Illness Versus Substance Use Effects on The Frontal White Matter in Early Schizophrenia: A 4Tesla 1H-MRS Study
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Illness versus substance use effects on the frontal white matter in earlyphase schizophrenia: A 4 Tesla1H-MRS studyDenise Berniera,RobertBarthab, David McAllindona,c, Christopher C. Hanstockd, Yannick Marchande,Kim N.H. Dillena, Michelle Gallanta, Kimberly P. Gooda,PhilipG.Tibboa,⁎aDepartment of Psychiatry, Dalhousie University, Nova Scotia, CanadabRobarts Research Institute, University of Western Ontario, Ontario, CanadacBiomedical Translational Imaging Centre, Halifax, Nova Scotia, CanadadDepartment of Biomedical Engineering, University of Alberta, Alberta, CanadaeFaculty of Computer Science, Department of Psychology and Neuroscience, Dalhousie University, Nova Scotia, Canadaabstractarticle infoArticle history:Received 4 September 2015Received in revised form 13 April 2016Accepted 15 April 2016Available online 6 May 2016Objective:Young adults with early phase schizophrenia often report a past or current pattern of illicit substanceuse and/or alcohol misuse. Still, little is known about the cumulative and separate effects of each stressor onwhite matter tissue, at this vulnerable period of brain development.Methods:Participants involved 24 healthy controls with a past or current history of sustained illicit drug use and/or alcohol misuse (users), 23 healthy controls without such history (normative data), and 27 users with earlyphase schizophrenia.1H-MRSdata were acquired from a large frontal volumeencompassing95% of white matter,using a 4 Tesla scanner (LASER sequence, TR/TE 3200/46 ms).Results:Reduced levels of choline-containing compounds (Cho) were specific to the effect of illness (Cohen'sd=0.68), with 22% of the variance in Cho levels accounted for by duration of illness. Reduced levels of myoInositol(d= 1.10) and creatine plus phosphocreatine (d= 1.07) were specific to the effects of illness plus substanceuse. Effect of substance use on its own was revealed by reductions in levels of glutamate plus glutamine (d=0.83) in control users relative to normative data.Conclusions:The specific effect of illness on white matter might indicate a decreased synthesis of membranephospholipids or alternatively, reduced membrane cellular density. In terms of limitations, this study did notinclude patients without a lifetime history of substance use (non-users), and the specific effect of each substanceused could not be studied separately.