Klinik für Psychiatrie und Psychotherapie

Research focus

The neurochemistry is of utmost importance in neuropsychiatric research, since the neurochemical alterations are thought to be central in the pathophysiology of the most psychiatric disorders. The research focus of the molecular imaging group concerns the detection of metabolic alteration in psychiatric disorders using the methods of the Magnet Resonance Spectroscopy (MRS).

The MRS is the unique non-invasive and non-radioactive method of in vivo detection of metabolites in the human brain. Using the single voxel spectroscopy with PRESS at 3 T MRT-Machine (Trio, Prisma, Siemens, Erlangen) we are currently able to detect the metabolic spectra of N-Acetyl-Aspartate (the marker of neuronal integrity), Creatine (energy metabolism), Choline (important membrane, white matter and acetyl-choline component), myo-Inositol (intracellular osmolyte marker) glutamate and glutamine (the most important excitatory neurotransmitter) and GABA (the most important inhibitory neurotransmitter) (Figure 1). 

The MR-Spectroscopy research started in our group at the beginning of 2000s with the first measurements in schizophrenia and later in borderline personality disorder. In the last years we are focusing on the neurometabolism of neurodevelopment disorders in psychiatry – the ADHD and autism spectrum disorder (ASD) in adults. We were able to perform the most comprehensive MRS-studies in this field, focusing on glutamatergic alterations as an evidence for hypothesis of disturbed excitatory/inhibitory balance. Additionally we have performed measurements of gluthation, the important antioxidant in the human brain, in ASD and ADHD. In cooperation with the clinic for psychosomatics we have also performed the first MRS-study in eating disorders.

Research projects

Recently completed:

• Cross-sectional MR-Spectroscopy of ACC and cerebellum in adult ADHD (part of the multicenter COMPAS-Studie)
• MR-Spectroscopy of ACC and cerebellum before and after treatment with psychostimulants in adult ADHD
• MRS in adult high-functioning ASD with above average IQ
• Gluthaion in adult high-functioning ASD

 Ongoing:

• Simultaneous measurements of GABA and Glutamate in adult high-functioning ASD (DFG-granted)
• Cooperation with Psychosomatics (A. Joos, S. Maier): Intimacy in Anorexia nervosa – MRS of the insula (DFG-granted)

 Planned Projects:

• Mapping of Excitatory and Inhibitory Neurometabolites in Adolescents with Autism Spectrum Disorder (in cooperation with child and adolescent psychiatry, DFG-application)
• Neurobiological substrates of fear conditioning and intimacy in anorexia nervosa - A follow-up study (in cooperation with Psychosomatics, DFG-application)
• Frequency of cerebral energy-metabolic anomalies in autism spectrum disorder – a tool for subgroup definition?

Selected publications

• Endres D, Tebartz van Elst L, Feige B, Backenecker S, Nickel K, Bubl A, Lange T, Mader I, Maier S, Perlov E. On the Effect of Sex on Prefrontal and Cerebellar Neurometabolites in Healthy Adults: An MRS Study. Front Hum Neurosci. 2016 Aug 2;10:367.  
• Maier S, Tebartz van Elst L, Beier D, Ebert D, Fangmeier T, Radtke M, Perlov E, Riedel A. Increased hippocampal volumes in adults with high functioning autism spectrum disorder and an IQ>100: A manual morphometric study. Psychiatry Res. 2015 Oct 30;234(1):152-5.  
• Endres D, Perlov E, Maier S, Feige B, Nickel K, Goll P, Bubl E, Lange T, Glauche V, Graf E, Ebert D, Sobanski E, Philipsen A, Tebartz van Elst L. Normal Neurochemistry in the Prefrontal and Cerebellar Brain of Adults with Attention-Deficit Hyperactivity Disorder. Front Behav Neurosci. 2015 Sep 28;9:242.  
• Maier S, Perlov E, Graf E, Dieter E, Sobanski E, Rump M, Warnke A, Ebert D, Berger M, Matthies S, Philipsen A, Tebartz van Elst L. Discrete Global but No Focal Gray Matter Volume Reductions in Unmedicated Adult Patients With Attention-Deficit/Hyperactivity Disorder. Biol Psychiatry. 2016 Dec 15;80(12):905-915  
• Endres D, Perlov E, Stich O, Rauer S, Maier S, Waldkircher Z, Lange T, Mader I, Meyer PT, van Elst LT. Hypoglutamatergic state is associated with reduced cerebral glucose metabolism in anti-NMDA receptor encephalitis: a case report. BMC Psychiatry. 2015 Aug 1;15:186.  
• Tebartz van Elst L, Maier S, Klöppel S, Graf E, Killius C, Rump M, Sobanski E, Ebert D, Berger M, Warnke A, Matthies S, Perlov E, Philipsen A. The effect of methylphenidate intake on brain structure in adults with ADHD in a placebo-controlled randomized trial. J Psychiatry Neurosci. 2016 Oct;41(6):422-430. (shared last)  
• Endres D, Tebartz van Elst L, Meyer SA, Feige B, Nickel K, Bubl A, Riedel A, Ebert D, Lange T, Glauche V, Biscaldi M, Philipsen A, Maier SJ, Perlov E. Glutathione metabolism in the prefrontal brain of adults with high-functioning autism spectrum disorder: an MRS study. Mol Autism. 2017 Mar 7;8:10.  
• Nickel K, Tebartz van Elst L, Perlov E, Endres D, Müller GT, Riedel A, Fangmeier T, Maier S. Altered white matter integrity in adults with autism spectrum disorder and an IQ >100: a diffusion tensor imaging study. Acta Psychiatr Scand. 2017 Jun;135(6):573-583.  
• Nickel K, Tebartz van Elst L, Perlov E, Jitten-Schachenmeier R, Beier D, Endres D, Goll P, Philipsen A, Maier S. Manual morphometry of hippocampus and amygdala in adults with attention-deficit hyperactivity disorder. Psychiatry Res. 2017 Jul 14;267:32-35.
• Tebartz van Elst L, Maier S, Fangmeier T, Endres D, Mueller GT, Nickel K, Ebert D, Lange T, Hennig J, Biscaldi M, Riedel A, Perlov E. (2014) Disturbed cingulate glutamate metabolism in adults with high-functioning autism spectrum disorder: evidence in support of the excitatory/inhibitory imbalance hypothesis. Mol Psychiatry. 2014 Dec;19(12):1314-25.
• Joos AA, Perlov E, Büchert M, Hartmann A, Saum B, Glauche V, Freyer T, Weber-Fahr W, Zeeck A, Tebartz van Elst L (2011) Magnetic resonance spectroscopy of the anterior cingulate cortex in eating disorders. Psychiatry Res. 2011 Mar 31;191(3):196-200.
• Perlov E, Tebarzt van Elst L, Buechert M, Maier S, Matthies S, Ebert D, Hesslinger B, Philipsen A. (2010) H¹-MR-spectroscopy of cerebellum in adult attention deficit/hyperactivity disorder. J Psychiatr Res. 2010 Oct;44(14):938-43.
• Rüsch N, Boeker M, Büchert M, Glauche V, Bohrmann C, Ebert D, Lieb K, Hennig J, Tebartz Van Elst L. (2010) Neurochemical alterations in women with borderline personality disorder and comorbid attention-deficit hyperactivity disorder. World J Biol Psychiatry. 2010 Mar;11(2 Pt 2):372-81.
• Perlov E, Philipsen A, Matthies S, Drieling T, Maier S, Bubl E, Hesslinger B, Buechert M, Henning J, Ebert D, Tebartz Van Elst L. (2009) Spectroscopic findings in attention-deficit/hyperactivity disorder: review and meta-analysis. World J Biol Psychiatry. 2009;10(4 Pt 2):355-65.
• Perlov E, Philipsen A, Hesslinger B, Buechert M, Ahrendts J, Feige B, Bubl E, Hennig J, Ebert D, Tebartz van Elst L. (2007) Reduced cingulate glutamate/glutamine-to-creatine ratios in adult patients with attention deficit/hyperactivity disorder -- a magnet resonance spectroscopy study. J Psychiatr Res. 2007 Dec;41(11):934-41.
• Rüsch N, Tebartz van Elst L, Valerius G, Büchert M, Thiel T, Ebert D, Hennig J, Olbrich HM. (2008) Neurochemical and structural correlates of executive dysfunction in schizophrenia. Schizophr Res. 2008 Feb;99(1-3):155-63.