Am J Psychiatry 1995; 152:876-882
Copyright © 1995 by American Psychiatric Association
High-resolution SPECT study of regional cerebral blood flow in drug- free and drug-naive schizophrenic patients
A Vita, S Bressi, D Perani, G Invernizzi, GM Giobbio, M Dieci, M Garbarini, A Del Sole and F Fazio
Institute of Psychiatry, University of Milan, Italy.
OBJECTIVE: The purpose of the study was to compare regional cerebral blood
flow (CBF) in schizophrenic patients never treated with psychotropic drugs
(drug-naive) and in schizophrenic patients free from drugs for various
amounts of time. METHOD: Seventeen schizophrenic patients (nine who were
drug naive and eight who had been drug free for at least 3 weeks) and 12
healthy volunteers were included in the study. Regional cerebral perfusion
was studied with the use of a head- dedicated, high-resolution single
photon emission computed tomography (SPECT) system. Cerebral SPECT scans
were performed with technetium-99m- hexamethyl-propyleneamine oxime as a
tracer. Regional CBF was measured as a ratio of regional tracer uptake to
either cerebellar or whole brain tracer uptake. RESULTS: When the
cerebellum was taken as the reference region, the drug-naive patients
showed a significant bilateral reduction of perfusion in the mesial,
dorsolateral, and basal prefrontal cortex, in the temporal cortex, and in
the subcortical gray structures: thalamus, caudate nucleus, and
putamen/pallidum complex. No significant differences emerged in the
comparison between the drug-free patients and the healthy subjects. With
correction for whole brain activity, some of the differences that had been
found disappeared, but a significant hypoperfusion persisted in the basal
ganglia and thalamus of the drug-naive, but not the drug-free, patients.
Few correlations between symptom presentation and regional CBF perfusion
were observed in the schizophrenic patients. CONCLUSIONS: These results
suggest a pattern of cerebral hypoperfusion in schizophrenic patients never
treated with neuroleptics that was not detectable in patients who had
undergone various periods of pharmacological washout.
