Magnetic Resonance Spectroscopy Studies in Psychiatry

I have not written much about Dager, but perhaps that was an oversight. Dager is at the following address:

Department of Radiology, Neuroimaging Research Group, University of Washington School of Medicine, 1100 NE 45th Street, Seattle, WA 98105, USA. srd@u.washington.edu

Ref. 1 is an article by Dager and his Seattle group. This article is available free full text at Pubmed Central, which is a US government website. It is a database that is searchable. The magnetic resonance spectroscopy technique is very useful because it can be used to measure the chemistry of the living brain. Measuring the chemistry of the blood is much easier. In psychiatry problems are often largely restricted to the brain, making blood analysis frustrating.

"Advances in magnetic resonance spectroscopy (MRS) methodology and related analytic strategies allow sophisticated testing of neurobiological models of disease pathology in psychiatric disorders." (1)

Panic Disorder

Ref. 2 is a study of panic disorder.

"Previous findings of excess brain lactate and delayed end-tidal CO(2) (pCO(2)) recovery in subjects with panic disorder during hyperventilation suggested altered acid-base regulation." (2)

"It is suggested that increased lactate could account for these findings." (2)

Ref. 2 is from the same Seattle group. Ref. 4 is another study on panic disorder.

Bipolar Disorder

Ref. 5 is a study on bipolar disorder. This report is very useful for several reasons. For one thing, positive findings were reported in medication free bipolar patients. For another thing, the article is available free full text at the Archives of General Psychiatry website.

The findings included elevated lactate and GLX. GLX is the sum of glutamate and glutamine. These findings were in gray matter and were highly significant from a statistical point of view.

"The possibility of mitochondrial alterations underlying these findings is discussed and may provide a theoretical framework for future targeted treatment interventions." (5)

Ref. 5 was a cooperative effort involving both The Center for Anxiety and Depression at the University of Washington in Seattle and the Bipolar Research Programs at McLean Hospital and the Massachusetts General Hospital in Boston. One of the workers, Andrew Stoll of McLean Hospital, has advocated the use of fish oil as a treatment.

Schizophrenia

Bioenergetics has been reported to be abnormal in schizophrenia (6).

Autism

Many studies have been on autism. Positive findings have been reported (8, 9).

Conclusions

The magnetic resonance spectroscopy technique is a useful tool for psychiatry and for neurology. However, there are also other useful tools such as electron microscopy. Since it is difficult to get brain biopsies, the electron microscopy tool is useful mostly postmortem and with blood cells. Muscle biopsies are easier.

Other, older approaches are discussed in Refs. 10-12, which are available free full text on the Internet.

Unfortunately magnetic resonance spectroscopy has not yet led to a treatment. However, it has led to a better understanding of brain diseases. Knowing that schizophrenia is a disease of brain bioenergetics is a giant step towards new treatments.

The Seattle group's finding of elevated amino acid levels in the brain supports my own theory of amino acids flooding the brain cells in the various forms of mental disease. This would alter brain bioenergetics adversely. Also the extra amino acids in the brain could explain the excess lactate in the brain found by the Seattle group. The excess lactate could be formed from the brain burning amino acids for fuel. If this is true, then a diet low in amino acids might alleviate the problem.

References

1. Top Magn Reson Imaging. 2008 Apr;19(2):81-96. Research applications of magnetic resonance spectroscopy to investigate psychiatric disorders. Dager SR, Corrigan NM, Richards TL, Posse S.

2. Friedman SD, Mathis CM, Hayes C, Renshaw P, Dager SR. Brain pH response to hyperventilation in panic disorder: preliminary evidence for altered acid-base regulation. Am J Psychiatry. 2006;163(4):710-5.

3. Coyle JT, Schwarcz R. Mind glue: implications of glial cell biology for psychiatry. Arch Gen Psychiatry. 2000;57:90-93.

4. Dager SR, Strauss WL, Marro KI, Richards TL, Metzger GD, Artru AA. Proton magnetic resonance spectroscopy investigation of hyperventilation in subjects with panic disorder and comparison subjects. Am J Psychiatry. 1995;152:666-672.

5. Dager SR, Friedman SD, Parow A, Demopulos C, Stoll AL, Lyoo IK, Dunner DL, Renshaw PF. Brain metabolic alterations in medication-free patients with bipolar disorder. Arch Gen Psychiatry. 2004;61:450-458.

6. Dager SR, Steen RG. Applications of magnetic resonance spectroscopy to the investigation of neuropsychiatric disorders. Neuropsychopharmacology. 1992;6:249-266.

7. Lyoo IK, Renshaw PF. Magnetic resonance spectroscopy: current and future applications in psychiatric research. Biol Psychiatry. 2002;51:195-207.

8. Friedman SD, Shaw DW, Artru AA, Dawson G, Petropoulos H, Dager SR. Gray and white matter brain chemistry in young children with autism. Arch Gen Psychiatry. 2006;63:786-794.

9. DeVito TJ, Drost DJ, Neufeld RW, Rajakumar N, Pavlosky W, Williamson P, Nicolson R. Evidence for cortical dysfunction in autism: a proton magnetic resonance spectroscopic imaging study. Biol Psychiatry. 2007;61(4):465-73.

10. www.associatedcontent.com/article/2255365/depression_research_including_treatments.html

11. www.associatedcontent.com/article/2245331/affective_illnesses_organic_theories.html

12. www.associatedcontent.com/article/2233855/schizophrenia_as_a_toxic_encephalopathy.html