Phosphorus-31 chemical shift imaging showed regional abnormalities of in vivo 31P NMR spectra in the brains of chronic schizophrenic patients. In the left temporal region, the level of % phosphodiesters (PDE) was increased and the level of % gamma alpha beta-ATP (obtained by summation of gamma-ATP, alpha-ATP, and beta-ATP) was decreased. In the basal ganglia, the levels of % PDE were decreased and the level of % phosphomonoesters was increased. The levels of % gamma alpha beta-ATP were increased in the right basal ganglia. The level of % phosphocreatine was decreased in the frontoparietal region. These findings may represent different patterns of dysfunction of membrane phospholipid bilayers and high-energy phosphate metabolism in the specific cerebral regions.

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31P magnetic resonance spectroscopy was performed in 16 mediated schizophrenic patients with neuroleptic-resistant marked positive symptoms and in 16 healthy volunteers matched for age and sex in order to determine what changes in phosphorus metabolites are detected in such patients as compared to the controls. The schizophrenic patients showed an increased level of phosphodiesters in the bilateral medial temporal lobes. They also showed a decrease in the level of beta-ATP in the left medial temporal lobe. These findings suggest that schizophrenic patients with prominent positive symptoms refractory to neuroleptics may have a disturbance of bilateral membrane phospholipid and left-sided high-energy phosphate metabolism in the medial temporal lobe.