Detection of metabolites in the white matter of frontal lobes and hippocampus with proton in first-episode treatment-naïve schizophrenia patients


Professor Tao Li, The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. Email:


Aim: This study aimed to investigate the changes of the metabolites in the white matter of frontal lobes and hippocampus in schizophrenia by using proton magnetic resonance spectroscopy (1H-MRS).

Methods: Sixty-three first-episode treatment-naïve schizophrenia (FES) patients and 63 age-, gender- and education level-matched healthy controls were recruited. The relative levels of metabolites including N-acetylaspartate (NAA), choline-containing compounds (Cho), (Cr) and myo-inositol (MI) were detected with 1H-MRS, and the laterality index (Li) was calculated. The severity of symptoms was assessed using the Positive and Negative Syndrome Scale.

Results: Compared with controls, FES patients did not show significant differences in all metabolites. The severity of positive symptoms was negatively correlated with the NAA/Cho in the white matter of the left frontal lobe and positively correlated with the Cho/Cr in the right white matter of frontal lobes. A negative correlation was observed between the severity of negative symptoms and the NAA/Cr in the white matter of bilateral frontal lobes. No difference was shown in the Li of metabolites between FES patients and controls.

Conclusions: The metabolites such as NAA, Cho and MI in white matter of frontal lobes and hippocampus were not significantly altered in FES patients. The lower axonal integrity/number (NAA concentration) may be associated with more severe negative symptoms, and dysmetabolism in process of myelination in the white matter of frontal lobes associated with more severe positive symptoms.