Prof K C Dube Poster Award

Abstract

BACKGROUNDRecent studies have shown altered N-Acetyl Aspartate (NAA) levels in the anterior cingulate cortex (ACC). Magnetic Resonance Spectroscopy (MRS) is a non-invasive method to examine the brain metabolites. In adult patients, most of the studies reported abnormalities in terms of decreased NAA levels in the ACC. Schizophrenia patients also show impaired performance on neurocognitive measures. These impairments are also seen in first episode patients.AIMS and OBJECTIVESThe purpose of the current study was to investigate the levels of NAA in the ACC along with neurocognitive deficits in patients of first episode schizophrenia, and if 6 weeks of usual treatment was able to produce any changes in the same.METHODOLOGY20 drug free or drug naïve patients of first episode schizophrenia and 10 healthy controls were taken. Single-voxel 1H-MRS was performed using the PRESS sequence with number of scans (NS) of 160, TR of 1500 ms and TE of 80 ms. Neurocognitive test was performed using Wisconsin Card Sorting test (WCST) and Montreal Cognitive Assessment (MoCA). Tests were repeated after 6 weeks of treatment. Statistical analysis was performed by SPSS 25.RESULTSThe peak height of NAA in the ACC and performance of the patients on the WCST and MoCA showed significant difference compared to healthy controls at baseline. The peak height of NAA in the ACC showed significant improvement after 6 weeks of treatment. Correlation studies showed significant positive correlation between MoCA total score and NAA height at baseline.DISCUSSION and CONCLUSIONThe study findings provide evidence in support of cognitive dysfunction in first episode schizophrenia, which is associated with neuronal loss, as evidenced by lower NAA peaks in the ACC in patients. The improvement in the metabolite levels after 6 weeks of antipsychotic treatment demonstrates neuroplastic effects of drug therapy.