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The management of schizophrenia is a major public health issue, due to its particularly disabling psychotic symptoms and their onset at an early age, typically in adolescents or young adults.
The physiopathological hypothesis of an anomaly relating to the renewal of cell membranes and energy metabolism in schizophrenia was proposed as early as the 1930s. This is based on anomalies at certain times in the development of the balance between phosphomonesters, precursors of membrane phospholipids, and phosphodiesters, catabolites of membrane phospholipids. Alterations of these different balances sign neurodevelopmental disorders, and can be objectified by specific techniques such as phosphorus-31 magnetic resonance spectroscopy (SMR-31P). This is used in particular to characterize the energy metabolism of the brain and allows in vivo quantification of phosphorus metabolites.
The application of SMR-31P techniques to assess the metabolism of membrane phospholipids and cellular energy metabolism in subjects at high risk of psychotic transition could make it possible to objectify a difference between subjects subsequently suffering from a psychotic transition compared to those who do not suffer from it. Alterations in the metabolism of membrane phospholipids could thus represent a biomarker of psychotic transition. Secondarily, this approach would make it possible to provide elements as to the validity as a diagnosis of this category, which is very heterogeneous in its future.
Among the Ultra High Risk (UHR) group, subjects with a psychotic transition (UHR-T) are compared to subjects without this transition (UHR-NT) during the two years of follow-up.
The UHR group is compared to the control group.
At T0, UHR patients and healthy volunteers will perform brain MRI with Phosphorus 31 magnetic resonance spectroscopy.
UHR patients will then be reviewed:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patient group | Experimental | Participants of this group are subjects with ultra high risk of psychotic transition. At inclusion visit, subjects will have a psychiatric evaluation and a cerebral MRI examination with phosphorus 31 Magnetic Resonance Spectroscopy in order to investigate membrane phospholipid metabolism and cellular energy metabolism. One and two years after the inclusion visit, subjects will have a psychiatric evaluation in order to objectivize if a psychotic transition has occured. |
|
| Control group | Active Comparator | Participants of this group are healthy volunteers. Subjects will have one single visit with a psychiatric evaluation and a cerebral MRI examination with phosphorus 31 Magnetic Resonance Spectroscopy in order to investigate membrane phospholipid metabolism and cellular energy metabolism. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cerebral MRI with Phosphorus 31 Magnetic Resonance Spectroscopy | Diagnostic Test | Cerebral MRI with Phosphorus 31 Magnetic Resonance Spectroscopy |
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| Measure | Description | Time Frame |
|---|---|---|
| Difference of cellular inorganic phosphate between UHR-T and UHR-NT patients. | Levels measurements of inorganic phosphate. | 2 years |
| Difference of cellular phosphocreatine between UHR-T and UHR-NT patients. | Levels measurements of phosphocreatine. | 2 years |
| Difference of cellular Gamma ATP between UHR-T and UHR-NT patients. | Levels measurements of Gamma ATP. | 2 years |
| Difference of cellular Alpha ATP between UHR-T and UHR-NT patients. | Levels measurements of Alpha ATP. | 2 years |
| Difference of cellular beta ATP between UHR-T and UHR-NT patients. | Levels measurements of beta ATP. | 2 years |
| Difference of intracellular pH between UHR-T and UHR-NT patients. | Levels measurements of intracellular pH. | 2 years |
| Difference of membrane phosphodiester alterations between UHR-T and UHR-NT patients. | Levels measurements of phosphodiester. | 2 years |
| Difference of membrane phosphomonoester alterations between UHR-T and UHR-NT patients. | Levels measurements of phosphomonoester. |
| Measure | Description | Time Frame |
|---|---|---|
| Difference of cellular inorganic phosphate between UHR subjects and control subjects. | Levels measurements of inorganic phosphate. | 2 years |
| Difference of cellular phosphocreatine between UHR subjects and control subjects. |
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Inclusion Criteria for the UHR group:
Inclusion Criteria for the Control group:
Exclusion Criteria for the UHR group:
The relative contraindications are to be considered, namely: previous surgical interventions, medically implanted device, tattoo or permanent make-up.
Exclusion criteria for the control group:
- Subject presenting an absolute contraindication to 7T MRI such as: foreign bodies (intracranial clips, vascular magnetic clips, cardiac or neural pacemakers, stents, coils, implantable chamber, intracorporeal metallic fragments, cochlear implants, intracorporeal metallic foreign bodies, valve mechanical heart, implanted injection pump, non-removable piercings), pregnant woman, allergy to contrast products, moderate to severe renal insufficiency, breast-feeding, implanted contraception, tinnitus, claustrophobia and braces.
The relative contraindications are to be considered, namely: previous surgical interventions, medically implanted device, tattoo or permanent make-up.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Richard HARY | Contact | 0033 5 49 44 57 57 | richard.hary@ch-poitiers.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Henri Laborit | Recruiting | Poitiers | 86000 | France |
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| 2 years |
Levels measurements of phosphocreatine.
| 2 years |
| Difference of cellular Gamma ATP between UHR subjects and control subjects. | Levels measurements of Gamma ATP. | 2 years |
| Difference of cellular Alpha ATP between UHR subjects and control subjects. | Levels measurements of Alpha ATP. | 2 years |
| Difference of cellular beta ATP between UHR subjects and control subjects. | Levels measurements of beta ATP. | 2 years |
| Difference of cellular intracellular pH between UHR subjects and control subjects. | Levels measurements of intracellular pH. | 2 years |
| Difference of membrane phosphodiester alterations between UHR subjects and control subjects. | Levels measurements of phosphodiester. | 2 years |
| Difference of membrane phosphomonoester alterations between UHR subjects and control subjects. | Levels measurements of phosphomonoester. | 2 years |