Epidemiologic, genetic, and neurobiological studies suggest considerable overlap between schizophrenia and mood disorders. Importantly, both disorders are associated with a broad range of cognitive deficits as well as altered glutamatergic and GABAergic neurometabolism. We conducted a systematic review of magnetic resonance spectroscopy (MRS) studies investigating the relationship between glutamatergic and GABAergic neurometabolites and cognition in schizophrenia spectrum disorders and mood disorders. A literature search in Pubmed of studies published before April 15, 2019 was conducted and 37 studies were deemed eligible for systematic review. We found that alterations in glutamatergic and GABAergic neurotransmission have been identified relatively consistently in both schizophrenia and mood disorders. However, because of the vast heterogeneity of published studies in terms of illness stage, medication exposure, MRS acquisition parameters and data post-processing strategies, we still do not understand the relationship between those neurotransmitters and cognitive dysfunction in mental illness, which is a critical initial step for rational drug development. Our findings emphasize the need for coordinated multi-center studies that characterize cognitive function and its biological substrates in large and well-defined clinical populations, using harmonized imaging sequences and analytical methods with the goal to elucidate the underlying pathophysiological mechanisms and to inform future clinical trials.

中文翻译：

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谷氨酸和 GABA 在精神分裂症和情绪障碍认知功能障碍中的作用——磁共振波谱研究的系统回顾

流行病学、遗传学和神经生物学研究表明，精神分裂症和情绪障碍之间存在相当大的重叠。重要的是，这两种疾病都与广泛的认知缺陷以及谷氨酸能和氨基丁酸能神经代谢的改变有关。我们对磁共振波谱 (MRS) 研究进行了系统回顾，研究了精神分裂症谱系障碍和情绪障碍中谷氨酸能和 GABA 能神经代谢物与认知之间的关系。在 Pubmed 中对 2019 年 4 月 15 日之前发表的研究进行了文献检索，37 项研究被认为符合系统评价的条件。我们发现，在精神分裂症和情绪障碍中，谷氨酸能和 GABA 能神经传递的改变相对一致。然而，由于已发表的研究在疾病阶段、药物暴露、MRS 采集参数和数据后处理策略方面存在巨大异质性，我们仍然不了解这些神经递质与精神疾病认知功能障碍之间的关系，这是关键的第一步用于合理的药物开发。我们的研究结果强调需要协调的多中心研究来表征大型和明确临床人群的认知功能及其生物学底物，使用统一的成像序列和分析方法，目的是阐明潜在的病理生理机制并为未来的临床试验提供信息. 我们仍然不了解这些神经递质与精神疾病认知功能障碍之间的关系，这是合理药物开发的关键第一步。我们的研究结果强调需要协调的多中心研究来表征大型和明确临床人群的认知功能及其生物学底物，使用统一的成像序列和分析方法，目的是阐明潜在的病理生理机制并为未来的临床试验提供信息. 我们仍然不了解这些神经递质与精神疾病认知功能障碍之间的关系，这是合理药物开发的关键第一步。我们的研究结果强调需要协调的多中心研究来表征大型和明确临床人群的认知功能及其生物学底物，使用统一的成像序列和分析方法，目的是阐明潜在的病理生理机制并为未来的临床试验提供信息.