(31)
Phosphorus magnetic resonance spectroscopy ((31)P-MRS) allows in vivo investigation of cerebral
phospholipid and energy metabolism. Using 2D chemical shift imaging, this method can be applied to study multiple brain areas and to assess concentrations of both
phospholipids and high-energy
phosphates. The purpose of our study was to assess multiregional metabolic profiles in
schizophrenia using a 2D-resolved MRS technique, and to assess the intercorrelation of findings. We applied (31)P-MRS chemical shift imaging in 31
schizophrenia patients (12
antipsychotic-naïve first-episode and 19
antipsychotic-free multi-episode patients) and 31 healthy age- and sex-matched controls. Spatially resolved maps were compared for the main metabolites of the (31)P spectrum. Metabolites of
phospholipid (PME and PDE) and energy (PCr and Pi) metabolism were significantly reduced in bilateral prefrontal and medial temporal (including hippocampal) brain regions, caudate nucleus, thalamus and anterior cerebellum as compared to controls. Moreover, factor analysis of these changes showed a characteristic spatial pattern of changes, which demonstrates significant associations between alterations of
phospholipid and energy metabolism, and between metabolic alterations and severity of symptoms (BPRS total score, but not SANS or SAPS scores). This suggests a pattern of intercorrelated changes of these metabolic markers. Results support the notion of disturbed
phospholipid turnover in
schizophrenia, probably unrelated to prior pharmacological treatment, and associated with increased energy demand.