Relationship between brain structure and function in disorders of the schizophrenic spectrum: single positron emission computerized tomography, computerized tomography and psychopathology of first episodes

Abstract

Fifty newly diagnosed, briefly treated or drug-naive patients with schizophrenia or schizophreniform disorder were examined by psychopathology scales for positive (SAPS), negative (SANS) and overall psychotic symptoms (PSE and BPRS). CT-scan and regional cerebral blood flow (rCBF) measurement by 99mTc-HMPAO SPECT during rest and mental activation by Wisconsin Card Sorting Test was performed as well. Twenty-five age-matched normal healthy volunteers served as controls. Thought disorders and fundamental symptoms correlated positively with relatively high, though subnormal prefrontal (PFC) rCBF and high rCBF in temporal cortex; positive symptoms correlated positively with high rCBF in the striatum and temporal cortex during activation. Negative symptoms correlated with high prefrontal rCBF. The patients had sulcal enlargement and smaller brain volume compared with the healthy volunteers. There were no signs of ventricular enlargement. Neither total negative symptoms, thought disorder nor fundamental symptoms correlated with any CT measurements. Total positive symptoms correlated negatively with the size of the temporal horns. The relatively high rCBF in PFC and temporal cortex of cases with pronounced positive and negative symptoms and thought disorder may imply that an aberrant cortical network has to be active to express a malattuned clinical output. The striatal hyperfunction mainly in productive cases may be a secondary phenomenon and more pronounced in cases where no signs of subcortical atrophy has (yet?) ensued.

Gray matter volume deficits and correlation with insight and negative symptoms in first-psychotic-episode subjects

“…Previous VBM studies found GM deficits in patients with negative schizophrenia, mainly in frontal, temporal opercular, and insular regions (45), but also in cerebellar vermis (46). Correlating VBM studies in patients with schizophrenia found negative correlations of negative symptoms with thalamus (52) or no correlation (28), and some functional neuroimaging studies also have linked prefrontal cortex with negative symptoms (53). Correlating VBM studies in patients with schizophrenia found negative correlations of negative symptoms with thalamus (52) or no correlation (28), and some functional neuroimaging studies also have linked prefrontal cortex with negative symptoms (53).…”

Interneurons Are Necessary for Coordinated Activity During Reversal Learning in Orbitofrontal Cortex

“…Patients with schizophrenia demonstrate impaired performance and increased errors when tested on reversals, implying compromised OFC function (18–20,69,70). The specific anatomical and cognitive deficits seen in our mouse model strongly recapitulate human disease (71,72).…”

The relationship between regional cerebral blood flow and the Wisconsin Card Sorting Test in negative schizophrenia

“…3,4 Studies have been conducted to investigate the regional cerebral flood flow (rCBF), especially in the frontal lobe, of both normal subjects and schizophrenic patients while tak-ing the WCST. [5][6][7][8][9][10][11][12][13] Rezai et al showed that the WCST primarily activates the left dorsolateral prefrontal cortex of normal adults. 14 Nevertheless, Cantor-Graae et al found no significant prefrontal flow augmentations during performance of the WCST of healthy volunteers.…”