Magnetic Resonance Spectroscopy Studies of Brain Energy Metabolism in Schizophrenia: Progression from Prodrome to Chronic Psychosis.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing literature without systematic search or meta-analytic pooling.
PubMed 37812338 · doi:10.1007/s11920-023-01457-1
What was done
The authors reviewed literature on molecular mechanisms and in vivo magnetic resonance spectroscopy (MRS) measures of brain energy metabolism across individuals at clinical high risk for psychosis, first-episode schizophrenia, and chronic schizophrenia. Evaluated markers included high-energy phosphate metabolism, lactate, intracellular pH, the NAD+/NADH redox ratio, and glutathione.
What was found
No numerical values, sample sizes, or effect sizes are reported in the abstract. Reported qualitative findings include significant reductions in creatine kinase reaction activity and redox (NAD+/NADH) ratios in the prefrontal cortex in both first-episode and chronic schizophrenia patients, as well as a trend toward increased lactate and decreased intracellular pH seen only in chronic schizophrenia.
Why it matters
These observations suggest a stage-dependent shift from oxidative phosphorylation to glycolysis over the course of schizophrenia, pointing to mitochondrial dysfunction and redox imbalance as potential therapeutic targets.
Limits
The abstract reports no quantitative data, error bounds, or study counts. As a narrative review, it lacks systematic search methodology, risk-of-bias evaluation, and meta-analytic pooling. Potential confounders such as lifetime antipsychotic exposure, smoking, and illness chronicity are not quantified.
Cited by
- supports Researchers at McLean Hospital and Harvard have published data directly measuring bioenergetic impairment and energy resistance in the human brain in mental illnesses.