Sandoy, L. B. | bioRxiv Science

bioRxiv2024

GABA, Glutamate dynamics and BOLD observed during cognitive processing in psychosis patients with hallucinatory traits

The perception of a voice in the absence of an external auditory source - an auditory verbal hallucination - is a characteristic symptom of schizophrenia. To better understand this phenomenon requires integration of findings across behavioural, functional, and neurochemical levels. We address this with a locally adapted MEGA-PRESS sequence incorporating interleaved unsuppressed water acquisitions, allowing concurrent assessment of behaviour, blood-oxygenation-level-dependent (BOLD) functional changes, Glutamate+Glutamine (Glx), and GABA, synchronised with a cognitive (flanker) task. We acquired data from the anterior cingulate cortex (ACC) of 51 patients with psychosis (predominantly schizophrenia spectrum disorder) and hallucinations, matched to healthy controls. Consistent with the notion of an excitatory/inhibitory imbalance, we hypothesized differential effects for Glx and GABA between groups, and aberrant dynamics in response to task. Results showed impaired task performance, lower baseline Glx and positive association between Glx and BOLD in patients, contrasting a negative correlation in healthy controls. Task-related increases in Glx were observed in both groups, with no significant difference between groups. No significant effects were observed for GABA. These findings suggest that a putative excitatory/inhibitory imbalance affecting inhibitory control in the ACC is primarily observed as tonic, baseline glutamate differences, rather than GABAergic effects or aberrant dynamics in relation to a task. HighlightsO_LIIn-vivo, GABA-edited functional 1H-MRS data were collected from 51 patients with hallucinations and a similar number of matched healthy controls C_LIO_LIReduced Glutamate+Glutamine (Glx) levels were observed in the patient group. C_LIO_LIBOLD association to baseline Glutamate+Glutamine (Glx) differed between patients and controls C_LIO_LIRobust task-related increases in measured Glx were observed in the Anterior Cingulate Cortex (ACC) C_LIO_LITask-related changes in measured Glx did not differ between patients and controls C_LI

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bioRxiv2023

GABA, glutamatergic dynamics and BOLD contrast concurrently assessed using functional MR spectroscopy during a cognitive task

A recurring issue in functional neuroimaging is how to link task-driven hemodynamic BOLD-fMRI responses to underlying neurochemistry at the synaptic level. Glutamate and GABA, the major excitatory and inhibitory neurotransmitters respectively, are typically measured with MR spectroscopy (MRS) sequences in a resting state, in the absence of a task. We propose to resolve this disconnect by applying a novel method to concurrently acquire BOLD, Glx and GABA measurements from a single voxel, using a locally adapted MEGA-PRESS sequence implementation which incorporates unsuppressed water reference signals at a regular interval, allowing continuous assessment of BOLD-related linewidth variation for fMRS applications. Healthy subjects (N = 81) performed a cognitive task (Eriksen Flanker) which was presented visually in a task-OFF, task-ON block design, with individual event stimulus timing varied with respect to the MRS readout. BOLD data acquired with the adapted MEGA-PRESS sequence were correlated with data acquired using a standard fMRI EPI sequence as a means of validating the concurrent approach: a significant (although moderate) correlation was observed, specific to the fMRS-targeted region of interest. We additionally present a novel linear model for extracting modelled spectra associated with discrete functional stimuli, building on well-established processing and quantification tools. Behavioural outcomes from the Flanker task, and activation patterns from the BOLD-fMRI sequence, were as expected from the literature. fMRS-assessed BOLD response correlated strongly with slowing of response time in the incongruent Flanker condition. Moreover, there was a significant increase in measured Glx levels (~8.8%), between task-OFF and task-ON periods. These findings verify the efficacy of our functional task and analysis pipelines for the simultaneous assessment of BOLD and metabolite fluctuations in a single voxel. As well as providing a robust basis for further work using these techniques, we also identify a number of clear directions for further refinement in future studies. HighlightsO_LIConcurrent measurement of temporally resolved metabolite estimates and local BOLD-related signal changes is demonstrated C_LIO_LIIn-vivo, GABA-edited functional 1H-MRS data were collected from 81 healthy subjects whilst they performed a cognitive task C_LIO_LIRobust task-related increases in measured Glutamate+Glutamine were observed in the Anterior Cingulate Cortex C_LIO_LIModerate correlation was observed between BOLD contrast strength as assessed by fMRS and fMRI techniques, specific to the prescribed region C_LIO_LIA novel technique for extraction of block- or event-related sub-spectra is demonstrated C_LI Graphical AbstractA novel sequence adaption for concurrent measurement of GABA-edited spectroscopy and functional BOLD changes is demonstrated on N=81 healthy subjects. Significant changes in measured Glutamate+Glutamine concentration are found, along with the expected behavioural and BOLD effects in response to a Flanker task. O_FIG O_LINKSMALLFIG WIDTH=170 HEIGHT=200 SRC="FIGDIR/small/539017v1_ufig1.gif" ALT="Figure 1"> View larger version (45K): org.highwire.dtl.DTLVardef@e06295org.highwire.dtl.DTLVardef@1683a30org.highwire.dtl.DTLVardef@1c45f7aorg.highwire.dtl.DTLVardef@1587cf0_HPS_FORMAT_FIGEXP M_FIG C_FIG

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