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CEREBRAL BLOOD FLOW AND METABOLISM IN SCHIZOPHRENIA The Effects of Barbiturate Semi-Narcosis, Insulin Coma and Electroshock
S. S. KETY; R. B. WOODFORD; M. H. HARMEL; F. A. FREYHAN; K. E. APPEL; C. F. SCHMIDT
Am J Psychiatry 1948;104:765-770.
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Departments of Pharmacology and Psychiatry, University of Pennsylvania School of Medicine, and the Delaware State Hospital.

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Abstract

Studies by the use of the nitrous oxide technique on 22 schizophrenic patients show no deviation from values obtained in normal young males for cerebral blood flow and oxygen consumption.A clinically significant change in 8 patients given sodium pentothal or amytal intravenously is not associated with a measurable change in cerebral blood flow or cerebral oxygen consumption.Insulin hypoglycemia and coma is associated with a progressive decrease in cerebral utilization of oxygen and blood glucose, the cerebral circulation remaining unimpaired. The fall in blood glucose utilization is greater than that of oxygen.Electroshock is followed by a moderate decrease in metabolism and a marked decrease in cerebral blood flow in the face of a severe acidosis.Although there were no demonstrable deviations from the normal in this group of schizophrenic patients, our experience with this technique leads us to believe that it is worthy of extensive application in the study of the metabolic derangements in the brain associated with mental disease. It makes possible a new approach to psychiatric disorders, and gives the means of quantitatively determining the utilization or production of any substance capable of accurate analysis in the arterial and internal jugular venous blood.

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