Song · Molecular psychiatry 2021 · case-control study · n=?

Bioenergetics and abnormal functional connectivity in psychotic disorders.

Cited 36 times in the scientific literature.

Level 4 - case-series / case-control

Case-control observational neuroimaging and spectroscopy study comparing clinical groups to controls.

PubMed 33398087 · doi:10.1038/s41380-020-00993-z · record verified 2026-08-26

What was done

Demographically matched groups of schizophrenia (SZ), bipolar disorder (BD), and healthy control (HC) subjects underwent medial prefrontal cortex (MPFC) 31P magnetization transfer spectroscopy and whole-brain fMRI. The authors calculated the creatine kinase (CK) reaction flux to quantify regional brain energy production rate and evaluated resting-state functional connectivity using the MPFC as a seed region to assess default mode network (DMN) integration and MPFC-to-task-positive network (TPN) anticorrelation.

What was found

Compared to HC, SZ patients showed significantly lower MPFC CK flux. Both SZ and BD patients displayed decreased anticorrelation between the MPFC and TPN. In HC, CK flux was significantly positively correlated with functional connectivity within DMN nodes and negatively correlated with MPFC-TPN anticorrelation. This positive correlation was modestly reduced in BD and strongly reduced in SZ, while the negative correlation with MPFC-TPN anticorrelation was absent in both BD and SZ. The abstract does not report specific sample sizes, numerical values, effect sizes, or p-values.

Why it matters

These findings provide in vivo human evidence linking cellular-level prefrontal energy metabolism to large-scale functional network connectivity. They suggest that bioenergetic deficits may contribute to disrupted neural network organization in psychotic disorders.

Limits

The abstract provides no sample sizes, demographic details, exact numerical metrics, or confidence intervals. The cross-sectional design cannot establish causality between impaired bioenergetics and altered functional connectivity. Measurements were restricted to a single brain region (MPFC), and potential confounding variables such as medication status, substance use, and symptom severity are not described.

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