***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Reduction in hippocampal volume is a hallmark of schizophrenia and already present in the clinical high-risk state . Nevertheless , other subcortical structures , such as the thalamus , amygdala and pallidum can differentiate schizophrenia patients from controls . We studied the role of hippocampal and subcortical structures in clinical high-risk individuals from two cohorts .  High-resolution T1-weighted structural MRI brain scans of a total of 91 clinical high-risk individuals and 64 healthy controls were collected in two centers . The bilateral volume of the hippocampus , the thalamus , the cau date , the putamen , the pallidum , the amygdala , and the accumbens were automatically segmented using FSL-FIRST . A linear mixed-effects model and a prospect i ve meta- analysis were applied to assess group-related volumetric differences . We report reduced hippocampal and thalamic volumes in clinical high-risk individuals compared to healthy controls . No volumetric alterations were detected for the cau date , the putamen , the pallidum , the amygdala , or the accumbens . Moreover , we found comparable medium effect sizes for group-related comparison of the thalamus in the two analytical methods . These findings underline the relevance of specific alterations in the hippocampal and subcortical volumes in the high-risk state . Further analyses may allow hippocampal and thalamic volumes to be used as biomarkers to predict psychosis Studies with proton magnetic resonance spectroscopy ( MRS ) have reported abnormalities in N-acetyl-aspartate ( NAA ) , amino acids ( AA ) and choline ( Cho ) to creatine ( Cr ) ratios associated with schizophrenia . We report data on the three ratios in a sample of 18 neuroleptic naive patients with first-episode schizophrenia ( eight studied in the dorsolateral prefrontal and 10 in the midtemporal lobe ) and 24 healthy controls ( 14 studied in prefrontal and 10 in midtemporal lobes ) . Frontal lobe proton spectra were acquired with the stimulated-echo acquisition mode ( STEAM ) pulse sequence ( echo time 21 ms , repetition time 2 s ) . Temporal lobe proton spectra were acquired with the point-resolved spectroscopy ( PRESS ) pulse sequence ( echo time 16–21 ms , repetition time 2 s ) . Upon comparison with normal controls , NAA/Cr ratios were reduced in patients both for the frontal and the temporal lobe . By contrast , Cho/Cr ratios were slightly elevated in frontal and reduced in temporal lobes ; whereas , AA/Cr ratios were normal in frontal and markedly increased in the temporal lobe . The reduced NAA/Cr ratios suggest lower neuronal viability in patients and is consistent with findings of reduced brain volume in both frontal and temporal regions IMPORTANCE Increased glutamate levels in the right associative striatum have been described in patients during a first episode of psychosis . Whether this increase would persist after effective antipsychotic treatment is unknown . OBJECTIVES To compare the glutamate levels in  antipsychotic-naive patients with first-episode psychosis in the right associative striatum and right cerebellar cortex using proton magnetic resonance spectroscopy before and 4 weeks after antipsychotic treatment and to compare these results with normative data from sex-matched healthy control subjects . DESIGN , SETTING , AND PARTICIPANTS Before-after trial in an inpatient psychiatric research unit among 24 antipsychotic-naive patients with first-episode psychosis and 18 healthy controls matched for age , sex , h and edness , and cigarette smoking . INTERVENTIONS Participants underwent 2 proton magnetic resonance spectroscopy studies : patients were imaged at baseline and after 4 weeks of antipsychotic treatment , while controls were imaged at baseline and at 4 weeks after the baseline measurement . Patients were treated with oral risperidone ( open label ) for 4 weeks with dosages that were titrated on the basis of clinical judgment . MAIN OUTCOMES AND MEASURES Glutamate levels were estimated using LCModel ( version 6.2 - 1 T ) and were corrected for the cerebrospinal fluid proportion within the voxel . RESULTS Patients with first-episode psychosis had higher levels of glutamate in the associative striatum and the cerebellum during the antipsychotic-naive condition compared with controls . After clinical ly effective antipsychotic treatment , glutamate levels significantly decreased in the associative striatum , with no significant change in the cerebellum . No differences in glutamate levels were observed between groups at 4 weeks . CONCLUSIONS AND RELEVANCE Increased glutamate levels observed at baseline in patients with first-episode psychosis normalized after 4 weeks of clinical ly effective antipsychotic treatment . These results provide support for the hypothesis that improvement in clinical symptoms might be related to a decrease in glutamate levels OBJECTIVES To develop and vali date a new risk-of-bias tool for nonr and omized studies ( NRSs ) . STUDY DESIGN AND SETTING We developed the Risk of Bias Assessment Tool for Nonr and omized Studies ( RoBANS ) . A validation process with 39 NRSs examined the reliability ( interrater agreement ) , validity ( the degree of correlation between the overall assessment s of RoBANS and Method ological Index for Nonr and omized Studies [ MINORS ] , obtained by plotting the overall risk of bias relative to effect size and funding source ) , face validity with eight experts , and completion time for the RoBANS approach . RESULTS RoBANS contains six domains : the selection of participants , confounding variables , the measurement of exposure , the blinding of the outcome assessment s , incomplete outcome data , and selective outcome reporting . The interrater agreement of the RoBANS tool except the measurement of exposure and selective outcome reporting domains ranged from fair to substantial . There was a moderate correlation between the overall risks of bias determined using RoBANS and MINORS . The observed differences in effect sizes and funding sources among the assessed studies were not correlated with the overall risk of bias in these studies . The mean time required to complete RoBANS was approximately 10 min . The external experts who were interviewed evaluated RoBANS as a " fair " assessment tool . CONCLUSIONS RoBANS shows moderate reliability , promising feasibility , and validity . The further refinement of this tool and larger validation studies are required 
    Output:
    
Conclusions : Our findings suggest that impaired neuronal integrity in the thalamus may be a potential trait maker in the early stages of schizophrenia .
This study replicated the finding of lower NAA levels in the Thalamus .
Impaired thalamic neuronal integrity may be a trait maker in early schizophrenia