Proton magnetic resonance spectroscopy study of prefrontal lobe and thalamus in schizophrenics on modified electroconvulsive therapy

Abstract

To explore the potential effects of modified electroconvulsive therapy (MECT) in prefrontal lobe and thalamus in patients with schizophrenia by proton magnetic resonance spectroscopy ((1)H-MRS). From November 2010 to June 2011, a total of 31 schizophrenics fulfilling the third edition of the Chinese Classification of Mental Disorders (CCMD-III) were recruited. And prefrontal lobe and thalamus were evaluated by multi-voxel (1)H-MRS before and after 8 sessions of MECT. The subjects were evaluated by the positive and negative syndrome scale (PANSS). And the N-acetylaspartate (NAA), choline-containing compounds (Cho) and creatine compounds (Cr) were measured and the ratios of NAA/Cr and Cho/Cr determined. (1) In left prefrontal lobe and bilateral thalamus, the NAA/Cr ratio at post-treatment demonstrated higher than that at pre-treatment (1.50 ± 0.31 vs 1.35 ± 0.30, t = 2.07, P < 0.05; 1.53 ± 0.31 vs 1.38 ± 0.27, t = 2.03, P < 0.05; 1.51 ± 0.29 vs 1.36 ± 0.26, t = 2.14, P < 0.05). (2) The major influencing factors of the changes of NAA/Cr in left prefrontal lobe were age of onset, decrease rate of PANSS, baseline PANSS total score and duration of illness. And the major influencing factors for left thalamus were age of onset and duration of illness while a major influencing factor for right thalamus was baseline PANSS total score. MECT may modify brain metabolism as measured by (1)H-MRS. The pattern of changes suggests possible neuroprotective effects in schizophrenics. And these effects are correlated with age of onset, duration and severity of illness.