Objective To study the features of treatment on neurochemical metabolites in prefrontal lobe and thalamus by proton magnetic resonance spectroscopy (1H-MRS) in first-episode drug-naive patients with early-onset schizophrenia (EOS).Methods Forty-two EOS (study group) met with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) were recruited.Prefrontal lobe and thalamus were evaluated by multi-voxel 1H-MRS before and 4-week after treatment with a single atypical antipsychotic.The levels of N-acetylaspartate (NAA),creatine compounds (Cr) and choline-containing compounds (Cho) were measured.The patients also received Positive and Negative Syndrome Scale (PANSS).Forty normal controls (normal control group) underwent the same 1H-MRS detection.Results Before treatment,the NAA/Cr ratios in left prefrontal lobe,right prefrontal lobe and lefi thalamus in study group were lower than those in normal control group (1.45 ± 0.26 vs 1.60 ± 0.34,t =2.251,P =0.027;1.43 ±0.26 vs 1.60 ±0.35,t =2.505,P=0.014;1.48 ±0.27 vs 1.65 ±0.35,t =2.470,P =0.016).After 4-week treatment,the NAA/Cr ratios in both left prefrontal lobe and left thalamus of study group were significantly increased compared with those before treatment (1.58 ± 0.30 vs 1.45 ± 0.26,t =2.122,P =0.037;1.62 ± 0.32 vs 1.48 ± 0.27,t =2.167,P =0.033).After 4-week treatment in study group,the total score,positive symptom score,negative symptom score and general pathologic score of PANSS,and the total score of Clinical Global Impression (CGI) were significantly lower compared with those before treatment (59.1 ± 10.2 vs 82.0 ± 13.2,t =8.896,P=0.000;15.3 ±5.1 vs 22.9 ±7.1,t =5.634,P =0.000;16.4 ±5.2 vs 21.1 ±7.8,t =3.249,P =0.002;27.4 ±7.6 vs 38.1 ± 8.8,t =5.963,P =0.000;3.6 ± 0.4 vs 4.4 ± 0.5,t =8.097,P =0.000).There was no correlation between the changes of neurochemical metabolite levels such as NAA/Cr and Cho/Cr both in prefrontal lobe and left thalamus,and the clinical symptoms changes,such as total score and every score of PANSS,the total score of CGI in study group after treatment (all P ＞ 0.05).Conclusions The ratios of NAA/Cr are decreased not only in bilateral prefrontal lobe,but also in left thalamus,and the ratios may increase both in left prefrontal lobe and left thalamus after 4 weeks' treatment with atypical antipsychotics in EOS.The treatment outcomes of NAA/Cr do not agree with the improvement of the clinical symptoms.

Objective To evaluate the effects of 6-week atypical antipsychotics treatment on serum brain-derived neurotrophic factor (BDNF)level,and the correlation between BDNF level and clinical efficiency in first-episode antipsychotic-na?ve schizophrenia.Methods We recruited 39 hospitalized patients with first-episode antipsychotic-na?ve schizophrenia that met with Diagnostic and Statistical Manual of Mental Disorders—4th Edition (DSM-IV).Both Positive and Negative Syndrome Scale (PANSS)and the level of serum BDNF were measured before and after 6 weeks’treatment with atypical antipsychotics.We also studied 30 healthy controls.Serum BDNF was assayed at baseline.Results Pre-treatment BDNF level was significantly lower in the schizophrenic patients than in the controls [(6.82±2.1 5 )μg/L vs .(1 1.6 ± 3.32 )μg/L,t = 7.239,P < 0.001 ].Although BDNF level increased with treatment (t =2.349,P =0.021)in the schizophrenics,post-treatment BDNF level was still lower than in the normal controls (t =4.634,P <0.001).After 6 weeks’treatment for schizophrenia,the total score of PANSS,the scores of positive and negative symptoms,and the score of general psychopathology scale were all decreased (t =6.1 64,P < 0.001;t = 4.520,P < 0.001;t = 4.132,P < 0.001;t = 5.142,P < 0.001 ).Pre-treatment BDNF levels were directly correlated not only with the rate of decreased PANSS total score (r =0.348, P <0.05),but also with the rate of decreased negative symptoms score (r = 0.35 1,P < 0.05 ).However,pre-treatment BDNF levels were not correlated with improved positive symptoms,general psychopathology (r =0.204, 0.186,P >0.05),or duration of illness (r = - 0.058,P > 0.05 ).Changes in BDNF levels with treatment were correlated with the duration of illness (r =-0.345,P <0.05),but not with psychiatric improvement (r =0.036-0.1 74,P >0.05).Conclusion BDNF level is significantly lower in patients with first-episode antipsychotic-na?ve schizophrenia than in normal controls.It could be improved by using antipsychotics.Higher pre-treatment BDNF level may predict better response to antipsychotics.

ObjectiveTo explore the metabolite status on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy (1H-MRS) and affecting factors in patients of schizophrenia.Methods 159 schizophrenics met with CCMD-3 and 45 normal controls were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS.The N-acetylaspartate ( NAA),Choline-congtaining compounds ( Cho),and Creatine compounds (Cr)were measured and the ratios of NAA/Cr,Cho/Cr were determined. Positive and Negative Syndrome Scale (PANSS),Social Disability Screening Schedule (SDSS),and Wisconsin Card Sorting Test (WCST) were also assessed.ResultsOn left prefrontal lobe of patients,the NAA/Cr ratio demonstrated lower than that in normal controls (1.42 ±0.34 vs.1.64 ±0.39,t =3.70,P＜0.01 ).The same phenomenon were appeared on left thalamus (1.46±0.35 vs.1.66±0.38,t=3.32,P＜0.01) and on right thalamus (1.49±0.34 vs.1.62±0.37,t=2.04,P ＜ 0.05 ).Contributing to the NAA/Cr ratio,main influencing factors on left prefrontal lobe were age of onset,duration of illness,score of negative symptoms,antipsychotic treatment,total score of PANSS,Categories completed of WCST,total score of SDSS,year of education.Main influencing factors on left thalamus were age of onset,duration of illness,antipsychotic treatment.Main influencing factors on right thalamus were duration of illness,age of onset,score of negative symptoms,antipsychotic treatment,and family history.ConclusionsAbnormalities in neuronal function and/or integrity presented on prefrontal lobe and thalamus in schizophrenics are related to many respects,especially age of onset,duration of illness and antipsychotic treatment.

Objective To identify the metabolite levels and to study the potential effects of risporidone tablets on prefrontal lobe and thalamus in male first-episode schizophrenia by proton magnetic resonance spectroscopy (1H-MRS).Methods Twenty-two male first-episode schizophrenics were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS before and after 8 weeks' risperidone tablets treatment,and 30 normal controls were assessed once.The patients were also received positive and negative syndrome scale(PANSS) and Wisconsin card sorting test (WCST) before and after treatment.The N-aeetylaspartate ( NAA ),Choline-congtaining compounds (Cho),and Creatine compounds (Cr) were measured and the ratios of NAA/Cr,Cho/Cr were determined.Results On left prefrontal lobe and left thalamus,the NAA/Cr ratio in patients before treatment demonstrated lower than those in normal controls ( ( 1.37 ± 0.33 ) vs ( 1.61 ± 0.38 ),t =2.57,P ＜ 0.05 ; ( 1.46 ± 0.35 ) vs ( 1.71 ± 0.38 ),t =2.36,P ＜ 0.05 ).There were no significant differences in both the ratios of NAA/Cr and Cho/Cr between pre- and post-treatment (P＞0.05 ).The changes of NAA/Cr on left prefrontal lobe post-treatment were negatively related with the alterations of the total score of PANSS ( r =- 0.46,P ＜ 0.05 ),the score of negative symptoms ( r =- 0.48,P ＜ 0.05 ),the responses errors ( r =- 0.42,P ＜ 0.05 ) and the porseverative errors ( r =- 0.40,P ＜ 0.05 ),meanwhile,positively related with the alterations of the categories completed ( r =0.44,P ＜0.05 ) and the conceptual level responses ( r =0.42,P ＜ 0.05 ).Conclusions Abnormalities in neuronal function and/or integrity presented on prefrontal lobe and thalamus maybe exist in male first-episode schizophrenics.Short-term antipsvchotic treatment with risperidone tablets may have no effects on measures of prefrontal lobe and thalamus.

Objective To compare the differences between the schizophrenics with negative and positive symptoms on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy ( 1 H-MRS). Methods 58 negative subtype and 51 positive subtype schizophrenics were examined at prefrontal lobe and thalamus by multivoxel 1H-MRS before antipsychotic treatment The N-acetylaspartate (NAA), choline-containing compounds ( Cho), and creatine compounds (Cr) were measured and the ratios of NAA/Cr, Cho/Cr were determined. Results On right thalamus,the NAA/Cr ratio in negative subtype patients ( 1.40 ± 0.29 ) demonstrated lower than that in positive subtype ( 1.62 ± 0.33 ), the same phenomenon were appeared on male, female, non-first-episode, with-medicine and without-medicine patients (P ＜ 0.05 or 0.01 ). The Cho/Cr ratio on right thalamus in negative subtype of female,non-first-episode,without-medicine schizophrenics were lower than those in positive subtype (P ＜ 0.05 ).On left prefrontal lobe,left thalamus and right thalamus, the NAA/Cr ratios both in negative subtype and positive subtype schizophrenics were significantly negatively related with age of onset(P＜0. 05 or 0.01 ). In negative subtype schizophrenics,the Cho/Cr ratio on right thalamus was positively related with age of onset ( r = 0. 25, P ＜0.05 ). In negative subtype schizophrenics of non-first-episode, without-medicine, the correlation was negative between the NAA/Cr ratio and the course of disease( r= -0.48, -0.46, P＜0.05 ) ,and was positive between Cho/Cr ratio and the course of disease on right thalamus( r= 0.58,0.56, P＜ 0.01 ). Conlusion Compared with positive subtype schizophrenics,negative subtype schizophrenics have greater impairments on 1 H-MRS on right thalamus. The course of disease has greater effects on 1 H-MRS in negative subtype schizophrenics.

ObjectivesTo explore the characteristic of different subtypes of depression on prefrontal lobe and hippocampus by proton magnetic resonance spectroscopy (1H-MRS),and its relationship.Methods 46 patients of depression,which were met with the third edition of the Chinese Classification of Mental Disorders (CC-MD-Ⅲ ) since December 2010 to March 2012 from Mental Diseases Prevention and Treatment Institute,were examined at prefrontal lobe and hippocampus by multi-voxel 1 H-MRS.They were divided into male ( n =25) and female ( n =21 ),early-onset subtype ( n =26) and late-onset subtype ( n =20 ),short-duration of illness ( n =23 )and long-duration of illness ( n =23 ) by different criteria.The N-acetylaspartate ( NAA),Choline-congtaining compounds (Cho),and Creatine compounds (Cr) were measured and the ratios of NAA/Cr,Cho/Cr were determined.ResultsOn left prefrontal lobe,the NAA/Cr ratios in patients of male ( 1.83 ± 0.19),late-onset subtype (1.86 ±0.16),and short-duration of illness ( 1.83 ±0.17) showed higher than those in female ( 1.70 ±0.12,t=2.711,P ＜ 0.01 ),early-onset subtype ( 1.70 ± 0.19,t =3.028,P ＜ 0.01 ),and long-duration of illness ( 1.71±0.20,t =2.192,P＜0.05).Both on left prefrontal and on left thalamus,the ratios of NAA/Cr were positively correlated with the age of onset ( r=0.493 and 0.478,P＜0.01 ),and were negatively correlated with the duration of illness ( r =- 0.482 and - 0.470,P ＜ 0.01 ).ConclusionsDifferent subtypes of depression maybe have different characteristics of 1H-MRS due to the age of onset and the duration of illness.

Objective To identify the metabolic alterations in the prefrontal lobe in male patients with schizophrenia by proton magnetic resonance spectroscopy (~1H-MRS), and to study the relationship between metabolic alterations and executive function. Methods The study was conducted in 26 male schizophrenics with medicine-free for at least 7 days and 28 normal controls. A multi-voxel ~1H-MRS on the prefrontal lobe was performed in all the subjects within 24 hours of admission. Wisconsin Card Sorting Test (WCST) was used to evaluate executive function. The NAA, Cho and Cr were measured and the ratios of NAA/Cr, Cho/Cr and NAA/(Cho+Cr) were calculated. Results Compared with normal controls, the patients demonstrated significantly lower NAA/Cr ratio (t=2.93, P<0.01) in the left prefrontal lobe and poorer performance in WCST (P<0.05). The NAA/Cr ratio in the left prefrontal lobe was positively associated with the responses errors and the perseverative errors of WCST(r=0.45, P＜0.05; r=0.47, P＜0.05)and negatively associated with the categories completed and conceptual level responses(r=-0.54, P＜0.01; r=-0.56, P＜0.01). Conclusions Abnormalities in neuronal function and/or integrity are present in the left prefrontal lobe of male schizophrenics. The neuron damage in the left prefrontal lobe of male schizophrenic may be the primary cause of cognition dysfunction.

Objective To compare with the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) between the left and the right prefrontal on refractory negative symptoms and serum brain-derived neurotrophic factor (BDNF). Methods 80 hospitalized schizophrenics with refractory negative symptoms were divided into study group (n=40) and control group (n=40) randomly. Both groups were received 4-week treatment of 10 Hz rTMS. The stimulus lo?cation of the study group was the left prefrontal, and the control group was the right prefrontal. The type and dose of anti?psychotics remained unchanged during the treatment. The evaluation of positive and negative symptom scale (PANSS) and the measurement of BDNF concentration before treatment and after 4 weeks treatment was analyzed. Results Com?pared with before treatment, the total score of PANSS after treatment significantly decreased (P<0.05) both in the study group [(71.2±13.8) vs. (63.3±11.4)] and the control group [(70.3±13.4) vs. (63.7±12.2)]. The score of negative symptoms in the study group decreased [(22.8±6.6) vs. (18.4±5.9), P<0.01]. The BDNF concentration increased in the study group ](6.78±2.16) vs. (8.74±2.76)] and the control group [(6.83±2.32) vs. (8.66±2.70)]. Conclusion 10Hz rTMS on the left pre?frontal combined with drugs are helpful to improve the refractory negative symptom of the patients with schizophrenia. Stimulation on both left and right prefrontal lobe could increase serum BDNF concentration.

Objective To identify the metabolite levels in prefrontal lobe and thalamus in patients of schizophrenia with proton magnetic resonance spectroscopy (1H-MRS). Methods Twenty-six schizophrenics with medicine-free for at least 7 d and 28 normal controls were assessed in this study. All subjects underwent examination of multi-voxel 1H-MRS on prefrontal lobe and thalamus within 24 h. The NAA, Cho and Cr were measured and the ratios of NAA/Cr, Cho/Cr and NAA/(Cho+Cr) were determined. Results Compared with the controls, the NAA/Cr ratio of schizophrenics was significantly lower in left prefrontal lobe and bilateral thalamus (all P＜0.05). No statistical difference of NAA/(Cho+Cr) ratio and the Cho/Cr ratio was found between two groups. Conclusion Abnormalities in neuronal function and/or integrity are present at left prefrontal lobe and bilateral thalamus simultaneously in schizophrenics.

Objective To evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) on serum brain-derived neurotrophic factor (BDNF) level in patients with schizophrenia.Methods Eighty hospitalized schizophrenics with refractory negative symptoms,admitted to our hospital from September 2012 to October 2013 and met the diagnostic and statistical manual of Mental Disorders-4th Edition (DSM-Ⅳ),were randomly divided into study group (n=40) and sham-operated group (n=40).The rTMS of 10 Hz on left prefrontal lobe was performed in study group and sham stimulation was used in sham-operated group; and the kinds and dosages of antipsychotics were preserved as before; other 40 healthy subjects were used as control group.Positive and Negative Syndrome Scale (PANSS) was performed and serum BDNF level was measured before and 4 weeks after treatment in all patients.Results BDNF level in both study group and sham-operated group before and after treatment was significantly lower than that in the control group (P＜0.05).The total PANSS scores and negative symptom scale scores in the study group after treatment were significantly decreased as compared with those before treatment (71.2±13.8 vs.63.3±11.4,t=2.721,P=0.008; 18.4±5.9 vs.22.8±6.6,t=3.064,P=0.003),and the BDNF level was statistically increased (8.74±2.76 vs.6.78±2.16,t=3.447,P=0.001).After treatment,the study group had significantly lower negative symptom scale scores and higher BDNF concentration than sham-operated group (t=2.470,P=0.016; t=3.180,P=0.002).For total PANSS scores,negative symptom scale scores and general psychopathology scale scores,the changed values before and after treatment of study group were all significantly higher than those in the sham-operated group (7.8±3.5 vs.2.0±0.9,t=9.893,P=0.000; 4.4±1.9 vs.0.5±0.2,t=12.584,P=0.000; 2.8±1.0 vs.0.9±0.4,t=10.875,P=0.000).For the study group,the changes of BDNF concentration showed no obvious correlation with the total PANSS scores or negative symptom scale scores (r=-0.156-0.247,P＞0.05).Conclusions The rTMS of 10 Hz on the left prefrontal lobe can increase the serum BDNF concentration of the schizophrenia.There is no correlation between the changes of BDNF concentration and improved negative symptoms.