REVIEW article

Front. Psychiatry, 11 August 2020

Sec. Molecular Psychiatry

Volume 11 - 2020 | https://doi.org/10.3389/fpsyt.2020.00802

Local and Interregional Neurochemical Associations Measured by Magnetic Resonance Spectroscopy for Studying Brain Functions and Psychiatric Disorders

  • Molecular Imaging Branch, National Institute of Mental Health, Bethesda, MD, United States

Abstract

Magnetic resonance spectroscopy (MRS) studies have found significant correlations among neurometabolites (e.g., between glutamate and GABA) across individual subjects and altered correlations in neuropsychiatric disorders. In this article, we discuss neurochemical associations among several major neurometabolites which underpin these observations by MRS. We also illustrate the role of spectral editing in eliminating unwanted correlations caused by spectral overlapping. Finally, we describe the prospects of mapping macroscopic neurochemical associations across the brain and characterizing excitation–inhibition balance of neural networks using glutamate- and GABA-editing MRS imaging.

Introduction

In vivo MRS is the only noninvasive technique that can directly measure brain chemicals in vivo. Using techniques similar to MRI, MRS can measure concentrations of many neurometabolites as well as metabolic fluxes from localized brain regions (1). Over the past decades, MRS studies have found biochemical abnormalities in essentially all neuropsychiatric disorders, providing important insights into our understanding of etiologies and treatments of various brain diseases. These studies have, in most cases, focused on alterations in the concentrations of individual brain neurometabolites by comparing them among different cohorts and/or effects of treatments.

Many significant correlations among neurometabolites and between individual neurometabolites and non-MRS measures of brain function and disorders have been reported more recently. Altered correlations have been found in neuropsychiatric disorders, revealing abnormal neurochemical associations under pathophysiological conditions [e.g., (212)]. The strong correlations among N-acetylaspartate (NAA)/choline in precentral gyrus, midcingulate cortex, and thalamus found in healthy subjects were absent in patients with amyotrophic lateral sclerosis (4). Correlation between hippocampal Glx (glutamate + glutamine) and NAA has been demonstrated to be a more sensitive biomarker differentiating between healthy controls and schizophrenia patients than either neurometabolite alone (6, 7). In patients with subclinical hepatic encephalopathy the occipital lobe phosphodiester measured by 31P MRS and Glx levels were found to be negatively correlated (13). Interregional correlations of glutamate and GABA levels have also been reported in many studies [e.g., (8, 1417)]. These studies have clearly demonstrated that neurochemical associations are abnormally altered in many brain disorders, but the absolute strengths of these correlations measured by different MRS methodologies have been inconsistent or controversial [e.g., (5, 14, 15, 1823)]. In particular, the effects of spectral overlap on the observed neurometabolite correlations have yet to be illustrated although they can significantly confound the intrinsic neurochemical correlations of interest.

Many studies of neurochemical associations rely on spectral fitting [e.g., (24)] to extract neurometabolite concentrations from overlapping signals. When there is significant spectral overlap between two signals overestimate of one signal is statistically correlated with underestimate of the other signal and vice versa, even when there exists no neurochemical correlation between the two signals. In addition, this type of statistical correlations can propagate due to the intensity constraints imposed by LCModel (24) or overlapping with neurochemically correlated signals. When neurometabolite concentrations are correlated with other measurements (e.g., behavior, resting state fMRI functional connectivity, or gene expression), statistical correlations due to spectral overlap among MRS measurements can also affect correlations between MRS measurements and non-MRS measurements.

In this article we review dominant metabolic pathways connecting major neurometabolites (2527) which underpin the neurochemical associations detected by MRS correlation studies. Non-MRS neurochemical studies of animal models that found correlated changes in neurometabolite concentrations under various pathophysiological conditions are also discussed. Monte Carlo simulations are performed to demonstrate the existence of statistical correlations that originated from spectral overlap. Finally, we discuss MRS techniques that eliminate spectral overlap and associated statistical correlations. We hope that these discussions will spur interest in developing MRS techniques for mapping neurochemical associations across the brain to facilitate a variety of clinical investigations. In particular, since glutamate and GABA play dominant roles in the excitation–inhibition balance (28, 29) and in many neuropsychiatric disorders (3033), MRS characterization of glutamate–GABA associations among the nodes of neural networks may provide considerable insight into the interactions between glutamatergic and GABAergic systems and their abnormalities.

Metabolic Pathways Underlying Neurochemical Associations

Predominant metabolic pathways connecting NAA, glutamate, glutamine, and GABA are reviewed in detail. For clarity, a table summarizing these pathways is provided (Table 1).

Table 1

NeurometabolitesAnabolic enzymesCatabolic enzymes
NAANAA synthaseaspartoacylase
glutamateaspartate aminotransferase, glutaminase, glutamate dehydrogenaseaspartate aminotransferase, glutamine synthetase, glutamate dehydrogenase, glutamic acid decarboxylase
glutamineglutamine synthetaseglutaminase
GABAglutamic acid decarboxylaseGABA transaminase

Predominant metabolic pathways of NAA, glutamate, glutamine and GABA in brain.

NAA-Glutamate Association

NAA is the most abundant free amino acid derivative in the CNS. NAA is found almost exclusively within the nervous system. In the adult brain, it is mostly confined to neurons. As such, it is of great clinical interest as it has been considered as a neuronal marker for assessment of neuronal viability in a variety of neuropsychiatric disorders using proton MRS. For example, NAA level is markedly reduced within the infarct of stroke patients (34), while a higher NAA level is associated with a better clinical outcome (35). Despite the intense interest in NAA, both its physiological and metabolic roles in normal brain functions as well as in neuropsychiatric disorders remain poorly understood [for a review of the putative role of NAA, see (36)].

Important metabolic associations exist among major neurometabolites observable by MRS through precursor–product relationships and sharing common substrates (26, 37, 38). Glutamate, the most abundant intracellular amino acids in mammals, is a key component of intermediary metabolism and a precursor of numerous cellular components including proteins as well as neurometabolites such as GABA, N-acetylaspartylglutamate (NAAG), and glutathione (26). As glutamate is also the primary excitatory neurotransmitter in the CNS, it is not surprising that the proton MRS has found abnormal glutamate levels in many neuropsychiatric disorders including multiple sclerosis (39), major depression (40), and bipolar disorder (41) where glutamatergic dysfunction is broadly implicated.

Glutamate is primarily synthesized by transamination from α-ketoglutarate catalyzed by aspartate aminotransferase (25):

Glutamate also is produced, to a much lesser extent, from α-ketoglutarate and ammonium via glutamate dehydrogenase, from glutamine via hydrolysis catalyzed by phosphate-activated glutaminase, by other transamination reactions that use α-ketoglutarate as receptor of the amino group, and during protein turnover (42).

The transaminases of importance for maintenance of glutamate homeostasis in the brain are mainly aspartate aminotransferase, branched-chain aminotransferase, and alanine aminotransferase with aspartate aminotransferase dominating overwhelmingly, representing >97% of the glutamate-related aminotransferase activities (26). 13C magnetization transfer MRS experiments have shown that the aspartate aminotransferase reaction is extremely fast in the brain in vivo (43). This rapid transamination by aspartate aminotransferase predominates in the formation of glutamate in the CNS, forming strong metabolic coupling between glutamate and aspartate (25). The tight connection between glutamate and aspartate becomes conspicuous under many pathophysiological conditions where the brain is challenged or perturbed metabolically. For example, during hypoglycemia a decrease in glutamate concentration was accompanied by an increase in aspartate concentration (4446). Similarly, barbiturate anesthesia and hypothermia were also found to lower the concentration of α-ketoglutarate accompanied by reduced glutamate concentration and increased aspartate concentration (4749). These correlated changes in glutamate and aspartate were explained by a sizable shift in the aspartate aminotransferase reaction towards aspartate formation at the cost of a reduction in glutamate concentration (25, 26). In contrast, both hypocapnia and hypoxic hypoxia are associated with an increase in glutamate concentration and a reduction in aspartate concentration with the aspartate aminotransferase reaction shifting in the opposite direction (25, 26, 50).

A strong metabolic coupling between glutamate and aspartate mediated by the rapid and ubiquitous aspartate aminotransferase reaction also affects NAA, the dominant signal in proton MRS, as NAA is primarily synthesized from acetyl coenzyme A (CoA) and aspartate by NAA synthase (51):

In addition to this indirect connection from glutamate to NAA synthesis via aspartate, both glutamate and NAA are products of NAAG catabolism catalyzed by N-acetylated-α-linked-amino dipeptidase (5254). The deacetylation of NAA catalyzed by aspartoacylase has also been proposed as a significant metabolic pathway for NAA to act as a reservoir for glutamate in brain (55).

Glutamate–Glutamine Association

In contrast to glutamate, which is predominantly located in glutamatergic neurons, glutamine is primarily an astrocytic chemical. In the MRS literature glutamate + glutamine is often collectively referred to as Glx as at lower magnetic fields it has been difficult to separate the two spectroscopically. Abnormal glutamine concentrations have been found in several brain disorders including cancer, hepatic encephalopathy, and other neuropsychiatric disorders (56, 57).

Although the overall glutamate pool in neural tissues rapidly turns over fueled by primarily glucose under normal physiological conditions, glutamate released from nerve terminals is replenished by astroglial glutamine via the glutamate–glutamine neurotransmitter cycle [Figure 1; (26, 59)]. The negatively charged highly hydrophilic glutamate cannot diffuse across cell membranes. The concentration of glutamate in the extracellular space is extremely low due to its rapid uptake into the astroglia facilitated by high-affinity Na+-dependent transport systems against a large concentration gradient (6062). Once taken up into the astroglial cells, glutamate is converted into glutamine by glutamine synthetase:

Figure 1

or oxidized by assimilation into the tricarboxylic acid cycle of astroglial cells (26, 63). Once formed, glutamine readily enters nerve terminals by its own low affinity transport system or by simple diffusion. There the phosphate-activated glutaminase converts it into glutamate (26):

A large number of neurochemical as well as autoradiographic studies have confirmed that glutamate is selectively taken up by astroglial cells and then converted into glutamine, while glutamine preferentially enters the neurons and is converted into glutamate there (64). In vivo13C and 15N MRS studies have quantitatively measured the glutamate–glutamine cycling flux in rodent and human brains [e.g., (58, 6569)]. Results from these studies have demonstrated that the glutamate–glutamine cycle between glutamatergic neurons and astroglia is metabolically significant, providing a major connection between glutamate and glutamine in the brain (70). In addition, over the range of glutamate concentrations found in the nerve terminals, product inhibition appears to be the main mechanism of control of glutaminase activity with glutamate significantly attenuating the activity of glutaminase (71).

The metabolic connection between glutamate and glutamine is manifested in many brain disorders and animal models. For example, elevated ammonia level in the brain is associated with increased glutamine synthesis for ammonia detoxification (67). It has been reported that in hyperammonemia and hepatic encephalopathy the elevation of glutamine level in the brain is accompanied by a reduced glutamate level as glutamate acts as a receptor for the excessive ammonia (72). The changes in glutamate and glutamine levels, however, do not necessarily go in opposite directions. Both glutamate and glutamine are abundant in the brain. Despite efforts to understand the roles of glutamate and glutamine, the reason for maintaining relatively high concentrations of glutamate and glutamine in the brain is still poorly understood. It is possible that a high concentration of glutamate and glutamine facilitates the generally high metabolic activities in the brain because glutamate and glutamine are key components of intermediary metabolism (25). They are also precursors of many other cellular components (26). Their role as “energy reservoirs” is particularly clear when the brain is under metabolic stress. For example, when glucose is scarce, such as in hypoglycemia, both glutamate and glutamine act as energy fuels. As a result, the concentrations of both glutamate and glutamine are reduced in synchrony during hypoglycemia and in many other pathophysiological conditions when normal oxidative metabolism is impaired (45, 73).

Glutamate–GABA Association

While glutamate is the major excitatory neurotransmitter in the mammalian brain, GABA is the major inhibitory neurotransmitter. Since the initial detection of reduced GABA levels in epilepsy patients by MRS (74) and a strong correlation between GABA levels and seizure control in epilepsy patients treated by vigabatrin (75), MRS of GABA has greatly advanced both in terms of MRS methodologies and their clinical applications in studying GABAergic abnormalities in neuropsychiatric disorders.

Like glutamate, GABA metabolism proceeds through important intermediates of the tricarboxylic acid cycle. When GABA was first discovered (76) it was realized that GABA was formed from glutamate. Later studies identified that the principal pathway of GABA goes through α-decarboxylation of glutamate via glutamic acid decarboxylase which converts glutamate directly into GABA (77):

The source of the GABA precursor is believed to be dominated by neuronal glucose with astroglial glutamine playing a smaller role (7880). GABA synthesis from putrescine and other polyamines is metabolically insignificant in the brain although polyamines play an important role in the developing brain (81).

A fundamental aspect of glutamate–GABA association is the excitation–inhibition balance in the brain (32, 82) because of their roles as the dominant excitatory and inhibitory neurotransmitters, respectively, in the CNS. Glutamatergic neurons (e.g., cortical pyramidal neurons) receive a significant degree of GABAA-mediated inhibition through interneurons (83). Balanced excitation and inhibition facilitate normal brain functions, and failure to maintain excitation–inhibition balance underlies dysfunction in many brain disorders (32, 33, 84). Many studies have also revealed altered glutamate and GABA. For example, GABA levels were found to decrease, whereas Glx levels increased with increasing visual input in the occipital cortex of healthy subjects (85). Both glutamate and GABA increased following vigorous exercise (86). In autistic patients the frontal lobe [GABA]/[Glu] ratio was found to be significantly lower, suggesting abnormality in the regulation between GABA and glutamate (87). Abnormalities in MRS measures of glutamate and/or GABA in many other neuropsychiatric disorders have also been reported and reviewed [e.g., (40, 8890)].

Long range excitatory and inhibitory interactions between functionally connected brain regions are well established (9193). The strong coupling between glutamatergic neurotransmission and total GABA level is supported by a large body of in vitro and in vivo evidence [e.g., (16, 75, 94100)]. A large number of neuroimaging studies have also shown that total glutamate or Glx concentration is significantly correlated with neural activity or glutamatergic neurotransmission [e.g., (28, 101103)]. Correlations of total glutamate and total GABA levels locally and among regions functionally connected in a specific neural network have also been reported [e.g., (1517, 19)].

Statistical Correlations Among MRS Signals Due to Spectral Overlap

Many neurometabolites have similar resonant frequencies, leading to spectral overlap among MRS signals. Effects of spectral overlap on the Cremer–Rao lower bounds of extracted neurometabolites have been analyzed previously (104). Extracting the concentrations of neurometabolites by spectral fitting is essentially mapping the acquired MRS spectrum (spec) into a vector (conc) consisting of concentrations by inverting the matrix equation spec = basisconc (24). Here, basis is a matrix consisting of basis spectra of the component neurometabolites, which transforms the concentration vector conc into the fitted spectrum that approximates spec in the sense of least squares. Overlapping neurometabolites become statistically correlated through the covariance matrix (COV) of conc (105):

where denotes Hermitian transposition and σ2 is the noise variance of the measured spectrum spec. The off-diagonal elements (proportional to the square of cross-correlation coefficients) of COV(conc) depend on the frequency separation among the resonances of the neurometabolites in basis. Figure 2 shows Monte Carlo simulations of the correlation between two singlet peaks as a function of their separation in the frequency domain. Figure 2A shows the correlation between conc1 and conc2 across individual fits when spectral overlap between the two signals is minimal. The correlation between conc1 and conc2 when their frequency separation equals their half-height linewidth is plotted in Figure 2B. Finally, the correlation between conc1 and conc2 when their frequency separation equals 0.5* half-height linewidth is plotted in Figure 2C. As shown by Figure 2 statistical correlation between these two neurochemically unrelated signals increases as their spectral overlap increases. Here the large correlation values occur when the two signals happen to exhibit similar chemical shifts, not because one signal influences the other neurochemically. This simple example of two overlapping singlets illustrates a point of caution in the interpretation of neurometabolite correlation results. For multiplets and neurometabolites with multiple resonances, spectral overlap occurs when two resonance lines overlap each other even when the chemical shifts are not very close.

Figure 2

The off-diagonal elements of the covariance matrix become highly significant in the presence of severe spectral overlap such as in short echo time MRS spectra. In addition to overlapping neurometabolites, a strong baseline can also cause statistical correlations (106, 107) because the baseline, which arises from macromolecules and/or lipids and residual water, overlaps with essentially all neurometabolite signals. Figure 3 compares spectral fitting of two 3 T short echo time single voxel in vivo spectra by the commercial LCModel software. The spectrum on the left was acquired using short echo time Point RESolved Spectroscopy (PRESS) technique from a cubic voxel in the anterior cingulate cortex of a healthy subject at 3 T (echo time = 35 ms, voxel size = 8 ml). The spectrum on the right was generated by broadening the linewidths of the spectrum on the left by 2.0 Hz and adding random noise to maintain the same signal-to-noise ratio (107). Both spectra in Figure 3 were fitted using LCModel with the same default settings (24). With 2.0 Hz line-broadening the LCModel baseline was conspicuously stronger around the spectral region near 2.35 ppm where glutamate and the aspartyl moiety of NAA resonate. Both NAA and glutamate levels reported by LCModel were lowered by approximately the same amount (~11%) after the line-broadening [n = 10; (107)]. This reduction in the extracted metabolite concentrations was found to be generally more pronounced with greater line-broadening. Although the concentrations of neurometabolites in the two spectra of Figure 3 are identical, the LCModel produced lower neurometabolite levels and a more intense baseline after 2.0 Hz line-broadening. Because of the spectral overlap between baseline and neurometabolites, overestimating (underestimating) the baseline causes underestimating (overestimating) neurometabolites and vice versa. Neurometabolites overlapping with the same broad baseline peak are similarly underestimated (overestimated) due to the broad baseline signals. This in turn, contributes to positive statistical correlations among those neurometabolites regardless of the underlying neurochemical associations.

Figure 3

Spectral fitting techniques such as the LCModel heavily rely on the linewidth difference between neurometabolites and background signals to separate them. Broad neurometabolite peaks in the presence of a strong baseline, as often seen in clinical short echo time MRS data, can lead to significant quantification errors and unwanted statistical correlations because of the large baseline-metabolite covariances. The results in Figure 3 are also corroborated by an earlier study which quantitatively analyzed the estimation uncertainties caused by the baseline using Cramer–Rao lower bound (CRLB) of the baseline (106), confirming that the estimation uncertainty significantly increases with decreased baseline smoothness and increased spectral linewidths.

Prospects for Mapping Macroscopic Neurochemical Associations By MRS Imaging

Although group comparison of neurometabolite correlations between healthy controls and patients reveals altered neurochemical associations in brain disorders, determining the absolute strength of these correlations is important for interpreting clinical findings (20, 21) and for potentially relaying interregional associations across the brain. As linewidth variations in clinical MRS studies are very common, our analysis of statistical correlations that originated from the spectral overlap in the section Statistical Correlations Among MRS Signals Due to Spectral Overlap has demonstrated that spectral overlap should be eliminated or minimized when the absolute strength of neurometabolite correlations is to be determined. To facilitate measurement of the absolute strength of neurochemical associations, MRS techniques that result in flat baselines and isolated signals of interest would be ideal. Many existing single voxel spectral editing techniques generate flat or weak baselines while eliminating or minimizing overlapping resonances (74, 108115), which are likely suited for measuring local or intraregional neurochemical associations.

Mapping macroscopic neurochemical associations across the human brain has the exciting potential to broadly impact studies of normal brain functions as well as neuropsychiatric disorders (32, 116, 117). Here we discuss the prospects for measuring interregional excitation–inhibition balance (32, 118120) by spectroscopic imaging of spectrally resolved glutamate and GABA. Participant motion is a major issue in scanning many patients of neuropsychiatric disorders. Studying these patients using chemical shift imaging is technically challenging because of the relatively long scan time required for phase encoding. As artifacts in chemical shift images caused by motion are hard to detect, they can lead to erroneous diagnosis and data interpretation (121). It is well-known that participant motion inside a magnetic field causes changes in resonant frequencies. Incorporating spectral editing techniques based on highly selective radiofrequency pulses into chemical shift imaging therefore can lead to even larger errors due to the additional effects of carrier frequency mismatch on spectral editing yield.

To minimize error due to unavoidable patient movement during extended scan time necessary for phase encoding, we focus on techniques that can resolve glutamate or GABA in a single shot with relatively weak baselines at 7 T. Spectral isolation of glutamate or GABA accompanied with a weak baseline will minimize the unwanted correlations that originated from spectral overlap (107). The emphasis on minimizing spectral overlap for measuring interregional neurometabolite correlations may seem counterintuitive. However, it is necessary because, for example, overlapping with interregionally correlated signals can relay the correlation to overlapped signals. To spectrally resolve glutamate or GABA over an extended brain region, highly frequency-selective pulses popular for single voxel spectral editing cannot be used because of the unavoidable and significant residual B0 inhomogeneity across a large volume in the brain, especially at high magnetic field strength. Highly frequency-selective pulses are sensitive to patient movement, system instability, and B0 inhomogeneity as they will miss or partially miss the editing target in part of the slice(s) where resonance frequencies are shifted away (122, 123).

Weak or nearly flat baselines are automatically produced at long echo times because of the shorter T2 values of macromolecules (1). Serendipitously, the strongly coupled glutamate H4 (2.35 ppm) forms an intense pseudo singlet at a relatively long echo time (~100 ms) at 7 T (111, 112). The resonances of glutamine H4 at 2.45 ppm and glutathione glutamyl H4 at 2.49 ppm also form pseudo singlets at ~100 ms echo time (see Figure 4). Therefore, glutamate can be spectrally resolved in a single shot without using any spectrally selective pulses at ~100 ms echo time at 7 T (111). At 7 T the multiplet signal of the aspartyl moiety of NAA at 2.49 ppm still overlaps with glutamine H4 and glutathione glutamyl H4 at ~100 ms echo time (111). The overlapping NAA aspartyl moiety signals can be eliminated using a J-suppression pulse acting on the α-H of the aspartyl moiety of NAA at 4.38 ppm (112). The J suppression pulse can be made band-selective with a flat top frequency profile (124) to accommodate variations in B0. Either because no frequency selective pulses are needed (111) or with band-selective J suppression (112), chemical shift imaging of glutamate is feasible at 7 T in the presence of significant patient motion and residual static magnetic field inhomogeneity across the slice(s).

Figure 4

Multiple quantum filtering can be used to edit GABA in a single shot (125128). It is also possible to generate a flat baseline using multiple quantum filtering (127). Chemical shift imaging of GABA over a large volume in the brain is challenging even at the high magnetic field strength of 7 T as all available GABA editing techniques rely on frequency selective pulses that differentially act on GABA H3 at 1.91 ppm and GABA H4 at 3.02 ppm. At 7 T, the chemical shift dispersion between GABA H3 and GABA H4 is 328 Hz. This relatively large chemical shift difference makes it possible to use band-selective pulses with a flat top (124) to accommodate changes in B0 due to patient movement, system instability, and residual B0 inhomogeneity while still affording a close to uniform editing yield. Figure 5 proposes a band-selective multiple quantum filtering scheme that combines spectral selectivity while allowing signal to shift within the flat passband. This multiple quantum GABA editing scheme is expected to tolerate a large frequency shift with GABA H3 lying within the flat bandwidth and GABA H4 staying outside of the downfield transition band of the band-selective pulse acting on GABA H3.

Figure 5

Although we have focused on discussing chemical shift imaging of spectrally resolved glutamate and GABA without using highly selective editing pulses for the magnetic field strength of 7 T, similar ideas may also be developed for lower magnetic field strengths such as 3 T. For example, multiecho time averaging at 3 T can isolate glutamate with a nearly flat baseline without using any spectral editing pulses (109). Directly combining this approach with conventional phase-encoding for chemical shift imaging would not be feasible due to the large number [e.g., (32)] of echoes required for each phase encoding step. Instead of using evenly spaced echo times, the averaging effect may be obtained using fewer echo times with numerical optimization. Many fast imaging strategies such as echo-planar readout can also greatly accelerate data acquisition of chemical shift imaging experiments.

The coordinated variations of glutamate and GABA across the brain can be assessed using chemical shift images of spectrally resolved glutamate and GABA. The absolute strengths of interregional correlations of spectrally resolved glutamate and GABA have the exciting potential for characterizing excitatory–inhibitory connections among the nodes of neural networks, therefore providing novel parameters for gauging interregional excitation–inhibition balance, the disruption of which is implicated in many neuropsychiatric disorders [e.g., (33, 103, 117, 129, 130)].

Conclusions

Previous neurochemical studies of animal models have revealed coordinated changes in major neurometabolites under various pathophysiological conditions which were attributed to the well-studied metabolic pathways connecting them. Recent MRS findings of neurometabolite correlations in healthy subjects and altered correlations in patients have further corroborated these associations, and their disruption is a hallmark of many neuropsychiatric disorders. To measure the absolute strength of these correlations, it is necessary to use spectral editing techniques to minimize or eliminate statistical correlations among MRS signals that originated from spectral overlap. Finally, chemical shift imaging of spectrally resolved glutamate and GABA is technically feasible at 7 T. It is hoped that the prospects for eliminating the confounding statistical correlations due to spectral overlap will reduce controversies in the field and generate further interest in characterizing local and interregional neurochemical associations especially glutamate–GABA interactions in the brain for studying neuropsychiatric disorders.

Funding

This work was supported by the Intramural Research Program of National Institute of Mental Health, NIH.

Statements

Author contributions

JS conceived the paper and performed literature search. DS and LA conducted laboratory research. JST performed literature search. JS, LA, and JST wrote the paper. All authors contributed to the article and approved the submitted version.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

  • 1

    de GraafRA. In vivo NMR spectroscopy.John Wiley & Sons: Chichester, UK (1998).

  • 2

    KleinhansNMSchweinsburgBCCohenDNMüllerRACourchesneE. N-acetyl aspartate in autism spectrum disorders: regional effects and relationship to fMRI activation. Brain Res (2007) 1162:8597. doi: 10.1016/j.brainres.2007.04.081

  • 3

    WalterMHenningAGrimmSSchulteRFBeckJDydakUet al. The relationship between aberrant neuronal activation in the pregenual anterior cingulate, altered glutamatergic metabolism, and anhedonia in major depression. Arch Gen Psychiatry (2009) 66:478–86. doi: 10.1001/archgenpsychiatry.2009.39

  • 4

    SudharshanNHanstockCHuiBPyraTJohnstonWKalraS. Degeneration of the mid-cingulate cortex in amyotrophic lateral sclerosis detected in vivo with MR spectroscopy. AJNR Am J Neuroradiol (2011) 32:403–7. doi: 10.3174/ajnr.A2289

  • 5

    WaddellKWZanjanipourPPradhanSXuLWelchEBJoersJMet al. Anterior cingulate and cerebellar GABA and Glu correlations measured by ¹H J-difference spectroscopy. Magn Reson Imaging (2011) 29:1924. doi: 10.1016/j.mri.2010.07.005

  • 6

    KraguljacNVReidMAWhiteDMden HollanderJLahtiAC. Regional decoupling of N-acetyl-aspartate and glutamate in schizophrenia. Neuropsychopharmacology (2012) 37:2635–42. doi: 10.1038/npp.2012.126

  • 7

    KraguljacNVWhiteDMReidMALahtiAC. Increased hippocampal glutamate and volumetric deficits in unmedicated patients with schizophrenia. JAMA Psychiatry (2013) 70:1294–302. doi: 10.1001/jamapsychiatry.2013.2437

  • 8

    GussewABorysCJanetzkiLCleveMMalessaRHabenichtUet al. Altered regional and interregional interrelations of glutamate and GABA in patients with chronic low back pain – A 1H-MR spectroscopic study, Clin. Neurophysiology (2015) 126:e109–10. doi: 10.1016/j.clinph.2015.04.165

  • 9

    PlitmanEde la Fuente-SandovalCReyes-MadrigalFChavezSGómez-CruzGLeón-OrtizPet al. Elevated myo-inositol, choline, and glutamate levels in the associative striatum of antipsychotic-naive patients with first-episode psychosis: a proton magnetic resonance spectroscopy study with implications for glial dysfunction. Schizophr Bull (2016) 42:415–24. doi: 10.1093/schbul/sbv118

  • 10

    CleveMGussewAWagnerGBärKJReichenbachJR. Assessment of intra- and inter-regional interrelations between GABA+, Glx and BOLD during pain perception in the human brain - A combined 1H fMRS and fMRI study. Neuroscience (2017) 365:125–36. doi: 10.1016/j.neuroscience.2017.09.037

  • 11

    SalaACaminitiSPPresottoLPremiEPilottoATurroneRet al. Altered brain metabolic connectivity at multiscale level in early Parkinson's disease. Sci Rep (2017) 7:4256. doi: 10.1038/s41598-017-04102-z

  • 12

    NiddamDMLaiKLTsaiSYLinYRChenWTFuhJLet al. Neurochemical changes in the medial wall of the brain in chronic migraine. Brain (2018) 141:377–90. doi: 10.1093/brain/awx331

  • 13

    Taylor-RobinsonSDBuckleyCChanganiKKHodgsonHJBellJD. Cerebral proton and phosphorus-31 magnetic resonance spectroscopy in patients with subclinical hepatic encephalopathy. Liver (1999) 19:389–98. doi: 10.1111/j.1478-3231.1999.tb00067.x

  • 14

    GrachevIDApkarianAV. Chemical network of the living human brain. Evidence of reorganization with aging. Brain Res Cognit Brain Res (2001) 11:185–97. doi: 10.1016/S0926-6410(00)00068-9

  • 15

    CleveMGussewAJanetzkiLBorysCReichenbachJR. Interregional associations between excitatory and inhibitory neurotransmitters in the resting human brain. Proc ISMRM (2015) 2348.

  • 16

    JustNSonnayS. Investigating the Role of Glutamate and GABA in the Modulation of Transthalamic Activity: A Combined fMRI-fMRS Study. Front Physiol (2017) 8:30. doi: 10.3389/fphys.2017.00030

  • 17

    van VeenendaalTMBackesWHTseDHYScheenenTWJKlompDWHofmanPAMet al. High field imaging of large-scale neurotransmitter networks: Proof of concept and initial application to epilepsy. NeuroImage Clin (2018) 19:4755. doi: 10.1016/j.nicl.2018.04.006

  • 18

    KimHJKimJEChoGICSBaeSSJHet al. Associations between anterior cingulate cortex glutamate and gamma-aminobutyric acid concentrations and the harm avoidance temperament. Neurosci Lett (2009) 464:103–7. doi: 10.1016/j.neulet.2009.07.087

  • 19

    TremblaySBeauléVProulxSde BeaumontLMarjanskaMDoyonJet al. Relationship between transcranial magnetic stimulation measures of intracortical inhibition and spectroscopy measures of GABA and glutamate+glutamine. J Neurophysiol (2013) 109:1343–9. doi: 10.1152/jn.00704.2012

  • 20

    KraguljacNVCutterGRMorganCLahtiAC. In reply. JAMA Psychiatry (2014) 71:339–40. doi: 10.1001/jamapsychiatry.2014.22

  • 21

    MaddockR. The problem of spurious correlations between pairs of brain metabolite values measured in the same voxel with magnetic resonance spectroscopy. JAMA Psychiatry (2014) 71:338–9. doi: 10.1001/jamapsychiatry.2013.4343

  • 22

    EndeGCackowskiSVan EijkJSackMDemirakcaTKleindienstNet al. Impulsivity and aggression in female BPD and ADHD patients: association with ACC glutamate and GABA concentrations. Neuropsycho-pharmacology (2016) 41:410–8. doi: 10.1038/npp.2015.153

  • 23

    SchollJKollingNNelissenNStaggCJHarmerCJRushworthMF. Excitation and inhibition in anterior cingulate predict use of past experiences. elife (2017) 6:e20365. doi: 10.7554/eLife.20365

  • 24

    ProvencherSW. Estimation of Metabolite Concentrations from Localized in-Vivo Proton Nmr Spectra. Magn Reson Med (1993) 30(6):672–9. doi: 10.1002/mrm.1910300604

  • 25

    SiesjöBK. Brain Energy Metabolism.John Wiley & Sons: Chichester, UK (1978).

  • 26

    ErecinskaMSilverIA. Metabolism and role of glutamate in mammalian brain. Prog Neurobiol (1990) 35:245–96. doi: 10.1016/0301-0082(90)90013-7

  • 27

    WattsMEPocockRClaudianosC. Brain energy and oxygen metabolism: emerging role in normal function and disease. Front Mol Neurosci (2018) 11:216. doi: 10.3389/fnmol.2018.00216

  • 28

    DuncanNWWiebkingCNorthoffG. Associations of regional GABA and glutamate with intrinsic and extrinsic neural activity in humans - a review of multimodal imaging studies. Neurosci Biobehav Rev (2014) 47:3652. doi: 10.1016/j.neubiorev.2014.07.016

  • 29

    AjramLAPereiraACDurieuxAMSVelthiusHEPetrinovicMMMcAlonanGM. The contribution of [1H] magnetic resonance spectroscopy to the study of excitation-inhibition in autism. Prog Neuropsychopharmacol Biol Psychiatry (2019) 89:236–44. doi: 10.1016/j.pnpbp.2018.09.010

  • 30

    Yildiz-YesilogluAAnkerstDP. Review of 1H magnetic resonance spectroscopy findings in major depressive disorder: a meta-analysis. Psychiatry Res (2006) 147:125. doi: 10.1016/j.pscychresns.2005.12.004

  • 31

    DumanRSSanacoraGKrystalJH. Altered connectivity in depression: GABA and glutamate neurotransmitter deficits and reversal by novel treatments. Neuron (2019) 102:7590. doi: 10.1016/j.neuron.2019.03.013

  • 32

    SohalVSRubensteinJLR. Excitation-inhibition balance as a framework for investigating mechanisms in neuropsychiatric disorders. Mol Psychiatry (2019) 24:1248–57. doi: 10.1038/s41380-019-0426-0

  • 33

    HjelmervikHCravenARSinceviciuteIJohnsenEKompusKBlessJJet al. Intra-Regional Glu-GABA vs Inter-Regional Glu-Glu Imbalance: A 1H-MRS Study of the Neurochemistry of Auditory Verbal Hallucinations in Schizophrenia. Schizophr Bull (2020) 46:633–42. doi: 10.1093/schbul/sbz099

  • 34

    BruhnHFrahmJGyngellMLMerboldtKDHanickeWSauterR. Cerebral metabolism in man after acute stroke: new observations using localized proton NMR spectroscopy. Magn Reson Med (1989) 9:126–31. doi: 10.1002/mrm.1910090115

  • 35

    LemesleMWalkerPGuyFD'AthisPBilliarTGiroudMet al. Multi-variate analysis predicts clinical outcome 30 days after middle cerebral artery infarction. Acta Neurol Scand (2000) 102:117. doi: 10.1034/j.1600-0404.2000.102001011.x

  • 36

    MoffettJRRossBArunPMadhavaraoCNNamboodiriAM. N-Acetylaspartate in the CNS: from neurodiagnostics to neurobiology. Prog Neurobiol (2007) 81:89131. doi: 10.1016/j.pneurobio.2006.12.003

  • 37

    MagistrettiPJ. Cellular bases of functional brain imaging: insights from neuron-glia metabolic coupling. Brain Res (2000) 886:108–12. doi: 10.1016/S0006-8993(00)02945-0

  • 38

    RothmanDLde GraafRAHyderFMasonGFBeharKLDe FeyterHM. In vivo 13C and 1H-[13C] MRS studies of neuroenergetics and neurotransmitter cycling, applications to neurological and psychiatric disease and brain cancer. NMR Biomed (2019) 32:e4172. doi: 10.1002/nbm.4172

  • 39

    SrinivasanRSailasutaNHurdRNelsonSDaniel PelletierD. Evidence of elevated glutamate in multiple sclerosis using magnetic resonance spectroscopy at 3 T. Brain (2005) 128:1016–25. doi: 10.1093/brain/awh467

  • 40

    HaslerGvan der VeenJWTumonisTMeyersNShenJDrevetsWC. Reduced prefrontal glutamate/glutamine and gamma-aminobutyric acid levels in major depression determined using proton magnetic resonance spectroscopy. Arch Gen Psychiatry (2007) 64:193200. doi: 10.1001/archpsyc.64.2.193

  • 41

    StrawnJRPatelNCChuW-JLeeJ-HAdlerCMKimM-Jet al. Glutamatergic effects of divalproex in adolescents with mania: a proton magnetic resonance spectroscopy study. J Am Acad Child Adolesc Psychiatry (2012) 51:642–51. doi: 10.1016/j.jaac.2012.03.009

  • 42

    YelamanchiSDJayaramSThomasJKGundimedaSKhanAASinghalAet al. A pathway map of glutamate metabolism. J Cell Commun Signal (2016) 10:6975. doi: 10.1007/s12079-015-0315-5

  • 43

    ShenJ. In vivo carbon-13 magnetization transfer effect. Detection of aspartate aminotransferase reaction. Magn Reson Med (2005) 54:1321–6. doi: 10.1002/mrm.20709

  • 44

    LewisLDLjunggrenBNorbergKSiesjöBK. Changes in carbohydrate substrates, amino acids and ammonia in the brain during insulin-induced hypoglycemia. J Neurochem (1974) 23:659–71. doi: 10.1111/j.1471-4159.1974.tb04389.x

  • 45

    EngelsenBFonnumF. Effects of hypoglycemia on the transmitter pool and the metabolic pool of glutamate in rat brain. Neurosci Lett (1983) 42:317–22. doi: 10.1016/0304-3940(83)90281-1

  • 46

    WongKLTyceGM. Glucose and amino acid metabolism in rat brain during sustained hypoglycemia. Neurochem Res (1983) 8:401–15. doi: 10.1007/BF00965097

  • 47

    BetzALGilboeDD. Effect of pentobarbital on amino acid and urea flux in the isolated dog brain. Am J Physiol (1973) 224:580–7. doi: 10.1152/ajplegacy.1973.224.3.580

  • 48

    HägerdalMHarpJSiesjöBK. Effect of hypothermia upon organic phosphates, glycolytic metabolites, citric acid cycle intermediates and associated amino acids in rat cerebral cortex. J Neurochem (1975) 24:743–8. doi: 10.1111/j.1471-4159.1975.tb11673.x

  • 49

    ChapmanAGNordströmCHSiesjöBK. Influence of phenobarbital anesthesia on carbohydrate and amino acid metabolism in rat brain. Anesthesiology (1978) 48:175–82. doi: 10.1097/00000542-197803000-00003

  • 50

    MacMillanVSiesjöBK. The influence of hypocapnia upon intracellular pH and upon some carbohydrate substrates, amino acids and organic phosphates in the brain. J Neurochem (1973) 21:1283–99. doi: 10.1111/j.1471-4159.1973.tb07582.x

  • 51

    PatelTBClarkJB. Synthesis of N-acetyl-L-aspartate by rat brain mitochondria and its involvement in mitochondrial/cytosolic carbon transport. Biochem J (1979) 184(3):539–46. doi: 10.1042/bj1840539

  • 52

    RobinsonMBBlakelyRDCoutoRCoyleJT. Hydrolysis of the brain dipeptide N-acetyl-L-aspartyl-L-glutamate. Identification and characterization of a novel N-acetylated alpha-linked acidic dipeptidase activity from rat brain. J Biol Chem (1987) 262:14498–506.

  • 53

    BzdegaTTuriTWroblewskaBSheDChungHSKimHet al. Molecular cloning of a peptidase against N-acetylaspartylglutamate from a rat hippocampal cDNA library. J Neurochem (1997) 69(6):2270–7. doi: 10.1046/j.1471-4159.1997.69062270.x

  • 54

    Luthi-CarterRBergerUVBarczakAKEnnaMCoyleJT. Isolation and expression of a rat brain cDNA encoding glutamate carboxypeptidase II. Proc Natl Acad Sci USA (1998) 95:3215–20. doi: 10.1073/pnas.95.6.3215

  • 55

    ClarkJFDoepkeAFilosaJAWardleRLLuAMeekerTJet al. N-acetylaspartate as a reservoir for glutamate. Med Hypotheses (2006) 67:506–12. doi: 10.1016/j.mehy.2006.02.047

  • 56

    ChavarriaLCordobaJ. Magnetic resonance imaging and spectroscopy in hepatic encephalopathy. J Clin Exp Hepatol (2015) 5:S69–74. doi: 10.1016/j.jceh.2013.10.001

  • 57

    NatarajanSKVennetiS. Glutamine metabolism in brain tumors. Cancers (2019) 11:1628. doi: 10.3390/cancers11111628

  • 58

    SibsonNRDhankharAMasonGFBeharKLRothmanDLShulmanRG. In vivo 13C NMR measurements of cerebral glutamine synthesis as evidence for glutamate-glutamine cycling. Proc Natl Acad Sci U S A (1997) 94:2699–704. doi: 10.1073/pnas.94.6.2699

  • 59

    RothmanDLDe FeyterHMde GraafRAMasonGFBeharKL. 13C MRS studies of neuroenergetics and neurotransmitter cycling in humans. NMR Biomed (2011) 24:943–57. doi: 10.1002/nbm.1772

  • 60

    GreeneJGGreenamyreJT. Bioenergetics and glutamate excitotoxicity. Prog Neurobiol (1996) 48:613–34. doi: 10.1016/0301-0082(96)00006-8

  • 61

    RothsteinJDDykes-HobergMPardoCABristolLAJinLKunclRWet al. Knockout of glutamate transporters reveals a major role for astroglial transport in excitotoxicity and clearance of glutamate. Neuron (1996) 16:675–86. doi: 10.1016/S0896-6273(00)80086-0

  • 62

    GetherUAndersenPHLarssonOMSchousboeA. Neurotransmitter transporters: molecular function of important drug targets. Trends Pharmacol Sci (2006) 27:375–83. doi: 10.1016/j.tips.2006.05.003

  • 63

    HertzL. Intercellular metabolic compartmentation in the brain. Past Present Future Neurochem Int (2004) 45:285–96. doi: 10.1016/j.neuint.2003.08.016

  • 64

    DuceIRKeenP. Selective uptake of [3H]glutamine and [3H]glutamate into neurons and satellite cells of dorsal root ganglia in vitro. Neuroscience (1983) 8:861–6. doi: 10.1016/0306-4522(83)90016-7

  • 65

    SibsonNRMasonGFShenJClineGWHerskovitsAZWallJEet al. In vivo 13C NMR measurement of neurotransmitter glutamate cycling, anaplerosis and TCA cycle flux in rat brain during. J Neurochem (2001) 76:975–89. doi: 10.1046/j.1471-4159.2001.00074.x

  • 66

    GruetterRSeaquistERKimSUgurbilK. Localized in vivo 13C-NMR of glutamate metabolism in the human brain: initial results at 4 Tesla. Dev Neurosci (1998) 20:380–8. doi: 10.1159/000017334

  • 67

    ShenJSibsonNRClineGBeharKLRothmanDLShulmanRG. 15N-NMR spectroscopy studies of ammonia transport and glutamine synthesis in the hyperammonemic rat brain. Dev Neurosci (1998) 20:434–43. doi: 10.1159/000017341

  • 68

    ShenJPetersenKFBeharKLBrownPNixonTWMasonGFet al. Determination of the rate of the glutamate/glutamine cycle in the human brain by in vivo 13C NMR. Proc Natl Acad Sci USA (1999) 96:8235–40. doi: 10.1073/pnas.96.14.8235

  • 69

    LebonVPetersenKFClineGWShenJMasonGFDufourSet al. Astroglial contribution to brain energy metabolism in humans revealed by 13C nuclear magnetic resonance spectroscopy. Elucidation of the dominant pathway for neurotransmitter glutamate repletion and measurement of astrocytic oxidative metabolism. J Neurosci (2002) 22:1523–31. doi: 10.1523/JNEUROSCI.22-05-01523.2002

  • 70

    ShenJ. Modeling the glutamate-glutamine neurotransmitter cycle. Front Neuroenergetics (2013) 5(1). doi: 10.3389/fnene.2013

  • 71

    BradfordHFWardHKThomasAJ. Glutamine — a major substrate for nerve endings. J Neurochem (1978) 30:1453–9. doi: 10.1111/j.1471-4159.1978.tb10477.x

  • 72

    de GraafAADeutzNEBosmanDKChamuleauRAde HaanJGBoveeWM. The use of in vivo proton NMR to study the effects of hyperammonemia in the rat cerebral cortex. NMR Biomed (1991) 4:31–7. doi: 10.1002/nbm.1940040106

  • 73

    StelmashookEVIsaevNKLozierERGoryachevaESKhaspekovLG. Role of glutamine in neuronal survival and death during brain ischemia and hypoglycemia. Int J Neurosci (2011) 121:415–22. doi: 10.3109/00207454.2011.570464

  • 74

    RothmanDLPetroffOABeharKLMattsonRH. Localized 1H NMR measurements of gamma-aminobutyric acid in human brain in vivo. Proc Nat Acad Sci USA (1993) 90:5662–6. doi: 10.1073/pnas.90.12.5662

  • 75

    PetroffOABeharKLMattsonRHRothmanDL. Human brain gamma-aminobutyric acid levels and seizure control following initiation of vigabatrin therapy. J Neurochem (1996) 67:2399–404. doi: 10.1046/j.1471-4159.1996.67062399.x

  • 76

    RobertsEFrankelS. γ-Aminobutyric acid in brain: Its formation from glutamic acid. J Biol Chem (1950) 187:5563.

  • 77

    PriceNCStevensL. Fundamentals of Enzymology, 3rd ed.Oxford University Press: Oxford, UK (1999).

  • 78

    PreeceNECerdánS. Metabolic precursors and compartmentation of cerebral GABA in vigabatrin-treated rats. J Neurochem (1996) 67:1718–25. doi: 10.1046/j.1471-4159.1996.67041718.x

  • 79

    OlsenRWDeLoreyTM. GABA Synthesis, Uptake and Release. In: SiegelGJAgranoffBWAlbersRWFisherSKUhlerMD, editors. Basic Neurochemistry: Molecular, Cellular and Medical Aspects, 6th ed.Philadelphia, USA: Lippincott-Raven (1999).

  • 80

    YangJLiSSBacherJShenJ. Quantification of cortical GABA-glutamine cycling rate using in vivo magnetic resonance signal of [2-13C]GABA derived from glia-specific substrate [2-13C]acetate. Neurochem Int (2007) 50:371–8. doi: 10.1016/j.neuint.2006.09.011

  • 81

    SequerraEBGardinoPHedin-PereiraCde MelloFG. Putrescine as an important source of GABA in the postnatal rat subventricular zone. Neuroscience (2007) 146:489–93. doi: 10.1016/j.neuroscience.2007.01.062

  • 82

    TattiRHaleyMSSwansonOKTselhaTMaffeiA. Neurophysiology and regulation of the balance between excitation and inhibition in neocortical circuits. Biol Psychiatry (2017) 81:821–31. doi: 10.1016/j.biopsych.2016.09.017

  • 83

    ShepherdGM. Neurobiology. 3rd ed.Oxford University Press: Oxford, UK (1994).

  • 84

    RubensteinJLMerzenichMM. Model of autism: increased ratio of excitation/inhibition in key neural systems. Genes Brain Behav (2003) 2:255–67. doi: 10.1034/j.1601-183X.2003.00037.x

  • 85

    KurcyusKAnnacEHanningNMHarrisADOeltzschnerGEddenRet al. Opposite dynamics of GABA and glutamate levels in the occipital cortex during visual processing. J Neurosci (2018) 38:9967–76. doi: 10.1523/JNEUROSCI.1214-18.2018

  • 86

    MaddockRJCasazzaGAFernandezDHMaddockMI. Acute modulation of cortical glutamate and GABA content by physical activity. J Neurosci (2016) 36:2449–57. doi: 10.1523/JNEUROSCI.3455-15.2016

  • 87

    HaradaMTakiMMNoseAKuboHMoriKNishitaniHet al. Non-invasive evaluation of the GABAergic/glutamatergic system in autistic patients observed by MEGA-editing proton MR spectroscopy using a clinical 3 tesla instrument. J Autism Dev Disord (2011) 41:447–54. doi: 10.1007/s10803-010-1065-0

  • 88

    SanacoraGGueorguievaREppersonCNWuYTAppelMRothmanDLet al. Subtype-specific alterations of gamma-aminobutyric acid and glutamate in patients with major depression. Arch Gen Psychiatry (2004) 61:705–13. doi: 10.1001/archpsyc.61.7.705

  • 89

    PollackMHJensenJESimonNMKaufmanRERenshawPF. High-field MRS study of GABA, glutamate and glutamine in social anxiety disorder: response to treatment with levetiracetam. Prog Neuropsychopharmacol Biol Psychiatry (2008) 32:739–43. doi: 10.1016/j.pnpbp.2007.11.023

  • 90

    MaddockRJBuonocoreMH. MR spectroscopic studies of the brain in psychiatric disorders. Curr Top Behav Neurosci (2012) 11:199251. doi: 10.1007/7854_2011_197

  • 91

    ThomsonAMLamyC. Functional maps of neocortical local circuitry. Front Neurosci (2007) 1:1942. doi: 10.3389/neuro.01.1.1.002.2007

  • 92

    CaputiAMelzerSMichaelMMonyerH. The long and short of GABAergic neurons. Curr Opin Neurobiol (2013) 23:179–86. doi: 10.1016/j.conb.2013.01.021

  • 93

    ZikopoulosBBarbasH. Altered neural connectivity in excitatory and inhibitory cortical circuits in autism. Front Hum Neurosci (2013) 7:609. doi: 10.3389/fnhum.2013.00609

  • 94

    WoodJDKuryloELaneR. gamma-Aminobutyric acid release from synaptosomes prepared from rats treated with isonicotinic acid hydrazide and gabaculine. J Neurochem (1988) 50:1839–43. doi: 10.1111/j.1471-4159.1988.tb02486.x

  • 95

    GolanHTalpalarAESchleifstein-AttiasDGrossmanY. GABA metabolism controls inhibition efficacy in the mammalian CNS. Neurosci Lett (1996) 217:25–8. doi: 10.1016/0304-3940(96)13061-5

  • 96

    JacksonMFEsplinBCapekR. Reversal of the activity-dependent suppression of GABA-mediated inhibition in hippocampal slices from gamma-vinyl GABA (vigabatrin)-pretreated rats. Neuropharmacology (2000) 39:6574. doi: 10.1016/S0028-3908(99)00075-1

  • 97

    WuYWangWRichersonGB. GABA transaminase inhibition induces spontaneous and enhances depolarization-evoked GABA efflux via reversal of the GABA transporter. J Neurosci (2001) 21:2630–9. doi: 10.1523/JNEUROSCI.21-08-02630.2001

  • 98

    ChenZSilvaACYangJShenJ. Elevated endogenous GABA level correlates with decreased fMRI signals in the rat brain during acute inhibition of GABA transaminase. J Neurosci Res (2005) 79:383–91. doi: 10.1002/jnr.20364

  • 99

    YangJShenJ. Elevated endogenous GABA concentration attenuates glutamate-glutamine cycling between neurons and astroglia. J Neural Transm (2009) 116:291300. doi: 10.1007/s00702-009-0186-0

  • 100

    RaeCD. A guide to the metabolic pathways and function of metabolites observed in human brain 1H magnetic resonance spectra. Neurochem Res (2014) 39:136. doi: 10.1007/s11064-013-1199-5

  • 101

    BoumezbeurFMasonGFde GraafRABeharKLClineGWShulmanGIet al. Altered brain mitochondrial metabolism in healthy aging as assessed by in vivo magnetic resonance spectroscopy. J Cereb Blood Flow Metab (2010) 30:211–21. doi: 10.1038/jcbfm.2009.197

  • 102

    WagnerGGussewAKöhlerSde la CruzFSmesnySReichenbachJRet al. Resting state functional connectivity of the hippocampus along the anterior-posterior axis and its association with glutamatergic metabolism. Cortex (2016) 81:104–17. doi: 10.1016/j.cortex.2016.03.022

  • 103

    ShuklaDKWijtenburgSAChenHChiappelliJJKochunovPHongLEet al. Anterior cingulate glutamate and GABA associations on functional connectivity in schizophrenia. Schizophr Bull (2019) 45:647–58. doi: 10.1093/schbul/sby075

  • 104

    CavassilaSDevalSHuegenCvan OrmondtDGraveron-DemillyD. Cramer-Rao bounds an evaluation tool for quantitation. NMR Biomed (2001) 14:278–83. doi: 10.1002/nbm.701

  • 105

    DraperNRSmithH. Applied regression analysis. 3rd ed.Wiley, New York: USA (1998). p. 135139.

  • 106

    ZhangYShenJ. Smoothness of in vivo spectral baseline determined by mean-square error. Magn Reson Med (2014) 72:913–22. doi: 10.1002/mrm.25013

  • 107

    ZhangYShenJ. Effects of noise and linewidth on in vivo analysis of glutamate at 3 T. J Magn Reson (2020) 314:106732. doi: 10.1016/j.jmr.2020.106732

  • 108

    MescherMMerkleHKirschJGarwoodMGruetterR. Simultaneous in vivo spectral editing and water suppression. NMR Biomed (1998) 11:266–72. doi: 10.1002/(SICI)1099-1492(199810)11:6<266::AID-NBM530>3.0.CO;2-J

  • 109

    HurdRSailasutaNSrinivasanRVigneronDBPelletierDNelsonSJ. Measurement of brain glutamate using TE-averaged PRESS at 3T. Magn Reson Med (2004) 51:435–40. doi: 10.1002/mrm.20007

  • 110

    SchubertFGalliantJSeifertFRinnebergH. Glutamate concentrations in human brain using single voxel proton magnetic resonance spectroscopy at 3 Tesla. Neuroimage (2004) 21:1762–71. doi: 10.1016/j.neuroimage.2003.11.014

  • 111

    ChoiCHDimitrovIEDouglasDPatelAKaiserLGAmezcuaCAet al. Improvement of resolution for brain coupled metabolites by optimized H-1 MRS at 7 T. NMR BioMed (2010) 23:1044–52. doi: 10.1002/nbm.1529

  • 112

    AnLLiSMurdochJBAranetaMFJohnsonCShenJ. Detection of glutamate, glutamine, and glutathione by radiofrequency suppression and echo time optimization at 7 Tesla. Magn Reson Med (2015) 73:451–8. doi: 10.1002/mrm.25150

  • 113

    ZhangYShenJ. Simultaneous quantification of glutamate and glutamine by J-modulated spectroscopy at 3 Tesla. Magn Reson Med (2016) 76:725–32. doi: 10.1002/mrm.25922

  • 114

    SalehMGOeltzschnerGChanKLPutsNAJMikkelsenMSchärMet al. Simultaneous edited MRS of GABA and glutathione. Neuroimage (2016) 142:576–82. doi: 10.1016/j.neuroimage.2016.07.056

  • 115

    OeltzschnerGSalehMGRimbaultDMikkelsenMChanKLPutsNAJet al. Advanced Hadamard-encoded editing of seven low-concentration brain metabolites: Principles of HERCULES. Neuroimage (2019) 185:181–90. doi: 10.1016/j.neuroimage.2018.10.002

  • 116

    MedfordNCritchleyHD. Conjoint activity of anterior insular and anterior cingulate cortex: awareness and response. Brain Struct Funct (2010) 214:535–49. doi: 10.1007/s00429-010-0265-x

  • 117

    LeeELeeJKimE. Excitation/inhibition imbalance in animal models of autism spectrum disorders. Biol Psychiatry (2017) 81:838–47. doi: 10.1016/j.biopsych.2016.05.011

  • 118

    SridharanDLevitinDJMenonV. A critical role for the right fronto-insular cortex in switching between central-executive and default-mode networks. Proc Natl Acad Sci U S A (2008) 105:12569–74. doi: 10.1073/pnas.0800005105

  • 119

    TaylorKSSeminowiczDADavisKD. Two systems of resting state connectivity between the insula and cingulate cortex. Hum Brain Mapp (2009) 30:2731–45. doi: 10.1002/hbm.20705

  • 120

    HornDIYuCSteinerJBuchmannJKaufmannJOsobaAet al. Glutamatergic and resting-state functional connectivity correlates of severity in major depression - the role of pregenual anterior cingulate cortex and anterior insula. Front Syst Neurosci (2010) 4:33. doi: 10.3389/fnsys.2010.00033

  • 121

    MaclarenJHerbstMSpeckOZaitsevM. Prospective motion correction in brain imaging: a review. Magn Reson Med (2013) 69:621–36. doi: 10.1002/mrm.24314

  • 122

    EvansCJPutsNARobsonSEBoyFMcGonigleDJSumnerPet al. Subtraction artifacts and frequency (mis-)alignment in J-difference GABA editing. J Magn Reson Imaging (2013) 38:970–5. doi: 10.1002/jmri.23923

  • 123

    AnLAranetaMFJohnsonCShenJ. Effects of carrier frequency mismatch on frequency-selective spectral editing. MAGMA (2019) 32:237–46. doi: 10.1007/s10334-018-0717-5

  • 124

    GeenHFreemanR. Band-selective radiofrequency pulses J. Magn Reson (1991) 93:93141. doi: 10.1016/0022-2364(91)90034-Q

  • 125

    McLeanMABuszaALWaldLLSimisterRJBarkerGJWilliamsSR. In vivo GABA+ measurement at 1.5T using a PRESS-localized double quantum filter. Magn Reson Med (2002) 48:233–41. doi: 10.1002/mrm.10208

  • 126

    ChoiCCouplandNJHanstockCCOgilvieCJHigginsACGheorghiuDet al. Brain gamma-aminobutyric acid measurement by proton double-quantum filtering with selective J rewinding. Magn Reson Med (2005) 54:272–9. doi: 10.1002/mrm.20563

  • 127

    ChoiIYLeeSPMerkleHShenJ. In vivo detection of gray and white matter differences in GABA concentration in the human brain. Neuroimage (2006) 33:8593. doi: 10.1016/j.neuroimage.2006.06.016

  • 128

    SimisterRJMcLeanMABarkerGJDuncanJS. Proton MR spectroscopy of metabolite concentrations in temporal lobe epilepsy and effect of temporal lobe resection. Epilepsy Res (2009) 83:168–76. doi: 10.1016/j.eplepsyres.2008.11.006

  • 129

    CoyleJT. The GABA-glutamate connection in schizophrenia: which is the proximate cause? Biochem Pharmacol (2004) 68:1507–14. doi: 10.1016/j.bcp.2004.07.034

  • 130

    CherlynSYWoonPSLiuJJOngWYTsaiGCSimK. Genetic association studies of glutamate, GABA and related genes in schizophrenia and bipolar disorder: a decade of advance. Neurosci Biobehav Rev (2010) 34:958–77. doi: 10.1016/j.neubiorev.2010.01.002

Summary

Keywords

glutamate, GABA, neurochemical correlations, magnetic resonance spectroscopy, spectral editing, psychiatric disorders

Citation

Shen J, Shenkar D, An L and Tomar JS (2020) Local and Interregional Neurochemical Associations Measured by Magnetic Resonance Spectroscopy for Studying Brain Functions and Psychiatric Disorders. Front. Psychiatry 11:802. doi: 10.3389/fpsyt.2020.00802

Received

08 June 2020

Accepted

27 July 2020

Published

11 August 2020

Volume

11 - 2020

Edited by

Maria Concepcion Garcia Otaduy, University of São Paulo, Brazil

Reviewed by

Mark Mikkelsen, Johns Hopkins University, United States; Stefania Schiavone, University of Foggia, Italy

Updates

Copyright

*Correspondence: Jun Shen,

This article was submitted to Molecular Psychiatry, a section of the journal Frontiers in Psychiatry

Disclaimer

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Outline

Figures

Cite article

Copy to clipboard


Export citation file


Share article

Article metrics