Previous proton MR spectroscopic imaging of the hippocampus distinguished schizophrenia cases from controls by elevated creatine [Cr] and more variable N-acetylaspartate [NAA] and choline [Cho] concentrations. Here we examine these metabolite’s concentrations in 15 cases against their research diagnostic interviews and symptom ratings. Despite modest cohort size we find: (a) elevated [Cho] predicts psychotic; and (b) manic symptoms severity; and (c) lower [NAA] trended with negative symptoms. These findings suggest that microgliosis and demyelination, reflected by reduced [NAA] and elevated [Cho], may be related to active psychotic and manic symptoms, potentially benefiting precision medicine in selection and monitoring schizophrenia treatment.
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