N-acetyl-aspartate (NAA) is a readily measured marker of neuronal metabolism. Previous analyses in schizophrenia have shown NAA levels are low in frontal, temporal and thalamic regions, but may be underpowered to detect effects in other regions, in high-risk states and in first episode psychosis. We searched for magnetic resonance spectroscopy studies comparing NAA in chronic schizophrenia, first episode psychosis and high risk of psychosis to controls. 182 studies were included and meta-analysed using a random-effects model for each region and illness stage. NAA levels were significantly lower than controls in the frontal lobe [Hedge’s g = -0.36, p < 0.001], hippocampus [-0.52, p < 0.001], temporal lobe [-0.35, p = 0.031], thalamus [-0.32, p = 0.012] and parietal lobe [-0.25, p = 0.028] in chronic schizophrenia, and lower than controls in the frontal lobe [-0.26, p = 0.002], anterior cingulate cortex [-0.24, p = 0.016] and thalamus [-0.28, p = 0.028] in first episode psychosis. NAA was lower in high-risk of psychosis in the hippocampus [-0.20, p = 0.049]. In schizophrenia, NAA alterations appear to begin in hippocampus, frontal cortex and thalamus, and extend later to many other regions.

N-乙酰天冬氨酸 (NAA) 是一种易于测量的神经元代谢标志物。先前对精神分裂症的分析表明，额叶、颞叶和丘脑区域的 NAA 水平较低，但可能不足以检测其他区域、高风险状态和首发精神病的影响。我们搜索了磁共振波谱研究，将 NAA 在慢性精神分裂症、首发精神病和精神病高风险患者中与对照组进行比较。纳入了 182 项研究，并使用随机效应模型对每个地区和疾病阶段进行了荟萃分析。NAA 水平显着低于额叶中的对照 [Hedge's g= -0.36，p < 0.001]，海马体 [-0.52，p < 0.001]，颞叶 [-0.35，p = 0.031]，丘脑 [-0.32，p = 0.012] 和顶叶 [-0.25，p = 0.028]在慢性精神分裂症中，在首发精神病中，额叶 [-0.26，p = 0.002]、前扣带皮层 [-0.24，p = 0.016] 和丘脑 [-0.28，p = 0.028] 低于对照组。NAA 在海马体精神病高风险中较低 [-0.20，p = 0.049]。在精神分裂症中，NAA 改变似乎始于海马体、额叶皮层和丘脑，然后延伸到许多其他区域。