of antipsychotic medication.

Keywords: Antipsychotics; Glutamate; Glx; Striatum.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Aspartic Acid / analogs & derivatives
  • Aspartic Acid / cerebrospinal fluid
  • Case-Control Studies
  • Choline / cerebrospinal fluid
  • Corpus Striatum / metabolism*
  • Creatine / cerebrospinal fluid
  • Female
  • Glutamic Acid / cerebrospinal fluid
  • Glutamine / cerebrospinal fluid
  • Humans
  • Inositol / cerebrospinal fluid
  • Male
  • Middle Aged
  • Proton Magnetic Resonance Spectroscopy / statistics & numerical data*
  • Reproducibility of Results
  • Schizophrenia / cerebrospinal fluid*
  • Schizophrenia / drug therapy


  • Antipsychotic Agents
  • Glutamine
  • Aspartic Acid
  • Glutamic Acid
  • Inositol
  • N-acetylaspartate
  • Creatine
  • Choline