Omega-3 polyunsaturated fatty acids and antioxidants for the treatment of schizophrenia: A role for magnetic resonance imaging

Abstract

Omega-3 polyunsaturated fatty acids and antioxidants have important physiological functions in the brain including energy storage and production, gene expression, and cell signaling. Myelin is formed from the membranes of oligodendrocytes and phospholipid bilayers of these membranes which contain polyunsaturated fatty acids. Reactive oxygen species are created as part of the normal metabolism of oxygen within the cell and are important for cell signaling and homeostasis. Enzymes such as superoxide dismutase and glutathione are antioxidants that protect against free radicals that can damage cellular structure. Further, although the use of polyunsaturated fatty acid and antioxidants as potential therapeutic agents to treat individuals with or at risk for psychosis has generated considerable enthusiasm given their relative safety, minimal side effects, and low cost, clinical studies have yielded inconsistent evidence regarding their efficacy. The use of magnetic resonance imaging techniques such as diffusion tensor imaging and proton magnetic resonance spectroscopy, however, could provide information regarding the mechanism(s) of action for these compounds. For example, several studies have demonstrated a consistent relationship between peripheral omega-3 polyunsaturated fatty acid levels and fractional anisotropy, a putative measure of white matter integrity obtained using diffusion tensor imaging. Magnetic resonance imaging studies may also provide information about whether there are subgroups of individuals with psychosis who may be responsive to intervention with omega-3 polyunsaturated fatty acids and/or antioxidants. This approach could hold promise for better understanding how these compounds affect brain structure and function to elucidate possible targets for treatment intervention that can benefit patients.