Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-27T14:34:19.320Z Has data issue: false hasContentIssue false

Limbic Dysfunction in Schizophrenia and Mania

A Study Using 18F-Labelled Fluorodeoxyglucose and Positron Emission Tomography

Published online by Cambridge University Press:  02 January 2018

Adil H. Al-Mousawi*
Affiliation:
Department of Psychological Medicine, University of Wales College of Medicine
Noel Evans
Affiliation:
MRC Brain Metabolism Unit, Edinburgh
Klaus P. Ebmeier
Affiliation:
MRC Brain Metabolism Unit, Edinburgh
Dirk Roeda
Affiliation:
Department of Bio-Medical Physics, University of Aberdeen
Fiona Chaloner
Affiliation:
Department of Bio-Medical Physics, University of Aberdeen
George W. Ashcroft
Affiliation:
University of Aberdeen
*
Dr A. H. Al-Mousawi, Department of Psychological Medicine, University of Wales College of Medicine, Gwenfro Buildings, Wrexham Technology Park, Wrexham, North Wales LL13 7YP

Abstract

Background

Diagnostic classes (derived from catego) can be correlated with regional brain metabolism in patients with major psychiatric disorders.

Method

Seventeen patients with schizophrenia, 15 with mania, 10 with depression and 10 healthy volunteers were examined with positron emission tomography (PET) and 18F-labelled fluorodeoxyglucose, as a marker for glucose metabolism. The number of possible comparisons of regions of interest was reduced by principal-components analysis, and differences in factor scores were determined between diagnostic groups.

Results

Four independent factors, representing distributed brain systems, emerged: an anterior–posterior (1), a left–right temporal (2), a temporofrontal (3), and a mediofrontal (4) system, of which (1), (2) and (3) were abnormal in schizophrenia, (1) and (2) in mania, and (1) in depression.

Conclusions

Abnormal patterns of metabolism could be detected, in decreasing order, in schizophrenia, mania and depression. Some of these abnormalities are likely to be due to medication, but others will be associated with structural or functional abnormalities of the frontolimbic system in the diagnostic groups.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altshuler, L. L., Conrad, A., Kovelman, J. A., et al (1987) Hippocampal pyramidal cell orientation in schizophrenia. Archives of General Psychiatry, 44, 10941098.CrossRefGoogle ScholarPubMed
Annett, M. (1970) A classification of hand preference by association analysis. British Journal of Psychology, 61, 303321.CrossRefGoogle ScholarPubMed
Aquilonius, S.-M. & Eckernäs, S.-A. (1980) A Colour Atlas of The Human Brain Adapted to Computed Tomography. New York: Raven Press.Google Scholar
Austin, M.-P., Dougall, N., Ross, N., et al (1992) Single photon emission tomography with 99Tc-exametazime in major depression and the pattern of brain activity underlying the psychotic/neurotic continuum. Journal of Affective Disorders, 26, 3144.CrossRefGoogle ScholarPubMed
Bartlett, E. J., Wolkin, A., Brodie, J. D., et al (1991) Importance of pharmacologic control in PET studies: effects of thiothixene and haloperidol on cerebral glucose utilization in chronic schizophrenia. Psychiatry Research: Neuroimaging, 40, 115124.CrossRefGoogle ScholarPubMed
Baxter, L. R., Schwartz, J. M., Phelps, M. E., et al (1989) Reduction of prefrontal cortex glucose metabolism common to three types of depression. Archives of General Psychiatry, 46, 243250.CrossRefGoogle ScholarPubMed
Bench, C. J., Friston, K. J., Brown, R. G., et al (1992) The anatomy of melancholia. Abnormalities of regional cerebral blood flow in major depression. Psychological Medicine, 22, 607615.CrossRefGoogle ScholarPubMed
Berman, K. F., Zec, R. F. & Weinberger, D. R. (1986) Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia II. Role of neuroleptic treatment, attention, and mental effort. Archives of General Psychiatry, 43, 126135.CrossRefGoogle ScholarPubMed
Bogerts, B., Meertz, E. & Schonfeldt-Bausch, R. (1985) Basal ganglia and limbic system pathology in schizophrenia: a morphometric study of brain volume and shrinkage. Archives of General Psychiatry, 42, 784791.CrossRefGoogle ScholarPubMed
Bogerts, B., Ashtari, M., Degreef, G., et al (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., Corselli, J. A. N., et al (1986) Postmortem evidence of structural brain changes in schizophrenia: differences in brain weight, temporal horn area and parahippocampal gyrus compared with affective disorder. Archives of General Psychiatry, 43, 3642.CrossRefGoogle ScholarPubMed
Buchsbaum, M. S., Cappelletti, J. & Ball, R. (1984) Positron emission tomographic image measurement in schizophrenia and affective disorders. Annals of Neurology, 15, 157165.CrossRefGoogle ScholarPubMed
Buchsbaum, M. S., Wu, J., DeLisi, L. E., et al (1986) Frontal cortex and basal ganglia metabolic rates assessed by positron emission tomography with F-2-deoxyglucose in affective illness. Journal of Affective Disorders, 10, 137152.CrossRefGoogle Scholar
Buchsbaum, M. S., Haier, R. J., Potkin, S. G., et al (1992a) Frontal–striatal disorder of cerebral metabolism in never-medicated schizophrenics. Archives of General Psychiatry, 49, 935942.CrossRefGoogle Scholar
Buchsbaum, M. S., Potkin, S. G., Siegel, B. V. Jr, et al (1992b) Striatal metabolic rate and clinical response to neuroleptics in schizophrenia. Archives of General Psychiatry, 49, 966974.CrossRefGoogle ScholarPubMed
Cohen, R. M., Semple, W. E., Gross, M., et al (1989) Evidence for common alterations in cerebral glucose metabolism in major affective disorders and schizophrenia. Neuropsychopharmacology, 2, 241254.CrossRefGoogle ScholarPubMed
Conrad, A. J., Abebe, T., Austin, R., et al (1991) Hippocampal pyramidal cell disarray in schizophrenia as a bilateral phenomenon. Archives of General Psychiatry, 48, 413417.CrossRefGoogle ScholarPubMed
Cummings, J. L. & Mendez, M. F. (1984) Secondary mania with focal cerebrovascular lesions. American Journal of Psychiatry, 141, 10841087.Google ScholarPubMed
Davison, K. & Bagley, C. R. (1969) Schizophrenia-like psychoses associated with organic disorders of the central nervous system: a review of the literature. In Current Problems in Neuropsychiatry, British Journal of Psychiatry Special Publication No. 4 (ed. Herrington, R. N.), pp. 113184. Ashford, Kent: Headley Brothers.Google Scholar
DeLisi, L. E., Buchsbaum, M. S., Holcomb, H. H., et al (1985) Clinical correlates of decreased anteroposterior metabolic gradients in positron emission tomography of schizophrenia patients. American Journal of Psychiatry, 142, 7881.Google Scholar
Ebmeier, K. P., Blackwood, D. H. R., Murray, C., et al (1993) Single photon emission computed tomography with 99Tc-exametazime in unmedicated schizophrenic patients. Biological Psychiatry, 33, 487495.CrossRefGoogle ScholarPubMed
Gur, R. E., Resnick, S. M., Alavi, A., et al (1987a) Regional brain function in schizophrenia I. A positron emission tomography study. Archives of General Psychiatry, 44, 119125.CrossRefGoogle Scholar
Gur, R. E., Resnick, S. M., Gur, R. C., et al (1987b) Regional brain function in schizophrenia. II. Repeated evaluation with positron emission tomography. Archives of General Psychiatry, 44, 126129.CrossRefGoogle ScholarPubMed
Jibiki, I., Matsuda, H., Yamaguchi, N., et al (1992) Acutely administered haloperidol-induced pattern changes of regional cerebral blood flow in schizophrenics. Neuropsychobiology, 25, 182187.CrossRefGoogle ScholarPubMed
Liddle, P. F., Friston, K. J., Frith, C. D., et al (1992) Patterns of cerebral blood flow in schizophrenia. British Journal of Psychiatry, 160, 179186.CrossRefGoogle ScholarPubMed
Musalek, M., Podreka, I., Walter, H., et al (1989) Regional brain function in hallucinations: a study of regional cerebral blood flow with 99mTc-HMPAO-SPECT in patients with auditory hallucinations, tactile hallucinations and normal controls. Comprehensive Psychiatry, 30, 99108.CrossRefGoogle Scholar
Reynolds, G. P. (1983) Increased concentrations and lateral asymmetry of amygdala dopamine in schizophrenia. Nature, 305, 527529.CrossRefGoogle ScholarPubMed
Schneider, K. (1959) Clinical Psychopathology (trans. Hamilton, M. W.). New York: Grune & Stratton.Google Scholar
Siegel, B. V., Buchsbaum, M. S., Bunney, W. E., et al (1993) Cortical–striatal–thalamic circuits and brain glucose metabolic activity in 70 unmedicated male schizophrenic patients. American Journal of Psychiatry, 150, 13251336.Google ScholarPubMed
SPSS Inc. (1993) SPSS for Windows: Advanced Statistics, Release 6. Chicago: SPSS Inc.Google Scholar
Starkstein, S. E. & Robinson, R. G. (1989) Affective disorders and cerebrovascular disease. British Journal of Psychiatry, 154, 170182.CrossRefGoogle Scholar
Suddath, R. L., Casanova, M. F., Goldberg, T. E., et al (1989) Temporal lobe pathology in schizophrenia: a quantitative magnetic resonance imaging study. American Journal of Psychiatry, 146, 464472.Google ScholarPubMed
Suddath, R. L., Christison, W., Torrey, E. F., et al (1990) Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine, 322, 789794.CrossRefGoogle ScholarPubMed
Szechtman, H., Nahmias, C., Garnett, S., et al (1988) Effect of neuroleptics on altered cerebral glucose metabolism in schizophrenia. Archives of General Psychiatry, 45, 523532.CrossRefGoogle ScholarPubMed
Tamminga, C. A., Thaker, G. K., Buchanan, R., et al (1992) Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluorodeoxyglucose and neocortical alterations with deficit syndrome. Archives of General Psychiatry, 49, 522529.CrossRefGoogle ScholarPubMed
Trimble, M. R. (1990) First rank symptoms of Schneider a new perspective? British Journal of Psychiatry, 156, 195200.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.