OBJECTIVETo study the changes in the frontal white matter, the head of the hippocampus, and the anterior cingulate fasciculus metabolites in first-episode patients with positive symptoms of schizophrenia.

METHODSTwenty first-episode patients with positive symptoms of schizophrenia underwent diffusion tensor imaging (DTI) and proton multi-voxel spectroscopy (1H-MRS) examination. 1H-MRS images were obtained from two sides of the frontal white matter, the head of the hippocampus and the anterior cingulate fasciculus regions. The metabolites detected included N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine and phosphocreatine (Cr), and the ratios of NAA/Cr, Cho/Cr and NAA/Cho were determined. The fractional anisotropy (FA) values were measured in the frontal white matter, the head of the hippocampus, and the anterior cingulate fasciculus.

RESULTSThe Cho/Cr ratio was significantly reduced in the left frontal white matter (1.18 ± 0.21) of the patients as compared to the right side (1.44 ± 0.34, P<0.05). In the left head of the hippocampus, NAA/Cr (1.34 ± 0.45) and Cho/Cr (1.41 ± 0.39) were significantly reduced compared to those of the right side (1.75 ± 0.15 and 1.76 ± 0.36, respectively, P<0.05). No significant differences in the metabolite levels were found between the left and right anterior cingulate fasciculus (P>0.05). DTI showed similar FA values between the left and right sides of the frontal white matter, the head of the hippocampus, and the anterior cingulate fasciculus (P>0.05).

CONCLUSIONSPatients with positive symptoms of schizophrenia have diminished neuronal integrity and/or function in the left frontal white matter and head of the hippocampus, but not in the anterior cingulate fasciculus.