Reduction of N-acetyl aspartate (NAA) in association with relapse in early-stage psychosis: a 7-Tesla MRS study

Marina Mihaljevic; Yu-Ho Chang; Ashley M Witmer; Jennifer M Coughlin; David J Schretlen; Peter B Barker; Kun Yang; Akira Sawa

doi:10.1038/s41537-024-00451-7

Reduction of N-acetyl aspartate (NAA) in association with relapse in early-stage psychosis: a 7-Tesla MRS study

Schizophrenia (Heidelb). 2024 Mar 1;10(1):29. doi: 10.1038/s41537-024-00451-7.

Authors

Marina Mihaljevic¹, Yu-Ho Chang², Ashley M Witmer², Jennifer M Coughlin³, David J Schretlen³, Peter B Barker⁴, Kun Yang⁵, Akira Sawa^{6

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Affiliations

¹ Departments of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Departments of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Departments of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵ Departments of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA. kunyang@jhmi.edu.
⁶ Departments of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA. asawa1@jhmi.edu.
⁷ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. asawa1@jhmi.edu.
⁸ Departments of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA. asawa1@jhmi.edu.
⁹ Departments of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA. asawa1@jhmi.edu.
¹⁰ Departments of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. asawa1@jhmi.edu.
¹¹ Departments of Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. asawa1@jhmi.edu.

Abstract

Understanding the biological underpinning of relapse could improve the outcomes of patients with psychosis. Relapse is elicited by multiple reasons/triggers, but the consequence frequently accompanies deteriorations of brain function, leading to poor prognosis. Structural brain imaging studies have recently been pioneered to address this question, but a lack of molecular investigations is a knowledge gap. Following a criterion used for recent publications by others, we defined the experiences of relapse by hospitalization(s) due to psychotic exacerbation. We hypothesized that relapse-associated molecules might be underscored from the neurometabolites whose levels have been different between overall patients with early-stage psychosis and healthy subjects in our previous report. In the present study, we observed a significant decrease in the levels of N-acetyl aspartate in the anterior cingulate cortex and thalamus in patients who experienced relapse compared to patients who did not. Altogether, decreased N-acetyl aspartate levels may indicate relapse-associated deterioration of neuronal networks in patients.

Abstract

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