ABSTRACT

The first study of schizophrenia using 31P MRS was conducted by Pettegrew et al.,* and 31P MRS with the surface coil method was applied. An increase in PDE level, a decrease in PME level, an increase in ATP level, and a decrease in Pi level in the dorsal prefrontal cortex of drug naYve, first episode schizophrenic patients5p6 were observed. Changes in PDE and PME reflect abnormalities of phospholipids, and alterations in ATP and PCr reflect impairment in the metabolism of highenergy phosphates. Fujimoto et al.7>8 investigated many regions of the schizophrenic brain using the 31P chemical shift imaging (CSI) technique, which is as reliable as the single voxel method. The evaluation of the 31P spectra of patients with schizophrenia by CS1 demonstrated localized abnormalities in PDE, PME, PCr and ATP in disorganized type of schizophrenia (DSM-111-R

Stanley et al.9 observed decreases in PME levels and an increase in PDE levels and the intracellular free magnesium level, but no abnormalities in high-energy phosphate levels, by employing the surface coil method with fast rotating gradient spectroscopy (FROG). Using the FROG method, Williamson et al.lOJ1 noted a decrease in PME, an increase in PDE, and free magnesium in the left prefrontal region of patients, and reported a negative correlation between PDE levels and the duration of illness. According to the report of Kato et al.12J3 using the surface coil method, the PME levels were decreased in bilateral frontal lobes, but P-ATP levels and PCr levels were increased in the left frontal lobe, and the PCr levels had a positive correlation with scores on the Scale for Assessment of Negative Symptoms (SANS). However, the PDE levels did not show significant changes in the frontal lobes. Employing the CSI, Deicken14 showed higher levels of PDE in both right and left frontal lobes and decreased levels of PCr and Pi in medicated schizophrenic patients.