N-acetylcysteine add-on treatment leads to an improvement of fornix white matter integrity in early psychosis: a double-blind randomized placebo-controlled trial.

Details

Ressource 1Download: 30315150.pdf (478.50 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_EBD031ADB614
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
N-acetylcysteine add-on treatment leads to an improvement of fornix white matter integrity in early psychosis: a double-blind randomized placebo-controlled trial.
Journal
Translational psychiatry
Author(s)
Klauser P., Xin L., Fournier M., Griffa A., Cleusix M., Jenni R., Cuenod M., Gruetter R., Hagmann P., Conus P., Baumann P.S., Do K.Q.
ISSN
2158-3188 (Electronic)
ISSN-L
2158-3188
Publication state
Published
Issued date
12/10/2018
Peer-reviewed
Oui
Volume
8
Number
1
Pages
220
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Mechanism-based treatments for schizophrenia are needed, and increasing evidence suggests that oxidative stress may be a target. Previous research has shown that N-acetylcysteine (NAC), an antioxidant and glutathione (GSH) precursor almost devoid of side effects, improved negative symptoms, decreased the side effects of antipsychotics, and improved mismatch negativity and local neural synchronization in chronic schizophrenia. In a recent double-blind randomized placebo-controlled trial by Conus et al., early psychosis patients received NAC add-on therapy (2700 mg/day) for 6 months. Compared with placebo-treated controls, NAC patients showed significant improvements in neurocognition (processing speed) and a reduction of positive symptoms among patients with high peripheral oxidative status. NAC also led to a 23% increase in GSH levels in the medial prefrontal cortex (GSH <sub>mPFC</sub> ) as measured by <sup>1</sup> H magnetic resonance spectroscopy. A subgroup of the patients in this study were also scanned with multimodal MR imaging (spectroscopy, diffusion, and structural) at baseline (prior to NAC/placebo) and after 6 months of add-on treatment. Based on prior translational research, we hypothesized that NAC would protect white matter integrity in the fornix. A group × time interaction indicated a difference in the 6-month evolution of white matter integrity (as measured by generalized fractional anisotropy, gFA) in favor of the NAC group, which showed an 11% increase. The increase in gFA correlated with an increase in GSH <sub>mPFC</sub> over the same 6-month period. In this secondary study, we suggest that NAC add-on treatment may be a safe and effective way to protect white matter integrity in early psychosis patients.
Keywords
Acetylcysteine/therapeutic use, Adult, Antioxidants/therapeutic use, Antipsychotic Agents/therapeutic use, Double-Blind Method, Female, Fornix, Brain/diagnostic imaging, Fornix, Brain/drug effects, Fornix, Brain/pathology, Humans, Male, Neuroprotective Agents/therapeutic use, Psychotic Disorders/diagnostic imaging, Psychotic Disorders/drug therapy, Psychotic Disorders/pathology, Treatment Outcome, White Matter/diagnostic imaging, White Matter/drug effects, White Matter/pathology, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
23/10/2018 9:41
Last modification date
20/08/2019 16:14
Usage data