A Tc-99m HMPAO SPECT study of regional cerebral blood flow in drug-free schizophrenic patients with deficit and non-deficit syndrome

Gönül, Ali Saffet; Kula, Mustafa; Eşel, Ertuğrul; Tutuş, Ahmet; Sofuoğlu, Seher

doi:10.1016/s0925-4927(03)00067-2

Cited by 54 publications

(38 citation statements)

References 19 publications

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“…The present findings are also in accordance with imaging data suggesting that negative symptom profile in schizophrenia patients displays cognitive deficits and lower cerebral blood flow in the frontal lobes [11,12,14], as well as with the reported negative correlation of negative symptoms with regional cerebral blood flow in the left frontal lobe [13]. Taken together with our results, these data support the notion that the abnormal capillaries revealed in the prefrontal cortex in schizophrenia might reduce cerebral blood flow and consequently result in deficit of metabolic support to neurons.…”

Section: Discussionsupporting

confidence: 92%

“…Decreased blood flow [5] and glucose metabolic rates [6,7], as well as resting hypofrontality [8] and hypoperfusion [9,10] have been reported in the prefrontal cortex in patients with schizophrenia. Reduced frontal blood flow is associated with negative symptoms of schizophrenia [11,12,13,14]. Hanson and Gottesman [15] suggested that abnormalities of blood flow might lead to altered neuronal-glial relationships resulting in neuronal dysfunction and psychopathology.…”

Section: Introductionmentioning

confidence: 99%

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Reduced Capillary Density in the Prefrontal Cortex in Schizophrenia

Uranova¹,

Zimina²,

Vikhreva³

et al. 2013

AJMSM

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Neuroimaging studies have shown that the core symptoms of schizophrenia are associated with local changes of cerebral blood flow, particularly in the frontal cortex. Previously we reported ultrastructural damage of capillaries in the upper layers of the prefrontal cortex, Brodmann's area (BA) 10 and in the visual cortex, BA 17 in schizophrenia. An electron microscopic morphometric study was performed to estimate capillary area density (N cap/mm 2 ) in two upper layers of the prefrontal and visual cortices in 26 cases of schizophrenia and 26 normal controls. Capillary area density was lower in the prefrontal cortex in the schizophrenia group (-24%, p < 0.001) and in the subgroup of schizophrenia with predominantly negative symptoms (n=12, -35%, p < 0.001) as compared to controls. Group and subgroup differences were absent in the visual cortex. Dysfunction of neocortical microvasculature in schizophrenia is related to region-specific capillary deficiency in the prefrontal cortex. These changes might contribute to the lowered blood flow, reduced glucose metabolic rates, resting hypofrontality and hypoactivation reported in the prefrontal cortex of patients with schizophrenia.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Reduced Capillary Density in the Prefrontal Cortex in Schizophrenia

Uranova¹,

Zimina²,

Vikhreva³

et al. 2013

AJMSM

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“…The notion of the deficit syndrome as a homogeneous schizophrenia subgroup has been supported by empirical reports from many research and clinical domains that include poor premorbid adjustment (Galderisi et al 2003), increased negative symptoms, neurological impairment (Galderisi et al 2003), cognitive impairment (Buchanan et al 1994, Buchanan et al 1997, Ludewig et al 2003, poor functioning (Tiryaki et al 2003), clinical outcome , regional neuronal densities, regional Cerebral bloodflow (Gonul et al 2003, Vaiva et al 2002, Yurekli et al 2003. The majority of these studies have relied upon the SDS to identify patients with the Deficit Syndrome.…”

Section: Discussionmentioning

confidence: 98%

Validity of a ‘proxy’ for the deficit syndrome derived from the Positive And Negative Syndrome Scale (PANSS)

Goetz

Corcoran

Yale

et al. 2007

Schizophrenia Research

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Schizophrenia patients with the deficit syndrome (DS) may represent a homogeneous subgroup. To increase the practicability of diagnosing the DS, Kirkpatrick et al. (Kirkpatrick, B., Buchanan, RW., Breier, A. Carpenter, WT., 1993. Case identification and stability of the deficit syndrome of schizophrenia. Psychiatry Research 47,[47][48][49][50][51][52][53][54][55][56] proposed the use of a 'proxy' case identification tool using standardized symptom ratings instead of the Schedule for the Deficit Syndrome (SDS) which requires an independent clinical assessment. The Proxy for the Deficit Syndrome (PDS) is based on the extraction of symptoms that are essentially equivalent or overlap substantially with the restricted affect and diminished emotional range on the SDS. Kirkpatrick et al. (1993) reported good sensitivity and specificity in a comparison of SDS and PDS assessments among 100 chronic schizophrenia outpatients. The present investigation involves the comparison of the deficit syndrome as assessed by the "gold standard" Schedule for the Deficit Syndrome with the ratings of the same symptoms embodied in the "proxy instrument" the PANSS, within the same group of 156 inpatients.Forty-four patients were assessed by the SDS to have the deficit syndrome. Patients with and without the DS, as defined by the SDS, did not differ for age, education, age at illness onset and duration of illness. The two main 'proxy' measures PDS1 and PDS2 discriminated across the SDS groups. The direct dichotomous comparison of the actual SDS and the 'proxy' derived PDS groups demonstrated good specificity (78.6% and 79.5%) and moderate to very good sensitivity (61.4% and 86.4%) and there was a moderately low rate of false positive cases (21.4% and 20.5%). For the two main 'proxy' measures (PDS1 & PDS2) kappas were .38 and .59, representing poor to good agreement.In our sample of rigorously diagnosed schizophrenia inpatients, the use of a 'proxy' case identification tool for the deficit syndrome would appear to be a viable alternative in identifying a subgroup of schizophrenia patients with the deficit syndrome when the use of the actual SDS is

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“…Negative symptoms are often associated with hypofrontality and with a lack of dopamine in the prefrontal cortex [19,20].…”

Section: Negative Symptomsmentioning

confidence: 99%

Transcranial Magnetic Stimulation in Schizophrenia

Ustohal¹,

Svěrák²,

Albrechtová³

et al. 2016

Schizophrenia Treatment - The New Facets

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Transcranial magnetic stimulation (TMS) is a method that can be used in neurophysiological research of schizophrenia and in the treatment of some symptoms or syndromes of this mental disorder. The most important indications for TMS (or repetitive TMSrTMS) are the negative symptoms of schizophrenia and auditory hallucinations. Other less proven indications include cognitive deficit, especially working memory. This text summarizes general knowledge about (r)TMS and its use in schizophrenia. According to recent experiences, TMS is a very promising experimental and therapeutic method, but it needs further research for its optimized use.

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A Tc-99m HMPAO SPECT study of regional cerebral blood flow in drug-free schizophrenic patients with deficit and non-deficit syndrome

Cited by 54 publications

References 19 publications

Reduced Capillary Density in the Prefrontal Cortex in Schizophrenia

Reduced Capillary Density in the Prefrontal Cortex in Schizophrenia

Validity of a ‘proxy’ for the deficit syndrome derived from the Positive And Negative Syndrome Scale (PANSS)

Transcranial Magnetic Stimulation in Schizophrenia

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