Elsevier

Biological Psychiatry

Volume 22, Issue 4, April 1987, Pages 479-494
Biological Psychiatry

Positron emission tomography studies of basal ganglia and somatosensory cortex neuroleptic drug effects: Differences between normal controls and schizophrenic patients

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Abstract

Glucose metabolic rate in the basal ganglia, thalamus, and somatosensory cortex was examined in eight patients with schizophrenia before and after receiving neuroleptic medication. Basal ganglia metabolic rates were increased with medication: more on the right than on the left and more in putamen than caudate. The cortical anteroposterior ratio, an index of relative hypofrontality, was not affected by neuroleptics. The brain areas that were found to be altered by neuroleptics were selected for comparison between off-medication schizophrenics and controls. Metabolic rates in the basal ganglia tended to be low in patients with schizophrenia in comparison to 24 age- and sex-matched controls.

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      Buchsbaum et al. (1987) extended the visual identification methods of DeLisi et al. (1985b) by using a stereotaxic approach to identify the regions of interest. Buchsbaum et al. reported that basal ganglia GMR increased with medication, more in the putamen than in the caudate; however, similar to DeLisi et al. (1985b), the cortical anteroposterior ratio, an index of relative hypofrontality, was unaffected by neuroleptics (Buchsbaum et al., 1987). Up until this point, prior studies were confounded by order effects, doctor's choice of neuroleptic medications and doses, and a lack of placebo-controlled and blinded ratings.

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      The thalamus, a major cortical relay from the limbic system with many important frontal lobe connections, is of major interest in schizophrenia. Results from early FDG-PET studies of the thalamus in schizophrenia, (e.g., Buchsbaum et al., 1987; Resnick et al., 1988; Wiesel et al., 1987) were mixed, which was thought to be due to medication status, varied FDG-uptake conditions, or methodological issues with defining the thalamus visually vs. stereotaxically. In 1996, Buchsbaum et al. published the first evidence of reduced thalamic GMR in a never-medicated schizophrenia sample during the sustained-attention CPT (Buchsbaum et al., 1996).

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