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Regional cerebral blood flow (rCBF) in schizophrenia during verbal memory activation: a 99mTc-HMPAO single photon emission tomography (SPET) study

Published online by Cambridge University Press:  09 July 2009

G. F. Busatto*
Affiliation:
Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry; Institute of Nuclear Medicine, University College and Middlesex School of Medicine; Department of Psychological Medicine, King's College Hospital, London
D. C. Costa
Affiliation:
Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry; Institute of Nuclear Medicine, University College and Middlesex School of Medicine; Department of Psychological Medicine, King's College Hospital, London
P. J. Ell
Affiliation:
Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry; Institute of Nuclear Medicine, University College and Middlesex School of Medicine; Department of Psychological Medicine, King's College Hospital, London
L. S. Pilowsky
Affiliation:
Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry; Institute of Nuclear Medicine, University College and Middlesex School of Medicine; Department of Psychological Medicine, King's College Hospital, London
A. S. David
Affiliation:
Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry; Institute of Nuclear Medicine, University College and Middlesex School of Medicine; Department of Psychological Medicine, King's College Hospital, London
R. W. Kerwin
Affiliation:
Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry; Institute of Nuclear Medicine, University College and Middlesex School of Medicine; Department of Psychological Medicine, King's College Hospital, London
*
1 Address for correspondence: Dr Geraldo F Busatto, Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

Synopsis

Regional cerebral blood flow (rCBF) was investigated in a group of medicated DSM-III-R schizophrenic patients and age, sex and handedness matched normal volunteers using a split-dose 99mTc-HMPAO Single Photon Emission Tomography (SPET) protocol. Measures were taken during the performance of a verbal memory task aimed at activating the left medial temporal lobe, a region repeatedly suggested to be structurally abnormal in schizophrenia. In normal subjects, the performance of the task was associated with significant rCBF increases in the left medial temporal, left inferior frontal and anterior cingulate cortices, and right cerebellum. Despite their significantly poorer performance on the memory task, the degree of medial temporal activation measured in the schizophrenic patients was not significantly different from that found in the control group. This finding suggests that memory deficits in schizophrenia do not necessarily imply failure to activate the left medial temporal lobe as assessed by 99mTc-HMPAO SPET.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1994

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References

Altschuler, L. L., Conrad, A., Kovelman, J. A. & Scheibel, A. (1987). Hippocampal pyramidal cell orientation in schizophrenia. Archives of General Psychiatry 44, 10941098.CrossRefGoogle Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revised. American Psychiatric Association: Washington, DC.Google Scholar
Annett, M. (1970). A classification of hand preference by association analysis. British Journal of Psychology 61, 303321.CrossRefGoogle ScholarPubMed
Berman, K. F. (1988). Cortical ‘stress tests’ in schizophrenia: regional cerebral blood flow studies. Biological Psychiatry 22, 13041326.CrossRefGoogle Scholar
Bogerts, B., Meertz, F. & Schonfeldt-Bausch, R. (1985). Basal ganglia and limbic system pathology in schizophrenia: a morpho-metric study of brain volume and shrinkage. Archives of General Psychiatry 42, 784791.CrossRefGoogle Scholar
Bogerts, B., Ashtari, M., Degreef, G. J., Alvir, J., Bilder, R. M. & Lieberman, J. A. (1990). Reduced temporal limbic structure volumes on magnetic resonance images in first episode schizophrenia. Psychiatry Research: Neuroimaging 35, 113.CrossRefGoogle ScholarPubMed
Brown, R., Colter, N., Corsellis, J. A. N., Crow, T. J., Frith, C. D., Jagoe, R., Johnstone, E. C. & Marsh, L. (1986). Post-mortem evidence of structural brain changes in schizophrenia: differences in brain weight, temporal horn and parahippocampal gyrus compared with affective disorder. Archives of General Psychiatry 43, 3642.CrossRefGoogle Scholar
Buchsbaum, M. S., Nuechterlein, K. H., Haier, R. J., Wu, J., Sicotte, N., Hazlett, E., Asarnow, R., Potkin, S. & Guich, S. (1990). Glucose metabolic rate in normals and schizophrenics during the continuous performance test assessed by positron emission tomography. British Journal of Psychiatry 156, 216227.CrossRefGoogle ScholarPubMed
Christison, G. W., Casanova, M. F., Weinberger, D. R., Rawlings, R. & Kleinman, J. E. (1989). A quantitative investigation of parahippocampal pyramidal cell size, shape and variability of orientation in schizophrenia. Archives of General Psychiatry 46, 10271032.CrossRefGoogle Scholar
Costa, D. C., Ell, P. J., Burns, A., Philpot, M. & Levy, R. (1988). CBF tomograms with 99mTc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease-initial results. Journal of Cerebral Blood Flow and Metabolism 8, S109S115.CrossRefGoogle ScholarPubMed
Costa, D. C. (1990). Single photon emission tomography (SPET) with 99mTc-hexamethylpropyleneamineoxime (HMPAO) in research and clinical practice – a useful tool. Vascular Medicine Review 1, 179201.CrossRefGoogle Scholar
DeLisi, L. E., Holcomb, H. H., Cohen, R. M., Pickar, D., Carpenter, W., Morihisa, J. M., King, A. C., Kessler, R. & Buchsbaum, M. S. (1985). Positron emission tomography in schizophrenic patients with and without neuroleptic medication. Journal of Cerebral Blood Flow and Metabolism 5, 201206.CrossRefGoogle ScholarPubMed
Ell, P. J., Cullum, I. & Costa, D. C. (1985). Regional cerebral blood flow mapping with a new Tc-99m-labelled compound. Lancet ii, 5051.CrossRefGoogle Scholar
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview. The schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837844.CrossRefGoogle ScholarPubMed
Fazio, F., Perani, D., Gilardi, M. C., Colombo, F., Cappa, S. F., Vallar, G., Bettinardi, V., Paulesu, E., Alberoni, M., Bressi, S., Franceschi, M. & Lenzi, G. L. (1992). Metabolic impairment in human amnesia: a PET study of memory networks. Journal of Cerebral Blood Flow and Metabolism 12, 353358.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Minimental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.CrossRefGoogle Scholar
Frackowiak, R. S. J., Pozzilli, C., Legg, N. J., Du Boulay, G. H., Marshall, J., Lenzi, G. L. & Jones, T. (1981). Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography. Brain 104, 753778.CrossRefGoogle ScholarPubMed
Friston, K. J., Liddle, P. F., Frith, C. D., Hirsch, S. R. & Frackowiak, R. S. J. (1992). The medial temporal region in schizophrenia. A PET study. Brain 115, 367382.CrossRefGoogle ScholarPubMed
Frith, C. D., Friston, K. J., Liddle, P. F. & Frackowiak, R. S. J. (1991). A PET study of word finding. Neuropsychologia 29, 11371148.CrossRefGoogle ScholarPubMed
George, M. S., Ring, H. A., Costa, D. C., Ell, P. J., Kouris, K. & Jarritt, P. (1991). Neuroactivation and Neuroimaging with SPET. Springer-Verlag: London.CrossRefGoogle Scholar
George, M. S., Trimble, M. R., Costa, D. C., Robertson, M. M., Ring, H. A. & Ell, P. J. (1992). Elevated frontal cerebral blood flow in Gilles de la Tourette syndrome: a 99Tcm-HMPAO SPECT study. Psychiatry Research: Neuroimaging 45, 143151.CrossRefGoogle ScholarPubMed
Goldberg, T. E., Ragland, D., Fuller Torrey, E., Gold, J. M., Bigelow, L. B. & Weinberger, D. R. (1990). Neuropsychological assessment of monozygotic twins discordant for schizophrenia. Archives of General Psychiatry 47, 10391042.CrossRefGoogle ScholarPubMed
Goldstein, L. H., Canavan, A. G. M. & Polkey, C. E. (1988). Verbal and abstract designs paired associated learning after unilateral temporal lobectomy. Cortex 24, 4152.CrossRefGoogle ScholarPubMed
Gur, R. C., Gur, R. E., Resnick, S. M., Skolnick, B. E., Alavi, A. & Reivich, M. (1987). The effect of anxiety on cortical cerebral blood flow and metabolism. Journal of Cerebral Blood Flow and Metabolism 7, 173177.CrossRefGoogle ScholarPubMed
Holm, S., Madsen, P. L., Rubin, P., Sperling, B., Friberg, L. & Lassen, N. A. (1991). Tc-99m HMPAO activation studies: validation of the split-dose, image subtraction approach. Journal of Cerebral Blood Flow and Metabolism 11 (Suppl 2), S766.Google Scholar
Jakob, H. & Beckman, H. (1986). Prenatal developmental disturbances in the limbic allocortex in schizophrenics. Journal of Neural Transmission 65, 303326.CrossRefGoogle ScholarPubMed
Jeste, D. & Lohr, J. B. (1989). Hippocampal pathologic findings in schizophrenia. A morphometric study. Archives of General Psychiatry 46, 10191024.CrossRefGoogle ScholarPubMed
Kouris, K., Jarrit, P. H., Costa, D. C. & Ell, P. J. (1992). Physical assessment of the GE/CGR NEUROCAM and comparison to a single rotating gamma camera. European Journal of Nuclear Medicine 19, 236242.CrossRefGoogle ScholarPubMed
Kovelman, J. A. & Scheibel, A. B. (1984). A neurohistological correlate of schizophrenia. Biological Psychiatry 191, 16011621.Google Scholar
Ingvar, D. H. & Franzén, G. (1974). Distribution of cerebral activity in chronic schizophrenia. Lancet ii, 14841486.CrossRefGoogle Scholar
Leiner, H. C., Leiner, A. L. & Dow, R. S. (1989). Reappraising the cerebellum: what does the hindbrain contribute to the forebrain? Behavioral Neuroscience 103, 9981008.CrossRefGoogle ScholarPubMed
Lewis, S. W., Ford, R. A., Syed, G. M., Reveley, A. M. & Toone, B. K. (1992). A controlled study of 99mTc-HMPAO single-photon emission imaging in chronic schizophrenia. Psychological Medicine 22, 2735.CrossRefGoogle ScholarPubMed
Mazziotta, J. C., Valentino, D., Pelizzari, C. A., Chen, G. T. & Bookstein, F. (1990). Structure-function correlation of the living human brain with MRI and PET: a means of anatomical and functional localization. Clinical Neuropharmacology 13 (Suppl. 2), 460461.Google Scholar
Mesulam, M-M (1990). Neurocognitive networks and distributed processing for attention, language and memory. Annals of Neurology 28, 597613.CrossRefGoogle ScholarPubMed
Nelson, H. E. (1982). The National Adult Reading Test (NART) Test Manual. NFER-Nelson Publishing Co.: Windsor.Google Scholar
Petersen, S. E., Fox, P. T., Posner, M. I., Mintum, M. A. & Raichle, M. E. (1989). Positron emission tomographic studies of the processing of single words. Journal of Cognitive Neuroscience 1, 153170.CrossRefGoogle Scholar
Roberts, G. W. (1991). Schizophrenia: a neuropathological perspective. British Journal of Psychiatry 158, 817.CrossRefGoogle ScholarPubMed
Rubin, P., Holm, S., Friberg, L., Videbech, P., Andersen, H. S., Bendsen, B. B., Stromso, N., Larsen, J. K., Lassen, N. A. & Hemminsen, R. (1991). Altered modulation of prefrontal and subcortical brain activity in newly diagnosed schizophrenia and schizophreniform disorder. A regional cerebral blood flow study. Archives of General Psychiatry 48, 987995.CrossRefGoogle ScholarPubMed
Shedlack, K. J., Hunter, R., Wyper, D., McLuskie, R., Fink, G. & Goodwin, G. M. (1991). The pattern of cerebral activity underlying verbal fluency shown by split-dose single photon emission tomography (SPET or SPECT) in normal volunteers. Psychological Medicine 21, 687696.CrossRefGoogle Scholar
Shenton, M. E., Kikinis, R., Jolesz, F. A., Pollak, S. D., LeMay, M., Wible, C. G., Hokama, H., Martin, J., Metcalf, D., Coleman, M. & McCarley, R. W. (1992). Abnormalities of the left temporal lobe and thought disorder in schizophrenia. A quantitative magnetic resonance imaging study. New England Journal of Medicine 327, 604612.CrossRefGoogle ScholarPubMed
Sheppard, G., Gruzelier, J., Manchanda, R., Hirsch, S., Wise, R., Frackowiak, R., Jones, B. & Jones, T. (1983). 15O-Positron emission tomography scanning in predominantly never treated acute schizophrenics. Lancet ii, 14481452.CrossRefGoogle Scholar
Smith, M. L. (1989). Memory disorders associated with temporal lobe lesions. In Handbook of Neuropsychology 3 (ed. Boller, F. and Grafman, J.), pp. 91106. Elsevier: Amsterdam.Google Scholar
Suddath, R. L., Christison, G. W., Torrey, E. F., Casanova, M. F. & Weinberger, D. R. (1990). Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine 322, 789794.CrossRefGoogle ScholarPubMed
Tamlyn, D., McKenna, P. J., Mortimer, A. M., Lund, C. E., Hammond, S. & Baddeley, A. D. (1992). Memory impairment in schizophrenia: its extent, affiliations and neuropsychological character. Psychological Medicine 22, 101115.CrossRefGoogle ScholarPubMed
Tamminga, C. A., Thaker, G. K., Buchanan, R., Kirkpatrick, B., Alphs, L. D., Chase, T. N. & Carpenter, W. T. (1992). Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluorodeoxyglucose and neocortical alterations with deficit syndrome. Archives of General Psychiatry 49, 522530.CrossRefGoogle ScholarPubMed
Thorndike, E. L. & Lorge, I. (1944). The Teacher's Word Book of 30,000 words. Teacher College Press: New York.Google Scholar
Van Hoesen, G. W. (1982). The parahippocampal gyrus. New observations regarding its cortical connections in the monkey. Trends in Neurosciences 5, 345350.CrossRefGoogle Scholar
Volkow, N. D., Brodie, J. D., Wolf, A. P., Gomez-Mont, F. & Cancro, R. (1986). Brain organization in schizophrenia. Journal of Cerebral Blood Flow and Metabolism 6, 441446.CrossRefGoogle ScholarPubMed
Volkow, N. D., Wolf, A. P., Van Gelder, P., Brodie, J. D., Overall, J., Cancro, R. & Gomez-Mont, F. (1987). Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia. American Journal of Psychiatry 144, 151158.Google ScholarPubMed
Wechsler, D. & Stone, C. (1945). Wechsler Memory Scale. The Psychological Corporation: New York.Google Scholar
Weinberger, D. R., Berman, K. F. & Zec, R. F. (1986). Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia. I. Regional cerebral blood flow evidence. Archives of General Psychiatry 43, 114125.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wolkin, A., Jaeger, J., Brodie, J. D., Wolf, A. P., Fowler, J., Rotrosen, J., Gomez-Mont, F. & Cancro, R. (1985). Persistence of cerebral metabolic abnormalities in chronic schizophrenia as determined by positron emission tomography. American Journal of Psychiatry 142, 564571.Google ScholarPubMed