Response to initial antipsychotic treatment in first episode psychosis is related to anterior cingulate glutamate levels: a multicentre 1 H-MRS study (OPTiMiSE)
Conventional antipsychotic medication is ineffective in around a third of patients with schizophrenia, and the nature of the therapeutic response is unpredictable. We investigated whether response to antipsychotics is related to brain glutamate levels prior to treatment. Proton magnetic resonance sp...
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| Veröffentlicht in: | Molecular psychiatry 2018-11, Vol.23 (11), p.2145 |
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| creator | Egerton, A Broberg, B V Van Haren, N Merritt, K Barker, G J Lythgoe, D J Perez-Iglesias, R Baandrup, L Düring, S W Sendt, K V Stone, J M Rostrup, E Sommer, I E Glenthøj, B Kahn, R S Dazzan, P McGuire, P |
| description | Conventional antipsychotic medication is ineffective in around a third of patients with schizophrenia, and the nature of the therapeutic response is unpredictable. We investigated whether response to antipsychotics is related to brain glutamate levels prior to treatment. Proton magnetic resonance spectroscopy was used to measure glutamate levels (Glu/Cr) in the anterior cingulate cortex (ACC) and in the thalamus in antipsychotic-naive or minimally medicated patients with first episode psychosis (FEP, n = 71) and healthy volunteers (n = 60), at three sites. Following scanning, patients were treated with amisulpride for 4 weeks (n = 65), then
H-MRS was repeated (n = 46). Remission status was defined in terms of Positive and Negative Syndrome Scale for Schizophrenia (PANSS) scores. Higher levels of Glu/Cr in the ACC were associated with more severe symptoms at presentation and a lower likelihood of being in remission at 4 weeks (P |
| format | Article |
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H-MRS was repeated (n = 46). Remission status was defined in terms of Positive and Negative Syndrome Scale for Schizophrenia (PANSS) scores. Higher levels of Glu/Cr in the ACC were associated with more severe symptoms at presentation and a lower likelihood of being in remission at 4 weeks (P < 0.05). There were longitudinal reductions in Glu/Cr in both the ACC and thalamus over the treatment period (P < 0.05), but these changes were not associated with the therapeutic response. There were no differences in baseline Glu/Cr between patients and controls. These results extend previous evidence linking higher levels of ACC glutamate with a poor antipsychotic response by showing that the association is evident before the initiation of treatment.</description><identifier>EISSN: 1476-5578</identifier><identifier>PMID: 29880882</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Antipsychotic Agents - therapeutic use ; Female ; Glutamic Acid - analysis ; Glutamic Acid - drug effects ; Glutamic Acid - metabolism ; Gyrus Cinguli - drug effects ; Gyrus Cinguli - metabolism ; Humans ; Male ; Proton Magnetic Resonance Spectroscopy - methods ; Psychiatric Status Rating Scales ; Psychotic Disorders - drug therapy ; Schizophrenia - drug therapy ; Thalamus - drug effects ; Thalamus - metabolism ; Young Adult</subject><ispartof>Molecular psychiatry, 2018-11, Vol.23 (11), p.2145</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-5214-7421</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29880882$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egerton, A</creatorcontrib><creatorcontrib>Broberg, B V</creatorcontrib><creatorcontrib>Van Haren, N</creatorcontrib><creatorcontrib>Merritt, K</creatorcontrib><creatorcontrib>Barker, G J</creatorcontrib><creatorcontrib>Lythgoe, D J</creatorcontrib><creatorcontrib>Perez-Iglesias, R</creatorcontrib><creatorcontrib>Baandrup, L</creatorcontrib><creatorcontrib>Düring, S W</creatorcontrib><creatorcontrib>Sendt, K V</creatorcontrib><creatorcontrib>Stone, J M</creatorcontrib><creatorcontrib>Rostrup, E</creatorcontrib><creatorcontrib>Sommer, I E</creatorcontrib><creatorcontrib>Glenthøj, B</creatorcontrib><creatorcontrib>Kahn, R S</creatorcontrib><creatorcontrib>Dazzan, P</creatorcontrib><creatorcontrib>McGuire, P</creatorcontrib><title>Response to initial antipsychotic treatment in first episode psychosis is related to anterior cingulate glutamate levels: a multicentre 1 H-MRS study (OPTiMiSE)</title><title>Molecular psychiatry</title><addtitle>Mol Psychiatry</addtitle><description>Conventional antipsychotic medication is ineffective in around a third of patients with schizophrenia, and the nature of the therapeutic response is unpredictable. We investigated whether response to antipsychotics is related to brain glutamate levels prior to treatment. Proton magnetic resonance spectroscopy was used to measure glutamate levels (Glu/Cr) in the anterior cingulate cortex (ACC) and in the thalamus in antipsychotic-naive or minimally medicated patients with first episode psychosis (FEP, n = 71) and healthy volunteers (n = 60), at three sites. Following scanning, patients were treated with amisulpride for 4 weeks (n = 65), then
H-MRS was repeated (n = 46). Remission status was defined in terms of Positive and Negative Syndrome Scale for Schizophrenia (PANSS) scores. Higher levels of Glu/Cr in the ACC were associated with more severe symptoms at presentation and a lower likelihood of being in remission at 4 weeks (P < 0.05). There were longitudinal reductions in Glu/Cr in both the ACC and thalamus over the treatment period (P < 0.05), but these changes were not associated with the therapeutic response. There were no differences in baseline Glu/Cr between patients and controls. These results extend previous evidence linking higher levels of ACC glutamate with a poor antipsychotic response by showing that the association is evident before the initiation of treatment.</description><subject>Adult</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Female</subject><subject>Glutamic Acid - analysis</subject><subject>Glutamic Acid - drug effects</subject><subject>Glutamic Acid - metabolism</subject><subject>Gyrus Cinguli - drug effects</subject><subject>Gyrus Cinguli - metabolism</subject><subject>Humans</subject><subject>Male</subject><subject>Proton Magnetic Resonance Spectroscopy - methods</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychotic Disorders - drug therapy</subject><subject>Schizophrenia - drug therapy</subject><subject>Thalamus - drug effects</subject><subject>Thalamus - metabolism</subject><subject>Young Adult</subject><issn>1476-5578</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFj81KA0EQhAdBTDS-gvRRDwubxDWjV4nkEiJJ7mHc7cSW-WO6R9i38VGdRT0LDdVUF1_RZ2o8vV88VE2z0CN1yfxR14PRXKjR7FHrWuvZWH1tkWPwjCAByJOQsWC8UOS-fQ9CLUhCIw69lDscKbEARuLQIfyEmBjKJLRGsBtABYCJQoKW_CkPNpxsFuOGzeInWn4CAy7bUlDICWEKq2q93QFL7nq43bzuaU275d1EnR-NZbz-1St187LcP6-qmN8cdoeYyJnUH_5emv8b-AYL4FoK</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Egerton, A</creator><creator>Broberg, B V</creator><creator>Van Haren, N</creator><creator>Merritt, K</creator><creator>Barker, G J</creator><creator>Lythgoe, D J</creator><creator>Perez-Iglesias, R</creator><creator>Baandrup, L</creator><creator>Düring, S W</creator><creator>Sendt, K V</creator><creator>Stone, J M</creator><creator>Rostrup, E</creator><creator>Sommer, I E</creator><creator>Glenthøj, B</creator><creator>Kahn, R S</creator><creator>Dazzan, P</creator><creator>McGuire, P</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><orcidid>https://orcid.org/0000-0002-5214-7421</orcidid></search><sort><creationdate>201811</creationdate><title>Response to initial antipsychotic treatment in first episode psychosis is related to anterior cingulate glutamate levels: a multicentre 1 H-MRS study (OPTiMiSE)</title><author>Egerton, A ; 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We investigated whether response to antipsychotics is related to brain glutamate levels prior to treatment. Proton magnetic resonance spectroscopy was used to measure glutamate levels (Glu/Cr) in the anterior cingulate cortex (ACC) and in the thalamus in antipsychotic-naive or minimally medicated patients with first episode psychosis (FEP, n = 71) and healthy volunteers (n = 60), at three sites. Following scanning, patients were treated with amisulpride for 4 weeks (n = 65), then
H-MRS was repeated (n = 46). Remission status was defined in terms of Positive and Negative Syndrome Scale for Schizophrenia (PANSS) scores. Higher levels of Glu/Cr in the ACC were associated with more severe symptoms at presentation and a lower likelihood of being in remission at 4 weeks (P < 0.05). There were longitudinal reductions in Glu/Cr in both the ACC and thalamus over the treatment period (P < 0.05), but these changes were not associated with the therapeutic response. There were no differences in baseline Glu/Cr between patients and controls. These results extend previous evidence linking higher levels of ACC glutamate with a poor antipsychotic response by showing that the association is evident before the initiation of treatment.</abstract><cop>England</cop><pmid>29880882</pmid><orcidid>https://orcid.org/0000-0002-5214-7421</orcidid></addata></record> |
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| subjects | Adult Antipsychotic Agents - therapeutic use Female Glutamic Acid - analysis Glutamic Acid - drug effects Glutamic Acid - metabolism Gyrus Cinguli - drug effects Gyrus Cinguli - metabolism Humans Male Proton Magnetic Resonance Spectroscopy - methods Psychiatric Status Rating Scales Psychotic Disorders - drug therapy Schizophrenia - drug therapy Thalamus - drug effects Thalamus - metabolism Young Adult |
| title | Response to initial antipsychotic treatment in first episode psychosis is related to anterior cingulate glutamate levels: a multicentre 1 H-MRS study (OPTiMiSE) |
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