Metabolic Abnormalities and Spectroscopy Biochemical Cerebral Compounds Modifications in Children and Adolescents with Antipsychotic Treatment

Abstract

We approach an integrated, multidisciplinary, innovative research-action model in children and adolescents with psychosis. Our main focus was: to investigate the biochemical cerebral compounds and metabolites (NAA-N-acetylaspartate, GABA-Gama-Aminobutyric Acid, Asp-Aspartate, CR-Creatine, Gln-Glutamine, GPC-Glicerophosphocholine, PC-Phosphocholine, PCr-Phosphocreatine, Tau-Taurine, N-MDA-N-Metyl-D-Aspartate, Serine, Glicine, Cho-Choline); the neuroimagistic and neurobiological markers and the metabolic abnormalities in correlation with the molecular pharmacogenetic testing in psychoses, treated with antipsychotic medication; the dynamic evaluation of the clinical evolution for the studied groups in correlation with specific biochemical, metabolic, neurobiological and neuroimagistic variables and markers. Our research was conducted in the period 2010-2016 on 85 patients, children and adolescents with psychosis (42 took treatment after pharmacogenetic testing, 43 without). Also, the patients were evaluated through magnetic resonance (MR) spectroscopy at baseline and after pharmacotherapy. The efficacy of the chosen therapy in correlation with the pharmacogenetic testing was evaluated through the mean change in the Positive and Negative Syndrome Scale (PANSS) total scores, in the Clinical Global Impression Severity (CGI-S/I), Clinical Global Assessment of Functioning (CGAS) and through the change registered for the relevant biochemical, metabolic, neurobiological markers and MR spectroscopy metabolites, from baseline till endpoint in different timepoints. Our results, showed statistically significant differences of the clinical scores between the studied groups. Our research was a proof, that the biochemical brain metabolites register in psychoses modified values in the MR Spectroscopy, the administration of antipsychotics can determine metabolic abnormalities (changed lipid profiles, high insulin and blood sugar levels, weight gain, obesity). But on the other side, if the antipsychotic treatment is chosen properly according to the pharmacogenetic profile of the patient, then the biochemical metabolites obtained through the MR Spectroscopy, register improvement of the values correlated with the good clinical evolution.