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Hypermetabolic pattern in frontal cortex and other brain regions in unmedicated schizophrenia patients

Results from a FDG–PET study

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Abstract

We report results of a FDG–PET study in 10 patients with schizophrenia (6 unmedicated, 4 never medicated) and 12 healthy age–matched controls. The patients met ICD–10 and DSM–IV criteria for schizophrenia and all reported psychotic, "positive" symptoms when tested. Schizophrenic patients had higher absolute CMRGlu values in almost all quantified regions compared to normal subjects. Using the occipital cortex as the reference region patients showed a hyperfrontal metabolic pattern. Other significant regional differences were found with respect to thalamus, striatum and temporal cortex. The finding of a hyperfrontality in un– and never medicated psychotic schizophrenic patients must be discussed in the light of the psychopathological symptoms of patients when tested, a possible disruption of cortico–striato–thalamic feedback loops and recent findings of a hyperfrontality in experimentally induced psychosis (ketamine– and psilocybin–model of schizophrenia).

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References

  1. Andreasen NC, O’Leary DS, Flaum M, Nopoulos P, Watkins GL, Boles Ponto LL, Hichwa RD (1997) Hypofrontality in schizophrenia:distributed dysfunctional circuits in neuroleptic–naïve patients. Lancet 349:1730–1734

    Article  PubMed  Google Scholar 

  2. Andreasen NC, Rezai K, Alliger R, Swayze VW II, Flaum M, Kirchner P, Cohen G, O’Leary DS (1992) Hyperfrontality in neuroleptic– naive patients and in patients with chronic schizophrenia:assessment with xenon 133 single–photon emission computed tomography and the Tower of London. Arch Gen Psychiatry 49:943–958

    PubMed  Google Scholar 

  3. Berman KF, Torrey EF, Daniel DG, Weinberger DR (1992) Regional cerebral blood flow in monozygotic twins discordant and concordant for schizophrenia. Arch Gen Psychiatry 49:927–934

    PubMed  Google Scholar 

  4. Berman KF, Zec RF, Weinberger DR (1986) Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia, II:role of neuroleptic treatment, attention and mental effort. Arch Gen Psychiatry 43:126–135

    PubMed  Google Scholar 

  5. Berman L, Merson A, Sison C (1996) Regional cerebral blood flow changes associated with risperidone treatment in elderly schizophrenia patients:a pilot study. Psychopharmacol Bull 32:95–100

    PubMed  Google Scholar 

  6. Buchsbaum MS, Hazlett EA (1998) Positron emission tomography studies of abnormal glucose metabolism in schizophrenia. Schizophr Bull 24:343–64

    PubMed  Google Scholar 

  7. Buchsbaum MS, Fallon JH, WIE TC, Guich S, Spiegel–Cohen J, Hamilton M, Tang C (1998) A method of basal forebrain anatomical standardization for functional image analyses. Psychiatry Res 84:113–125

    PubMed  Google Scholar 

  8. Buchsbaum M, Wu J, DeLisi LE (1987) Positron emission tomography studies of the basal ganglia and somatosensory cortex neuroleptic drug effects:differences between normal controls and schizophrenic patients. Biol Psychiatry 22:479–494

    Article  PubMed  Google Scholar 

  9. Buchsbaum MS, Haier RJ, Potkin SG, Nuechterlein K, Bracha S, Katz M, Lohr J, Wu J, Lottenberg S, Jerabek PA, Trenary M, Tafalla R, Reynolds C, Bunney WE (1992) Fronto–striatal disorder of cerebral metabolism in never–medicated schizophrenics. Arch Gen Psychiatry 49:935–942

    PubMed  Google Scholar 

  10. Buchsbaum MS, Someya T, Teng CY, Abel L, Chin S, Najafi A, Haier RJ, Wu J, Bunney WE (1996) PET and MRI of the thalamus in never–medicated patients with schizophrenia. Am J Psychiatry 153:191–199

    PubMed  Google Scholar 

  11. Buchsbaum MS, Nenadic I, Hazlett EA, Spiegel–Cohen J, Fleischman MB, Akhavan A, Silverman JM, Siever LJ (2002) Differential metabolic rates in prefrontal and temporal Brodmann areas in schizophrenia and schizotypical personality disorder. Schizophrenia Res 54:141–150

    Article  Google Scholar 

  12. Carlsson M, Carlsson A (1990) Schizophrenia:A subcortical neurotransmitter imbalance syndrome? Schizophren Bull 16:425–432

    Google Scholar 

  13. Catafau AM, Parellada E, Lomena FJ et al. (1994) Prefrontal and temporal blood flow in schizophrenia. J Nucl Med 35:935–941

    PubMed  Google Scholar 

  14. Chakos HM, Lieberman JA, Bilder RM, Borenstein M, Lerner G (1994) Increase in caudate nuclei volumes of first–episode schizophrenic patients taking antipsychotic drugs. Am J Psychiatry 151:1430–1436

    PubMed  Google Scholar 

  15. Cleghorn JM, Garnett ES, Nahmias C, Firnau G, Brown GM, Kaplan R, Szechtman H, Szechtman B (1989) Increased frontal and reduced parietal glucose metabolism in acute untreated schizophrenia. Psychiatry Res 28:119–133

    Article  PubMed  Google Scholar 

  16. DeLisi LE, Holcomb HH, Cohen RM et al. (1985) Positron emission tomography in schizophrenic patients with and without neuroleptic medication. J Cereb Blood Flow Metab 5:201–206

    PubMed  Google Scholar 

  17. Desco M, Gispert JD, Reig S, Sanz J, Pascau J, Sarramea F, Benito C, Santos A, Polomo T, Molina V (2003) Cerebral metabolic patterns in chronic and recent–onset schizophrenia. Psychiatry Res Neuroimaging 122:125–135

    Article  Google Scholar 

  18. Devous MD Sr, Raese JD, Herman JH, Stokely EM, Bonte FJ (1985) Regional cerebral blood flow in schizophrenic patients at rest and during Wisconsin Card Sorting tasks. J Cereb Blood Flow Metab 5:201–202

    PubMed  Google Scholar 

  19. Ebert D, Feistel H, Kaschka W (1992) Left temporal hypoperfusion in catatonic syndromes:a SPECT study. Psychiatry Res:Neuroimaging 45:239–242

    Article  Google Scholar 

  20. Ebmeier KP, Blackwood HR, Murray C, Souza V, Walker M, Dougall N, Moffoot AP, O’Caroll RE, Goodwin GM (1993) Singlephoton emission computed tomography with 99mTC–exametazime in unmedicated schizophrenic patients. Biol Psychiatry 33:487–495

    Article  PubMed  Google Scholar 

  21. Gur RE, Resnick SM, Alavi A, Gur RC, Caroff S, Damm R, Silver FL, Seykin AJ, Chawluk JB (1987a) Regional brain function in schizophrenia I. A positron emission tomography study. Arch Gen Psychiatr 44:119–125

    Google Scholar 

  22. Gur RE, Resnick SM, Alavi A, Gur RC, Caroff S, Damm R, Silver FL, Seykin AJ, Chawluk JB (1987b) Regional brain function in schizophrenia II. Repeated evaluation with positron emission tomography. Arch Gen Psychiat 44:126–129

    Google Scholar 

  23. Harrison PJ (1999) The neuropathology of schizophrenia. A critical review of the data and their interpretation. Brain 122:593–624

    Article  PubMed  Google Scholar 

  24. Hazlett EA, Buchsbaum MS, Jeu LA, Nenadic I, Fleischman MB, Shihabuddin L, Haznedar MM, Harvey PD (2000) Hypofrontality in unmedicated schizophrenia patients studied with PET during performance of a serial verbal learning task. Schizophr Res 43:33–46

    Article  PubMed  Google Scholar 

  25. Hazlett EA, Buchsbaum MS (2001) Sensorimotor gating deficits and hypofrontality in schizophrenia. Front Biosci 6:D1069–D1072

    PubMed  Google Scholar 

  26. Hazlett EA, Buchsbaum MS, Tang CY, Fleischman MB, Wie T, Byne W, Haznedar MM (2001) Thalamic activation during an attention– to–prepulse startle modification paradigm:a functional MRI study. Biol Psychiatry 50:281–291

    Article  PubMed  Google Scholar 

  27. Haznedar MM, Buchsbaum MS, Luu C, Hazlett EA, Siegel BV Jr, Lohr J, Wu J, Haier RJ, Bunney WE Jr (1997) Decreased anterior cingulate gyrus metabolic rate in schizophrenia. Am J Psychiatry 154:682–684

    PubMed  Google Scholar 

  28. Kawasaki Y, Suzuki M, Maeda J, Urata K, Yamaguchi N, Matsuda H, Hisada K, Suzuki M, Takashima T (1992) Regional cerebral blood flow in patients with schizophrenia:a preliminary report. Eur Arch Psychiatry Clin Neurosci 241:195–200

    Article  PubMed  Google Scholar 

  29. Lewis SW, Ford RA, Syed GM, Reveley AM, Toone BK (1992) A controlled study of 99mTC–HMPAO single–photon emission imaging in chronic schizophrenia. Psychol Med 22:27–35

    PubMed  Google Scholar 

  30. Liddle PF, Lane CJ, Ngan ETC (2000) Immediate effects of risperidone on cortico–striato–thalamic loops and hippocampus. Brit J Psychiatry 177:402–407

    Article  Google Scholar 

  31. Matsuda H, Gyobu T, Ii M, Hisada K (1988) Iodine–123 iodoamphetamine brain scan in a patient with auditory hallucination. J Nucl Med 29:558–560

    PubMed  Google Scholar 

  32. Ngan ET, Lane CJ, Ruth TJ, Liddle PF (2002) Immediate and delayed effects of risperidone on cerebral metabolism in neuroleptic naive schizophrenic patients:correlations with symptom change. J Neurol Neurosurg Psychiatry 72:106–110

    Article  PubMed  Google Scholar 

  33. O’Connell RA, Van Herrtum RL, Billick SB, Holt AR, Conzales A, Notardonato H, Luck D, King LN (1989) Single photon emission computed tomography (SPECT) with [1231]IMP in the differential diagnosis of psychiatric disorders. J Neuropsychiatry Clin Neurosci 1:145–153

    PubMed  Google Scholar 

  34. Parellada E, Catafau AM, Bernado M, Lomena F, Gonzalez–Monclus E, Setoain J (1994) Prefrontal dysfunction in young acute neuroleptic–naive schizophrenic patients:A resting and activation SPECT study. Psychiatr Res Neurimaging 55:131–139

    Article  Google Scholar 

  35. Potkin SG, Alva G, Fleming K, Anand R, Keator D, Carreon D, Doo M, Jin Y, Wu JC, Fallon JH (2002) A PET study of the pathophysiology of negative symptoms in schizophrenia. Positron emission tomography. Am J Psychiatry 159:22–237

    Article  PubMed  Google Scholar 

  36. Riehemann S, Volz HP, Stutzer P, Smesny S, Gaser C, Sauer H (2001) Hypofrontality in neuroleptic–naive schizophrenic patients during the Wisconsin Card Sorting Test – a fMRI study. Eur Arch Psychiatry Clin Neurosci 25:66–71

    Article  Google Scholar 

  37. Rubin P, Holm S, Firberg L, Videbeck P, Andersen KS, Bendsen BB, Stromso N, Larsen JK, Lassen NA, Hemmingsen R (1991) Altered modulation of prefrontal and subcortical brain activity in newly diagnosed schizophrenia and schizophreniform disorder:a regional cerebral blood flow study. Arch Gen Psychiatry 48:987–995

    PubMed  Google Scholar 

  38. Rubin P, Holm S, Madsen PL, Firberg L, Videbech P, Andersen HS, Bendsen BB, Stromso N, Larsen JK, Lassen NA, Hommingsen R (1994) Regional cerebral blood flow distribution in newly diagnosed schizophrenia and schizophreniform disorder. Psychiatry Res 53:57–75

    Article  PubMed  Google Scholar 

  39. Sabri O, Erkwoh R, Schreckenberger M, Owega A, Sass H, Buell U (1997) Correlation of positive symptoms exclusively to hyperperfusion or hypoperfusion of cerebral cortex in never–treated schizophrenics. Lancet 349:1735–1739

    Article  PubMed  Google Scholar 

  40. Seppard G, Manchanda R, Gruzelier J, et al. (1983) 15O positron emission tomographic scanning in predominantly never–treated acute schizophrenic patients. Lancet ii:1448–1452

    Article  Google Scholar 

  41. Silbersweig DA, Stern E, Frith CD, et al. (1995) A functional neuroanatomy of hallucinations in schizophrenia. Nature 378:176–179

    Article  PubMed  Google Scholar 

  42. Soyka M, Zetsche T, Dresel S, Tatsch K (2000) FDG–PET and IBZM–SPECT suggest reduced thalamic activity but no dopaminergic dysfunction in chronic alcohol hallucinosis (letter). J Neuropsychiatry Clin Neurosci 12:287–288

    PubMed  Google Scholar 

  43. Szechtman H, Nahmias C, Garnett ES, et al. (1988) Effect of neuroleptics on altered cerebral glucose metabolism in schizophrenia. Arch Gen Psychiatry 45:523–532

    PubMed  Google Scholar 

  44. Vita A, Bressi S, Perani D, Invernizzi G, Giobbio GM, Dieci M, Garbarini M, Del Sole A, Fazio F (1995) High–resolution SPECT study of regional cerebral blood flow in drug–free and drugnaive schizophrenic patients. Am J Psychiatry 152:876–882

    PubMed  Google Scholar 

  45. Volkow ND, Brodie JD, Wolf AP, Angrist B, Russell J, Cancro R (1986) Brain metabolism in patients with schizophrenia before and after acute neuroleptic administration. Neurosurg Psychiatry 49:1199–1202

    Google Scholar 

  46. Vollenweider FX, Leenders KL, Scharfetter C, Antonini A, Maguire P, Missimer J, Angst J (1996) Metabolic hyperfrontality and psychopathology in the ketamine model of psychosis using positron emission tomography (PET) and [F–18]–fluorodeoxyglucose (FDG). Eur Neuropsychopharmacol 7:9–24

    Article  Google Scholar 

  47. Vollenweider FX, Leenders KL, Ove I, Hell D, Angst J (1997a) Differential psychopathology and patterns of cerebral glucose utilisation produced by (S)– and (R)–Ketamine in healthy volunteers using positron emission tomography (PET). Eur Neuropsychopharmacol 7:25–38

    Article  Google Scholar 

  48. Vollenweider FX, Leenders KL, Scharfetter C, Maguire P, Stadelmann O, Angst J (1997b) Positron emission tomography and fluorodeoxyglucose studies of metabolic hyperfrontality and psychopathology in psilocybin model of psychosis. Neuropsychopharmacology 16:357–372

    Article  Google Scholar 

  49. Weinberger DR, Berman KF, Zec RF (1986) Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia, I:regional cerebral blood flow (rCBF) evidence. Arch Gen Psychiatry 43:114–124

    PubMed  Google Scholar 

  50. Wolkin A, Jaeger J, Brodie JD, et al. (1985) Persistence of cerebral metabolic abnormalities in chronic schizophrenia as determined by positron emission tomography. Am J Psychiatry 142:564–571

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Psychiatric Hospital of the University of Munich, Nußbaumstr. 7, 80336, München, Germany

    M. Soyka, H. J. Möller & T. Rüther

  2. Department of Nuclear Medicine, Klinikum Großhadern, Marchioninistr. 15, 81366, München, Germany

    W. Koch & K. Tatsch

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  1. M. Soyka
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  2. W. Koch
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  3. H. J. Möller
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Correspondence to M. Soyka.

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Soyka, M., Koch, W., Möller, H.J. et al. Hypermetabolic pattern in frontal cortex and other brain regions in unmedicated schizophrenia patients. Eur Arch Psychiatry Clin Neurosci 255, 308–312 (2005). https://doi.org/10.1007/s00406-005-0563-0

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  • DOI: https://doi.org/10.1007/s00406-005-0563-0

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