technetium-tc-99m-exametazime and Schizophrenia

Single-photon emission computed tomography (SEPCT) and neuropsychological tests were performed in subjects with Asperger's disorder and schizophrenia with a statistical parametric mapping analysis of 99mECD-SPECT images. The SPM analysis of SPECT images demonstrated reduced regional cerebral blood flows in right parietal lobe and right superior temporal gyrus in Asperger's disorder. On the other hand, schizophrenic individuals showed mild hypoperfusions in bilateral frontal lobes. These abnormalities on SEPCT images in Asperser's disorder could be related to the cognitive dysfunction observed in the spatial working memory task and the impairment of gaze processing. The SEPCT study could be helpful to discriminate Asperser's disorder from schizophrenia.

Topics: Asperger Syndrome; Cerebrovascular Circulation; Diagnosis, Differential; Humans; Neuropsychological Tests; Parietal Lobe; Radiopharmaceuticals; Schizophrenia; Technetium Tc 99m Exametazime; Temporal Lobe; Tomography, Emission-Computed, Single-Photon

Brain SPECT with HMPAO or ECD has-due to its short accumulation period--a rather high time resolution of approx 60 sec. Compared to isopropyl amphetamine (I-123) and FDG-PET, shortlasting interventions may be evaluated by SPECT. Usually, a two-step approach is used, injecting one third of the dose under baseline conditions and two thirds during intervention. The first study is then subtracted from the second study, resulting in a "difference" image which allows to calculate the effect of the intervention. These interventional procedures may include drug, mechanical, and mental intervention as well as ictal, blood pressure and receptor intervention. Moreover, the difference of pCO2 after hyperventilation or hypoventilation may also be used as a stimulus. The above mentioned procedures are described in detail.

Topics: Brain; Cerebrovascular Circulation; Deoxyglucose; Depressive Disorder; Epilepsy; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Iodine Radioisotopes; Organotechnetium Compounds; Oximes; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Schizophrenia is a major psychiatric problem common in the younger population. Structural imaging and findings on autopsy have not yet revealed a specific deficit in these patients. Uncertainty in clinical diagnosis based on a set of signs and symptoms is another drawback in the management of this patient population. Regional cerebral blood flow studies (rCBF) using single photon emission computed tomography (SPECT) offers the opportunity to study the underlying phenomenon and to detect the specific functional deficits in schizophrenia.

Topics: Amphetamines; Brain; Cerebrovascular Circulation; Humans; Iodine Radioisotopes; Iofetamine; Organotechnetium Compounds; Oximes; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Xenon Radioisotopes

Dopamine D(2) blocking typical antipsychotic drugs are known to change the cerebral perfusion patterns of schizophrenic patients, especially in the frontal cortex and basal ganglia. In recent years atypical antipsychotics such as olanzapine, which have high serotonin 5-HT(2A)/dopamine D(2) occupation ratios, have been shown to be more effective in the treatment of schizophrenia symptoms. The aim of this study was to evaluate the regional cerebral blood flow (rCBF) of the schizophrenic patients treated with olanzapine in a within-subject design. Twenty-four patients with schizophrenia participated as subjects in the study. Each subject was scanned in a medication-free state and after 6 weeks of 10 mg/day fixed dose olanzapine treatment. Despite the clinical improvement seen in the patients, repeated-measures analysis of variance showed that olanzapine produced no significant changes in cortical rCBF after the six-week treatment. This finding indicates that unlike typical antipsychotics olanzapine has no negative effect on cortical cerebral perfusion patterns of schizophrenic patients.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Cerebral Cortex; Cerebrovascular Circulation; Female; Humans; Male; Olanzapine; Pirenzepine; Radiopharmaceuticals; Regional Blood Flow; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

In order to investigate cerebral perfusion changes induced by neuroleptic drugs, we performed 99Tc(m) hexamethyl propyleneamine oxime (HMPAO) single-photon emission computed tomography (SPET). Fifteen patients (nine drug naive, six non-naive) diagnosed by using the DSM-III-R criteria, and 10 right-handed age and sex matched normal volunteers were included in this study. The SPET study was performed with 740 MBq 99Tc(m)-HMPAO by using a 128 x 128 matrix, 30 s/frame for a total 64 view over 360 degrees before and after 1 month of neuroleptic treatment. A semiquantitative method was used for the analysis. Patients were clinically assessed using the Brief Psychiatric Rating Scale (BPRS). There was no significant regional cerebral blood flow (rCBF) difference between the patient group and control group in whole-brain regions except in the left temporal lobe. Although clinical scores of the patients improved after neuroleptic treatment no statistically significant difference was found in the rCBF between pre- and post-treatment. Moreover, there was no statistically significant correlation between the rCBF and BPRS in any region. These results suggest that there was a discrepancy between the clinical situation and rCBF in schizophrenia and the lateralized temporal lobe blood flow, which may have important implications for the evaluation of patients with schizophrenia.

Topics: Adult; Antipsychotic Agents; Cerebrovascular Circulation; Female; Functional Laterality; Humans; Image Processing, Computer-Assisted; Male; Psychiatric Status Rating Scales; Radiopharmaceuticals; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Functional neuroimaging findings of "hypofrontality" in schizophrenic patients is still controversial, due to the heterogeneity of methods and patient samples. This study tries to prevent some of these concerns by studying neuroleptic-naive (NN) and neuroleptic-free (NF) young female patients both in resting conditions and during a frontal cognitive activation task.. Regional cerebral blood flow (rCBF) was studied at rest and during the Wisconsin Card Sorting Test (WCST) in 25 young acute unmedicated schizophrenic female patients (14 NN and 11 NF) and 15 female controls, using single photon emission computed tomography.. The schizophrenic and control groups did not differ in rCBF during the baseline condition, but the schizophrenic group failed to activate the frontal lobe during the WCST condition. In addition, the left anterior temporal rCBF at rest correlated with the Scale for the Assessment of Positive Symptoms total score.. The results suggest that hypofrontality in young acute unmedicated schizophrenic patients is a result of an inability to activate frontal regions during cognition, rather than a baseline decrease in frontal activity. Furthermore, positive symptoms seem to be associated with left temporal cortex activity.

Topics: Adult; Cerebrovascular Circulation; Female; Frontal Lobe; Humans; Radiopharmaceuticals; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

This study examined saccadic eye movements, using simple stationary targets, in schizophrenic patients. The targets were eight black points or eight arabic-numbered points placed in randomized order on the circumference of a circle. Self-paced eye movements during clockwise tracking of these points, by 23 patients and 23 controls, were recorded using an infrared eye-mark recorder. Then the relationship between the saccades and clinical symptoms was investigated. Finally, the relationship between the performance of the saccades and resting regional cerebral blood flow (rCBF) was examined using single photon emission computed tomography with 99mTc-hexamethyl propyleneamine oxime (HMPAO). The results indicate that patients track with significantly fewer correct scores and more deviant scores than controls, in agreement with our previous study. There were two groups of patients: an ordinary group who obtained a full-target-hitting score at a 200-ms setting and a fast group who obtained the full score at 100 ms but not at 200 ms. Some patients displayed significantly more hypermetria than controls. Significant correlations were found between hallucination and delusion symptoms and correct score. With respect to relative rCBF, fast-group patients showed significantly decreased rCBF in the left limbic and inferior parietal areas as compared with ordinary group patients. These findings suggest that some schizophrenic patients view the stationary targets too fast and this may be related to dysfunction in the limbic-parietal association area in the left hemisphere.

Topics: Adolescent; Antipsychotic Agents; Cerebrovascular Circulation; Child; Female; Humans; Male; Parietal Lobe; Saccades; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Several studies with functional and structural brain-imaging techniques support the hypothesis that responders and non-responders to clozapine could show a different pattern of cerebral dysfunction. Thirty-nine neuroleptic-refractory schizophrenic patients were studied with 99Tc-labelled hexamethyl-propylene-aminoxime (HMPAO) and SPECT, while on classical neuroleptics and after 6 months of treatment with clozapine. The perfusion differences between responders and non-responders to clozapine were studied in the regions included within the dorsolateral and orbitofrontal fronto-striato-thalamic circuits, as well as the predictive value of these parameters. These values were compared to those of a normal database, and between both treatments within the two groups. On-neuroleptic perfusion in non-responders was lower in the thalamus, basal ganglia and dorsolateral prefrontal cortex. Thalamus and right prefrontal perfusion regions were selected as response predictors by a discriminant analysis. Thalamic and left basal ganglia activities while on neuroleptics were lower only in non-responders with respect to the normal subjects. Perfusion changes were only observed in the responder group in thalamus and basal ganglia. Study of regional perfusion may contribute to the prediction of clozapine response.

Topics: Adult; Antipsychotic Agents; Clozapine; Corpus Striatum; Frontal Lobe; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Predictive Value of Tests; Radiopharmaceuticals; Refractory Period, Psychological; Regional Blood Flow; Schizophrenia; Technetium Tc 99m Exametazime; Thalamus; Tomography, Emission-Computed, Single-Photon

In a security ward we assessed the diagnostic contribution of single photon scintigraphy [SPECT] in our diagnostic pathway for patients with serious mental disease and a history of violence.. Twenty patients were examined between 2012 and 2015 and the findings compared to those in nine patients with the same diagnosis, but no history of violence.. All violent patients had areas with reduced accumulation of 99mTc-HMPAO frontally and in the temporal lobe, in the non-violent group only two patients demonstrated these findings.. Traditionally, low accumulation of the tracer in SPECT is related to reduced perfusion of brain tissue. We discuss our findings in the light of other possible pathophysiological mechanisms.

Topics: Adolescent; Adult; Aged; Brain Chemistry; Female; Humans; Male; Middle Aged; Norway; Radiopharmaceuticals; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Violence

We studied relative cortical blood flow (relCBF) patterns associated to correct performance (CP) and perseverative error (PE) during Wisconsin Card Sorting Test (WCST) execution, in controls and patients with schizophrenia.. relCBF (regional cortical blood flow (rCBF) / whole cortex blood flow) of 10 well defined cortical regions was measured in 18 patients with schizophrenia and 13 healthy controls by a Technetium - 99 - HMPAO - SPECT, at rest and while they performed WCST.. Patients made significantly more PE than controls during WCST performance. In patients, we found a significant correlation between PE and relCBF in right occipital cortex. In controls, we found a significant correlation between CP and relCBF of several cortical regions during WCST execution: left orbitofrontal cortex and left global frontal cortex positively and parietal bilateral cortex negatively. PE was inversely correlated with relCBF in left temporal cortex.. Successful WCST performance is associated to a high left frontal activity in controls but not in patients. The severity of PE during WCST performance is associated to a low left frontal-temporal activity in controls and to a high right parietal-occipital activity in schizophrenia. This may represent a cortical activity redistribution pattern related to perseveration in schizophrenia.

Topics: Adult; Attention; Brain Mapping; Cerebral Cortex; Cognition Disorders; Dominance, Cerebral; Female; Humans; Male; Memory, Short-Term; Middle Aged; Neuropsychological Tests; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Stereotyped Behavior; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Young Adult

Brain imaging techniques are commonly used to define changes in the structure and functions of the brain in schizophrenic patients. The relationships between brain images and the cluster of symptoms provide us with more information about heterogeneous forms of schizophrenia. The aim of this study is to compare the regional blood flow of deficit and nondeficit syndrome schizophrenic patients.. Forty schizophrenic patients under the age of 65, without physical or neurological illness, mental retardation, a history of substance abuse, or ECT over the previous six months were included in the study. The Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, UKU Side Effect Rating Scale, Hamilton Rating Scale for Depression and The Schedule for the Deficit Syndrome (SDS) were used to evaluate the patients. The regional cerebral blood flow was measured semiquantitatively by SPECT imaging using radiopharmaceutical Tc 99m-HMPAO.. There was a significant reduction in the regional blood flow of deficit syndrome patients compared to nondeficit ones in the left frontal cortex (p= 0.002), right frontal cortex (p= 0.006) and right temporal cortex (p= 0.04).. We suggest that dysfunctions in some neuroanatomic structures are related to deficit syndrome and the concept of deficit syndrome is important for understanding underlying pathophysiologic mechanisms.

Topics: Adult; Case-Control Studies; Female; Frontal Lobe; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Radiopharmaceuticals; Regional Blood Flow; Schizophrenia; Technetium Tc 99m Exametazime; Telencephalon; Temporal Lobe; Tomography, Emission-Computed, Single-Photon

Functional neuroimaging techniques such as single-positron emission computed tomography (SPECT) and positron emission tomography (PET) offer considerable scope for investigating disturbances of brain activity in psychiatric disorders. However, the heterogeneous nature of disorders such as schizophrenia limits the value of studies that group patients under this global label. Some have addressed this problem by considering schizophrenia at a syndromal level, but so far, few have focussed at the level of individual symptoms. We describe the first neuroimaging study of the specific symptom of religious delusions in schizophrenia. 99mTc HMPAO high-resolution SPECT neuroimaging showed an association of religious delusions with left temporal overactivation and reduced occipital uptake, particularly on the left.

Topics: Adult; Delusions; Humans; Male; Radiopharmaceuticals; Religion and Psychology; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Regional cerebral blood flow (rCBF) was measured in 11 schizophrenic patients amid 10 normal controls, both at rest and while performing an auditory discrimination task. Single photon emission computed tomography with technetium-99m hexamethylpropylene amine oxime was used for quantitative evaluation of rCBF. The schizophrenic patients showed greater rCBF in the temporal and parietal regions at rest than the controls, but no abnormalities were found in frontal perfusion. During task performance. on the other hand, the patients showed a reduced frontal rCBF. whereas there was no group difference in rCBF in the temporal and parietal regions. In addition, the left> right hemisphere asymmetries of rCBF observed in the controls during task performance were not present in the patients. although there was no group difference in hemisphere laterality in rCBF at rest. These findings suggest that the employment of a cognitive task for neuroimaging studies is useful for detecting abnormalities of brain activation. such as hypofrontality and altered hemisphere laterality. in patients with schizophrenia.

Topics: Adult; Auditory Perception; Cerebrovascular Circulation; Cognition; Electroencephalography; Electrooculography; Event-Related Potentials, P300; Frontal Lobe; Functional Laterality; Humans; Male; Parietal Lobe; Radiopharmaceuticals; Regional Blood Flow; Schizophrenia; Technetium Tc 99m Exametazime; Temporal Lobe; Tomography, Emission-Computed, Single-Photon

The purpose of this work was to determine whether certain pathological groups and other groups at risk for neurological damage exhibited distinctive patterns of regional cerebral blood flow (rCBF) abnormality.. HMPAO SPECT images obtained from six groups of subjects were compared with a normal cortical rCBF atlas, based on multivariate, voxel-by-voxel methods. In each case, a significance image was outputted, highlighting voxels with deficits of > or =3 s.d. of normal. Abnormal patterns were examined for the six groups, which comprised a further 40 normal volunteers, 18 diver controls, 50 divers with decompression illness (DCI), 34 boxers, 23 schizophrenics and 21 subjects with Alzheimer's disease.. The percentages of abnormal cortical voxels for each group were 0.41%, 0.53%, 1.38%, 1.05%, 0.56% and 2.24%, respectively. The percentages of images in each group with at least one lesion of 10 or more connected abnormal voxels and at least 10 lesions of two or more connected voxels, respectively, were 8% and 8% (normal volunteers), 17% and 11% (diver controls), 38% and 38% (divers with DCI), 41% and 29% (boxers), 26% and 13% (schizophrenics) and 90% and 48% (subjects with Alzheimer's disease). This suggests that multiple small lesions are as common as single large lesions for divers with DCI but not for patients with Alzheimer's disease or schizophrenia. Large lesions are located predominantly in the parietal and inferior temporal regions for Alzheimer's disease, in the parietal and occipital regions for divers with DCI and boxers and in the inferior frontal region for schizophrenia.. It appears that the groups considered here do have different rCBF patterns and that the significance image is a useful way of demonstrating this fact.

Topics: Adult; Aged; Alzheimer Disease; Boxing; Brain; Case-Control Studies; Cerebrovascular Circulation; Decompression Sickness; Diving; Female; Humans; Image Processing, Computer-Assisted; Male; Radiopharmaceuticals; Reference Values; Risk Factors; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

A total of 38 patients in a first presentation of schizophrenia prior to drug treatment underwent a single photon emission computerized tomography (SPECT) scanning programme whilst undertaking a verbal fluency task. Their scans were compared with those of 38 normal volunteer controls matched for age, sex and father's social class. Schizophrenic patients displayed a trend towards a reduced blood flow in comparison with controls. Comparing right with left hemispheres, asymmetrical blood flow patterns were more likely to be found in patients in frontal regions than elsewhere. When 27 of the 38 patients underwent a repeat SPECT scanning programme after receiving 6 months of antipsychotic drug treatment, the hypofrontal blood flow pattern persisted. Increased blood flow was observed bilaterally in the putamen. The more symmetrical blood flow pattern of the patients compared to the control subjects did not alter substantially.

Topics: Adult; Antipsychotic Agents; Basal Ganglia; Brain; Case-Control Studies; Cerebrovascular Circulation; Female; Follow-Up Studies; Frontal Lobe; Humans; Male; Schizophrenia; Schizophrenic Psychology; Severity of Illness Index; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Verbal Behavior

The association between temporal lobe epilepsy and schizophrenia suggests that the critical abnormality may be pathology within the temporal lobes. People with schizophrenia-like psychosis of epilepsy (SLPE) provide a useful group in which to examine the importance of temporal and frontal lobe dysfunction in schizophrenia.. A verbal fluency activation paradigm and a 99mTc HMPAO SPET were used to study frontotemporal function in people with SLPE (n = 12), schizophrenia (n = 11) and epilepsy (n = 16).. People with SLPE differed from both other groups by showing lower blood flow in the left superior temporal gyrus during performance of a verbal fluency task compared with a word repetition task (F = 5.4, P = 0.01). During the verbal fluency task people with primary schizophrenia showed a greater increase in blood flow in anterior cingulate (F = 4.5, P = 0.02) than the other two groups. There were no between-group differences in frontal brain regions.. Our findings support an association between left temporal lobe abnormality and SLPE. The different patterns of activation observed in people with primary schizophrenia and SLPE suggests that different pathophysiological mechanisms may operate in these two groups. In SLPE the pathophysiology may be relatively confined to the dominant temporal lobe.

Topics: Adult; Epilepsy, Temporal Lobe; Female; Humans; Male; Radiopharmaceuticals; Schizophrenia; Schizophrenic Psychology; Speech Disorders; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

SPECT/PET studies in schizophrenia revealed inconsistent changes of regional cerebral blood flow (rCBF). Frontal hyperperfusion as well as hypoperfusion are described. This study was undertaken to investigate the relations between rCBF, psychopathology according to PANSS and effects of neuroleptic therapy.. Twenty-four drug-naive acute patients with a first manifestation of schizophrenia were examined with 99mTc-HMPAO brain SPECT and assessed according to PANSS. Of these, 22 were controlled again after neuroleptic treatment. Following attenuation correction, region-to-cerebellar count ratios were obtained from 98 irregular regions of interest drawn in all slices (6.25 mm). The ratios were compared to 20 control subjects, and changes lying outside of 2 s.d. were considered abnormal.. In different drug-naive patients, hyperperfusion as well as hypoperfused patterns were found. In drug-naive patients, the seven subscores of positive symptoms (pos 1-7) in PANSS showed different correlations to rCBF: Formal thought disorders (pos 2) and grandiosity (pos 5) were positively correlated to bifrontal and bitemporal rCBF (r = +0.59 to +0.70). Delusional ideas (pos 1), hallucinatory behavior (pos 3) and suspiciousness (pos 6) demonstrated a negative correlation to bifrontal, cingulate, left temporal and left thalamic rCBF (r = -0.59 to -0.66). Stereotyped ideas (neg 7) as a negative symptom showed a negative correlation to left frontal, left temporal and left parietal rCBF (r = -0.59 to -0.65). No correlations were found between residual positive symptoms and rCBF after neuroleptic treatment and clinical improvement, but all negative symptoms (neg 1-7) had a negative correlation to bifrontal, bitemporal, cingulate, basal ganglia and thalamic rCBF (r = -0.59 to -0.74).. Our results illustrate that different positive symptoms are accompanied by different rCBF values: some induce hyperperfusion, others hypoperfusion. After therapy (and reduction of positive symptoms), only negative symptoms correlate exclusively to hypoperfusion. This may be the crucial factor in explaining inconsistencies of past results in perfusion pattern in drug-naive schizophrenic patients.

Topics: Adult; Antipsychotic Agents; Brain; Cerebrovascular Circulation; Female; Humans; Male; Observer Variation; Organotechnetium Compounds; Oximes; Regional Blood Flow; Schizophrenia; Severity of Illness Index; Statistics as Topic; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

A 40-yr-old woman with a diagnosis of schizoaffective disorder developed catatonia in the context of a depressive episode. A dramatic decrease in perfusion of the inferior frontal, posterior temporal and parietal lobes bilaterally and in posterior frontal lobes corresponding to the motor cortices was noted on the 99mTc-HMPAO SPECT scan obtained in the acute phase. The most dramatic decreases compared to normal control subjects were observed in the left parietal and left motor cortices. The patient was treated with a five-treatment course of electroconvulsive therapy (ECT), which resulted in a complete resolution of catatonia and some resolution of her symptoms of depression. The repeat HMPAO-SPECT scan showed improved perfusion in all areas. The most dramatic increases occurred in the left parietal and left motor cortices. Decreased perfusion in motor and parietal cortices could be state-specific to catatonia. Thus, SPECT imaging may be a useful method for monitoring catatonia treatment response.

Topics: Adult; Brain; Catatonia; Cerebrovascular Circulation; Electroconvulsive Therapy; Female; Humans; Organotechnetium Compounds; Oximes; Regional Blood Flow; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Functional neuroimaging studies in schizophrenia have often been confounded by various factors including medication status. To explore the effects of antipsychotic medications on relative regional cerebral perfusion, we scanned a group of 33 persons with schizophrenia twice, while receiving a stable dose of antipsychotic and after being off antipsychotics for 3 weeks, using technetium-99m hexamethyl-propyleneamine oxime single photon emission computed tomography (Tc-99m HMPAO-SPECT. We found that antipsychotic significantly increased the mean relative cerebral perfusion in the left basal ganglia. Additionally, patients receiving thiothixene (n = 9) had a significantly greater increase in relative cerebral perfusion in the basal ganglia than patients receiving haloperidol (n = 12). These findings indicate that antipsychotics lead to regional increases in cerebral perfusion and that antipsychotic status must be controlled for in functional neuroimaging studies. Functional neuroimaging techniques such as SPECT may be useful in furthering our understanding of the mechanism of antipsychotics.

Topics: Adult; Antipsychotic Agents; Basal Ganglia; Brain; Brain Mapping; Cerebellum; Cerebral Cortex; Chronic Disease; Clozapine; Female; Haloperidol; Humans; Male; Organotechnetium Compounds; Oximes; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Thiothixene; Tomography, Emission-Computed, Single-Photon; Trifluoperazine

Structural and functional neuroimaging techniques have consistently demonstrated that abnormal lateralization of temporal lobes may be important in identifying the pathophysiologic processes in schizophrenia. The exact nature of these reported abnormalities has not been consistent.. We examined temporal lobe perfusion using HMPAO-SPECT in 22 individuals with schizophrenia in an effort to establish whether temporal lobe perfusion asymmetry is seen in these individuals, as compared to a group of 22 age- and sex-matched controls.. We found that the asymmetry index, a measure of perfusion differences between two homologous compared areas, was lower (more negative) in schizophrenic individuals. The asymmetry indices of patients considered with the results from globally corrected ROI means indicated that the left temporal lobes of individuals with schizophrenia were significantly hypoperfused when compared to controls. This finding does not appear to be caused by medication effects, demographic variables, handedness, imaging artifacts or analysis techniques.. In our sample, patients with schizophrenia appear to have significant left hypoperfusion relative to right of their temporal lobes. Abnormal lateralization of temporal lobe blood flow may have important clinical implications by assisting with diagnosis and appropriate treatment for individuals with schizophrenia.

Topics: Adolescent; Adult; Aged; Cerebrovascular Circulation; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Schizophrenia; Technetium Tc 99m Exametazime; Temporal Lobe; Tomography, Emission-Computed, Single-Photon

of this study was to investigate the relations between regional cerebral blood flow (rCBF) of different brain regions in acute schizophrenia and following neuroleptic treatment.. Twenty-two never-treated, acute schizophrenic patients were examined with HMPAO brain SPECT and assessed psychopathologically, and reexamined following neuroleptic treatment (over 96.8 days) and psychopathological remission, rCBF was determined by region/cerebellar count quotients obtained from 98 irregular regions of interest (ROIs), summed up to 11 ROIs on each hemisphere. In acute schizophrenics, interregional rCBF correlations of each ROI to every other ROI were compared to the interregional correlations following neuroleptic treatment and to those of controls.. All significant correlations of rCBF ratios of different brain regions were exclusively positive in controls and patients. In controls, all ROIs of one hemisphere except the mesial temporal ROI correlated significantly to its contralateral ROI. Each hemisphere showed significant frontal-temporal correlations, as well as cortical-subcortical and some cortico-limbic. In contrast, in acute schizophrenics nearly every ROI correlated significantly with every other ROI, without a grouping or relation of the rCBF of certain ROIs as in controls. After neuroleptic treatment and clinical improvement, this diffuse pattern of correlations remained.. These results indicate differences in the neuronal interplay between regions in schizophrenic and healthy subjects. In never-treated schizophrenics, diffuse interregional rCBF correlations can be seen as a sign of change and dysfunction of the systems regulating specificity and diversity of the neuronal functions. Neuroleptic therapy and psychopathologic remission showed no normalizing effect on interregional correlations.

Topics: Adult; Antipsychotic Agents; Brain; Cerebrovascular Circulation; Female; Humans; Male; Middle Aged; Prognosis; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

A 33-year-old patient, with pre-existing diagnosis of 'schizophrenic' disorder, came to our observation for severe diarrhoea and weight loss. Use of single photon emission computed tomography, (99mTc)HMPAO SPECT, demonstrated hypoperfusion of the left frontal brain area, without evidence of structural cerebral abnormalities. Jejunal biopsy showed villous atrophy. Antiendomysial antibodies were present. A gluten-free diet was started, resulting in a disappearence of psychiatric symptoms, and normalization of histological duodenal findings and of (99mTc)HMPAO SPECT pattern. This is the first case in which, in an undiagnosed and untreated coeliac patient with psychiatric manifestations, the (99mTc)HMPAO SPECT demonstrated a dysfunction of frontal cortex disappearing after a gluten-free diet.

Topics: Adult; Celiac Disease; Female; Glutens; Humans; Radiopharmaceuticals; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Functional neuroimaging studies have been performed in many young patients with schizophrenia, but late-onset schizophrenia (LOS) remains largely unexamined by these techniques. We predicted that LOS would demonstrate regional cerebral blood flow (rCBF) abnormalities similar to those seen in early-onset schizophrenia (EOS), but with a basis in demonstrable coarse brain disease. The subjects were 15 LOS and 7 EOS patients and 27 healthy controls. Each was given a detailed clinical and neuropsychological assessment and underwent MRI and Tc99m-HMPAO single photon emission computed tomography (SPECT) scans. The LOS subjects had a significantly lower cerebral hemispheric perfusion than controls, with a lower perfusion in the frontal and temporal lobes bilaterally. The LOS group also had significantly lower left-to-right hemisphere blood flow ratios. EOS subjects had a lower frontal perfusion than the controls, which was significant in the left frontal region. The temporal perfusion in the EOS subjects was greater than in the LOS group, and not different from the control subjects. Left temporal perfusion was the most discriminating variable between LOS and control subjects on logistic regression. Correlations of perfusion with MRI were generally low with the exception that the asymmetry indices were significantly correlated, and basal ganglia perfusion correlated with basal ganglia hyperintensities on MRI. The total cerebral perfusion index correlated significantly with the mini-mental state examination (MMSE) score, and the temporal lobe perfusion correlated with MMSE scores and some verbal memory measures. In the schizophrenic groups, perfusion correlated nonsignificantly with symptom profiles. We conclude that our findings of temporal and frontal rCBF abnormalities, especially on the left side, in LOS are similar to those reported in schizophrenia in general. The results do not provide evidence for coarse brain disease underlying the rCBF abnormalities in LOS, or support the specificity of these abnormalities for particular subsyndromes of schizophrenia.

Topics: Age of Onset; Aged; Antipsychotic Agents; Brain; Female; Frontal Lobe; Functional Laterality; Humans; Male; Middle Aged; Neuropsychological Tests; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Temporal Lobe; Tomography, Emission-Computed, Single-Photon

Recent research has shown that some patients with schizophrenia have a severe impairment in the suppression of reflexive saccadic eye movements in the ANTI-saccade task. This saccadic distractibility has previously been found in patients with lesions of dorsolateral prefrontal cortex, implicating an abnormality of prefrontal cortex. The objective of the present study was to determine the contribution of these and other areas to the ANTI-saccadic abnormality in schizophrenia by functional neuroimaging. Using 99mtechnetium-HMPAO high resolution multidetector single-photon emission tomography, regional cerebral blood flow (rCBF) during performance of the ANTI-saccade eye-movement task was compared, by statistical parametric mapping, in ten male schizophrenic patients on stable antipsychotic medication who had a high distractibility error rate on the task, and eight similar patients who had normal distractibility error rates. Compared with the normal error group, the patients with high error rates showed significantly decreased rCBF bilaterally, in the anterior cingulate, insula, and in left striatum. These same patients also had increased perseverative errors on the Wisconsin Card Sort Test.

Topics: Adult; Antipsychotic Agents; Arousal; Attention; Brain; Brain Mapping; Dominance, Cerebral; Frontal Lobe; Humans; Male; Middle Aged; Neuropsychological Tests; Organotechnetium Compounds; Oximes; Prefrontal Cortex; Reference Values; Reflex; Regional Blood Flow; Saccades; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

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.. 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.. 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.. 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.

Topics: Adolescent; Adult; Age of Onset; Antipsychotic Agents; Basal Ganglia; Brain; Cerebellum; Female; Frontal Lobe; Humans; Male; Middle Aged; Occipital Lobe; Organotechnetium Compounds; Oximes; Parietal Lobe; Schizophrenia; Technetium Tc 99m Exametazime; Temporal Lobe; Thalamus; Tomography, Emission-Computed, Single-Photon

The objective of this study was to search for regional cerebral blood flow (rCBF) abnormalities in adolescents with initial-stage schizophrenia by means of brain single-photon emission tomography (SPET) using technetium-99m hexamethylpropylene amine oxime (HMPAO). SPET studies were performed on a homogeneous sample of 15 carefully selected adolescents with a recent diagnosis of schizophrenia, and without previous electroconvulsive or antipsychotic drug treatment. Computed tomography (CT) and electro-encephalographic (EEG) studies were performed in all patients. Qualitative and semiquantitative analysis of 99mTc-HMPAO SPET studies showed an impaired rCBF in 12 patients (80%). The most common pattern was a decreased uptake of 99mTc-HMPAO in the frontal lobes, usually in the left hemisphere. Conventional and quantitative EEG was positive in 12 (80%) and 15 (100%) patients, respectively. CT findings were positive in two patients (13%). There was a high level of concordance between SPET and EEG results and between SPET and clinical features (P>0.05). This study suggests that previously untreated patients in the first stages of schizophrenia present functional abnormalities that are revealed by brain SPET.

Topics: Adolescent; Brain; Cerebrovascular Circulation; Electroencephalography; Female; Humans; Male; Organotechnetium Compounds; Oximes; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Single photon emission tomography with split-dose technetium-99m-d, l-hexamethyl-propylene amine oxime was used to measure regional cerebral blood flow (rCBF) during a memory-activation paradigm in a group of 18 medicated DSM-III-R schizophrenic patients. The relationship between clinical features of schizophrenia and rCBF patterns was examined. Increased blood flow to the left basal ganglia was revealed during activation in patients reporting hallucinations in the previous month, a finding that was not influenced by medication dose or other confounding variables. This result adds to previous functional imaging studies that have related basal ganglia abnormalities to hallucinatory phenomena and suggests that left basal ganglia hyperactivity may be relevant to an internal monitoring deficit responsible for the appearance of those symptoms in schizophrenia.

Topics: Adult; Arousal; Attention; Auditory Perception; Basal Ganglia; Blood Flow Velocity; Brain; Dominance, Cerebral; Female; Hallucinations; Humans; Male; Mental Recall; Middle Aged; Neurocognitive Disorders; Neuropsychological Tests; Organotechnetium Compounds; Oximes; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Verbal Learning

Single photon emission tomography with the intravenous blood flow marker 99mTc-exametazime was carried out in 14 acutely ill drug-free schizophrenic patients from whom P300 event-related potential, smooth eye pursuit eye tracking and verbal fluency were measured within a few days of scanning. Smooth pursuit eye movement abnormality correlated significantly with abnormal tracer uptake in superior pre-frontal cortex on the right and left and inferior pre-frontal cortex on the left. Abnormal eye movement was also associated with higher tracer uptake in left anterior cingulate and left posterior cingulate. P300 latency was significantly correlated with higher tracer uptake in left superior pre-frontal and left parietal regions. Verbal fluency performance was negatively correlated with tracer uptake in left frontal region. Eye tracking abnormality in schizophrenia is associated with bilateral frontal lobe disturbance and P300 latency increase with left-sided frontal and temporoparietal dysfunction. There was, however, a significant inverse relation between eye tracking abnormalities and abnormal perfusion in the left anterior cingulate region.

Topics: Adult; Arousal; Attention; Brain; Brain Mapping; Cerebral Cortex; Dominance, Cerebral; Evoked Potentials, Auditory; Female; Gyrus Cinguli; Humans; Male; Organotechnetium Compounds; Oximes; Pursuit, Smooth; Reaction Time; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

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.

Topics: Adult; Arousal; Brain; Cerebral Cortex; Dominance, Cerebral; Female; Gyrus Cinguli; Humans; Male; Mental Recall; Middle Aged; Organotechnetium Compounds; Oximes; Paired-Associate Learning; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Synaptic Transmission; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

This study assesses prefrontal and temporal regional cerebral blood flow (rCBF) changes in young, neuroleptic-naive schizophrenic patients with acute disease.. A selected population of 10 young, never-treated schizophrenic women with acute disease was studied by two hexamethylpropyleneamine oxime (HMPAO) brain SPECT sessions, performed 48 hr apart, both at rest and during a prefrontal activation task using the Wisconsin Card Sort Test (WCST). All patients met Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-revised criteria for schizophrenia or schizophreniform disorder, were neuroleptic-naive and had acute symptoms.. Under resting conditions, the schizophrenic group had significantly higher rCBF in the prefrontal regions, mainly in the left side and including the anterior cingulate, than did the controls. In addition, schizophrenic patients showed significant interhemispheric differences in prefrontal and posterior temporal index values at rest (left hyperfrontality and left hypotemporality). During WCST activation, the control group showed significant increases in prefrontal blood flow, whereas the schizophrenic group did not.. These results support a physiologic dysfunction of the prefrontal cortex in schizophrenia that is present at the onset of the illness prior to neuroleptic treatment. Furthermore, both left hyperfrontality and left hypotemporality may indicate a brain lateralization defect in schizophrenia.

Topics: Acute Disease; Adult; Cerebral Cortex; Cerebrovascular Circulation; Female; Frontal Lobe; Humans; Organotechnetium Compounds; Oximes; Rest; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Temporal Lobe; Thinking; Tomography, Emission-Computed, Single-Photon

Six depressed patients with schizophrenia and 6 depressed patients with major depression were investigated before and during somatosensory stimulation (SS) with Tc-99m HMPAO SPECT. 8 controls were investigated only under resting conditions. The results can be summarized as follows: 1. Both psychiatric patient groups were hypofrontal (dorsolateral prefrontal cortex) compared to controls. 2. Hypofrontality was further enhanced by SS, significantly only in affective psychoses in the right inferior frontal lobe and in the right frontal hemisphere in total, in schizophrenia in the left dorsolateral prefrontal cortex. 3. Within the frontal lobes different regions were affected by SS in the two diagnostic groups. 4. In the right inferior parietal lobe SS response was significantly different in the two illnesses with schizophrenia showing a relative decrease, affective psychoses showing a relative increase of activity. 5. SS produced an increase of cerebral blood flow in subcortical regions (statistically significant contralateral to SS in thalamus and basal ganglia, ipsilateral to SS in cerebellum), a pattern which was common to all psychiatric patients. 6. Somatosensory cortex flow was not changed by SS. In conclusion, we could not fully confirm our hypotheses that similar blood flow abnormalities in different illnesses during SS are only caused by similarities in depressive psychopathology. Instead, depressed patients with schizophrenia were different from depressed patients with major depression in showing decreased activity in interrelating brain regions participating in an attentional network.

Topics: Adult; Amitriptyline; Bipolar Disorder; Brain; Brain Mapping; Depressive Disorder; Dominance, Cerebral; Energy Metabolism; Evoked Potentials, Somatosensory; Female; Frontal Lobe; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Sulpiride; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

We examined 20 actively psychotic unmedicated schizophrenic patients and 20 matched control subjects by using single-photon emission, computed tomography (SPECT) with 99mtechnetium-exametazime. Patients showed a hyperfrontal pattern of tracer uptake with significant relative increases in superior prefrontal cortex. This abnormality was less pronounced in patients with higher symptom scores for psychomotor poverty. In addition, patients showed associations between certain schizophrenic syndrome scores, such as psychomotor poverty, disorganization, and reality distortion, and tracer uptake to a number of cortical and subcortical brain regions. This syndrome-related pattern of tracer uptake was, at least in part, consistent with similar associations previously reported in chronically medicated schizophrenic patients. SPECT therefore provides a readily available method to examine the relationship between symptom pattern and regional brain metabolism in psychotic patients. Any observed patterns of association will depend on the current mental and medication status of the patients examined.

Topics: Adult; Arousal; Cerebral Cortex; Dominance, Cerebral; Female; Frontal Lobe; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Topics: Adolescent; Adult; Brain; Cerebrovascular Circulation; Female; Humans; Male; Nerve Net; Organotechnetium Compounds; Oximes; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

We attempted to replicate the finding of Berman et al. (1987) that frontal cortical blood flow correlated inversely with ventricular size in schizophrenia. Computed tomography and high-resolution 99m-Tc-HMPAO single photon emission computed tomography were performed in 25 right-handed chronic schizophrenic men engaged in a word-fluency task. Weak, nonstatistically significant inverse correlations were found between the ventricle-brain ratio (VBR) and frontal cortical blood flow. The VBR was significantly inversely correlated with the ratio of left to right medial frontal blood flow.

Topics: Adult; Brain; Cerebral Ventricles; Dominance, Cerebral; Frontal Lobe; Humans; Male; Organotechnetium Compounds; Oximes; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The authors studied a group of thirteen schizophrenic patients with functional brain imaging, using single-photon-emission-computed tomography (S.P.E.C.T.). The radiotracer was the H.M.P.A.O. labelled with 99 m Technetium. All were being given neuroleptic drug. Forty-one lesions demonstrated decreased perfusion. These functional abnormalities are mainly located in the left hemisphere and this asymmetry is more pronounced in positive-symptom schizophrenics. However, at rest, these correlations are limited and finally we demonstrated a wide spectrum of metabolic dysfunctions in the same subtype of schizophrenia.

Topics: Adult; Brain Mapping; Cerebral Cortex; Delusions; Dominance, Cerebral; Energy Metabolism; Female; Hallucinations; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Psychiatric Status Rating Scales; Radionuclide Imaging; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime

Changes in regional cerebral blood flow in brain images with single photon emission computed tomography using technetium-99m hexamethyl-propyleneamine oxime before and after intramuscular injection of haloperidol (0.08 mg/kg) were studied in 5 medicated subjects in their twenties, consisting of 5 schizophrenics and 1 patient with histrionic personality disorder, by a subtraction method of brain images. The haloperidol injection induced two types of perfusion pattern change; in 2 of the schizophrenics, a relative hypoperfusion in the frontal lobes in the images prior to injection was converted to a relative hyperperfusion. In the other 3 schizophrenics and in the patient with histrionic personality disorder, the slight left hemispheric dominance was changed to a marked right hemispheric dominance. The results indicate that haloperidol affects perfusion patterns in schizophrenics.

Topics: Acute Disease; Adult; Brain; Cerebral Cortex; Dose-Response Relationship, Drug; Female; Haloperidol; Humans; Injections, Intramuscular; Male; Organotechnetium Compounds; Oximes; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Subtraction Technique; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

The effects of the choice of the reference region in determining the relative regional cerebral blood flow (rCBF) using 99Tcm-hexamethylpropylene amine oxime (HMPAO) single photon emission tomography (SPECT) have been studied in order to establish or exclude it as a cause of inconsistencies in these studies. Relative rCBF was estimated by normalizing the regional count densities to two reference regions, the cerebellum and the whole slice, in 35 patients with Alzheimer's disease (AD), 25 patients with chronic schizophrenia (SCH) and the same number of matched normal volunteers. The statistical significance of the differences in rCBF between patients and their matched normals varied in the two sets of rCBF data. Smaller differences were highly significant while some larger differences were of less significance with whole slice normalization. The results suggest that the choice of reference region is one of the causes resulting in discrepancies in the results from various centres. The need to use a standard reference region is indicated.

Topics: Alzheimer Disease; Cerebrovascular Circulation; Chronic Disease; Female; Humans; Male; Organotechnetium Compounds; Oximes; Reference Values; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Regional cerebral blood flow (rCBF) during a word fluency task was compared in twenty-five male, right-handed, medicated schizophrenic patients and twenty-five age-matched male, right-handed healthy volunteers, using 99mtechnetium-HMPAO multidetector single-photon emission tomography. Increased rCBF in caudate and thalamus was found in patients, probably secondary to neuroleptic medication. Patients showed decreased rCBF in left frontal cortical regions and increased rCBF in left posterior cortical regions, compared to controls. Patterns of left-sided frontal rCBF dominance in controls were reversed in patients, as were normal patterns of right-sided parietal rCBF dominance. Negative symptom score correlated inversely with mesial frontal rCBF, particularly on the left.

Topics: Adult; Arousal; Attention; Brain; Brain Mapping; Chronic Disease; Dominance, Cerebral; Female; Frontal Lobe; Humans; Male; Middle Aged; Neuropsychological Tests; Organotechnetium Compounds; Oximes; Problem Solving; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Language; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Regional cerebral blood flow was evaluated using Tc99m-HMPAO SPECT in 10 medicated patients with schizophrenia and 9 healthy volunteers. There were no prefrontal regions in the patient group with lower regional indices than in the control group. However, in the left hippocampal region, relative blood flow was significantly increased in the patient group compared with the control group. Furthermore, there was a relative increase in blood flow in the left basal ganglia of the patient group. A negative correlation coefficient was calculated between the relative blood flow in the left middle prefrontal cortex and the severity of the blunted affect, as well as between the relative blood flow in the left basal ganglia and the severity of the anhedonia-asociality. These findings indicate that prefrontal hypoactivity is not invariably present in all schizophrenics and that left basal ganglial hyperactivity may be associated with the effects of antipsychotic treatment and clinical improvement. Moreover, the left hippocampal hyperactivity may correspond to left limbic dysfunction in schizophrenia.

Topics: Adult; Brain; Brain Mapping; Cerebral Cortex; Chronic Disease; Hippocampus; Humans; Male; Organotechnetium Compounds; Oximes; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Social Isolation; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

This report describes a new approach to the evaluation of neuroleptic effects on regional brain function. Using Tc-99m HMPAO SPECT imaging, consecutive brain perfusion studies before and after acute haloperidol administration were performed on three schizophrenic patients and two normal volunteers. The antipsychotic drug ameliorated the hypoactivity in the frontal lobe and suppressed the hyperactivity in the temporo-occipito-parietal lobe selectively in the dominant hemisphere in the schizophrenic patients. It did not exert a significant influence on the brain perfusion pattern in normal volunteers. This nuclear medicine technique seems to be useful for the evaluation of drug effects in psychiatric diseases.

Topics: Adult; Brain; Female; Haloperidol; Humans; Male; Organotechnetium Compounds; Oximes; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Hypofrontality (hypometabolism and hypoperfusion) has been demonstrated in patients with schizophrenia by the use of several imaging methods, such as positron emission tomography (PET). In this study, Tc-99m hexamethylpropylene amineoxime (HMPAO) and SPECT were used to investigate regional blood flow changes in 20 schizophrenic patients (12 males and 8 females, aged 15-50 years) experiencing acoustic hallucinations. Tc-99m HM-PAO (15-20 mCi) was injected intravenously, eight regions/hemisphere were drawn on transaxial sections, and tracer redistribution was calculated for each region. Frontal/occipital ratios (0.917 +/- 0.045) and frontal/whole-slice ratios (0.984 +/- 0.036) were determined for each patient. The patients had significantly lower frontal/occipital ratios (P less than 0.0005) and lower frontal/whole-slice ratios (P less than 0.01) in comparison to a normal group (11 cases).

Topics: Adolescent; Adult; Cerebrovascular Circulation; Female; Frontal Lobe; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Tc-99m hexamethylpropylene amineoxime (HMPAO) was used to image cerebral perfusion changes in 20 patients with chronic schizophrenia (19 male and 1 female, aged 22-48, at an average age of 29.0). All were being given neuroleptic drugs. Twelve had electroconvulsive therapy. In addition, all had abnormal studies except one, who was normal and had a poor response to treatment. Ventricular dilatation and cerebral atrophy was seen in eleven patients, and 77 focal lesions were detected. Forty-two lesions demonstrated increased HMPAO retention, which was distributed as follows: 26 in the basal ganglia in 14 patients (12 bilateral, 2 unilateral); 10 along the sylvian fissure in the parietotemporal region; and 3 in the frontal and 1 in each of the temporal, parietal, and occipital regions. Thirty-five focal lesions exhibited decreased perfusion: ten parietal, eight frontal, seven temporal, six cerebellar, and four occipital lobes. This study demonstrates the potential value of Tc-99m HMPAO in schizophrenia and other psychiatric disorders.

Topics: Adult; Brain; Cerebrovascular Circulation; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Schizophrenia; Technetium Tc 99m Exametazime

Topics: Cerebral Cortex; Depressive Disorder; Dominance, Cerebral; Humans; Neurocognitive Disorders; Organotechnetium Compounds; Oximes; Pilot Projects; Psychotic Disorders; Regional Blood Flow; Schizophrenia; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Cerebral blood flow was measured in relative terms with Tc99m-hexamethylpropyleneamineoxim (HMPAO) and single photon emission computed tomography (SPECT) in 28 female schizophrenic patients (20 acute and 8 chronic) classified according to DSM-III. Eleven normals served as controls. The acute patients were classified according to positive and negative symptoms. Patients with predominantly positive symptoms showed by and large normal and homogeneous cerebral isotope uptake. Those with negative symptoms, and the chronic patients, showed inhomogeneous tracer uptake with multiple regions of hypoperfusion in slices 4-6 cm above the orbitomeatal line. The findings support in principle the notion that schizophrenia with negative or chronic symptoms does not affect the whole brain homogeneously. Brain imaging with Tc99m-HMPAO and SPECT might be used to distinguish various types of schizophrenia.

Topics: Adult; Brain; Chronic Disease; Female; Humans; Middle Aged; Organotechnetium Compounds; Oximes; Psychiatric Status Rating Scales; Regional Blood Flow; Schizophrenia; Schizophrenic Psychology; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

18 psychopharmacologically treated patients (7 schizophrenics, 5 schizoaffectives, 6 depressives) were studied using 99mTc-HMPAO-SPECT of the brain. The regional cerebral blood flow was measured in three transversal sections (infra-/supraventricular, ventricular) within 6 regions of interest (ROI) respectively (one frontal, one parietal and one occipital in each hemisphere). Corresponding ROIs of the same section in each hemisphere were compared. In the schizophrenics there was a significantly reduced perfusion in the left frontal region of the infraventricular and ventricular section (p less than 0.02) compared with the data of the depressives. The schizoaffectives took an intermediate place. Since the patients were treated with psychopharmaca, the result must be interpreted cautiously. However, our findings seem to be in accordance with post-mortem-, CT- and PET-studies presented in the literature. Our results suggest that 99mTc-HMPAO-SPECT may be helpful in finding cerebral abnormalities in endogenous psychoses.

Topics: Adult; Affective Disorders, Psychotic; Brain; Cerebrovascular Circulation; Female; Humans; Male; Middle Aged; Organometallic Compounds; Oximes; Schizophrenia; Technetium; Technetium Tc 99m Exametazime; Tomography, Emission-Computed