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CT morphology and outcome in schizophrenia
204
13 normal volunteers and 20 ICD-9 schizophrenic patients (IO with medication and 10 without medication) were examine for regional cerebral bloodflow (rCBF) during 4 conditions; 1) resting state, 2) reflexive saccade task, 3) volitional saccade task, 4) memory-guided saccade task. O-l.5 water-PET (haKlife=123sec, resolution =8 mm) was used. Frontal eye field (FEF), Primary visual cortex (PVC), Dorsolateral prefrontal cortex (DLPFC) and Posterior Parietal cortex (PPC) were analyzed. Absolute rCBF values of each regions during 4 conditions were normalized and then compared. Normal volunteer study revealed left DLPFC activation during volitional saccade task, which suggests left DLPFC played a role in performing visually-guided saccade while ignoring distractible stimuli. Schizophrenia study revealed that left DLPFC activation was lacked during volitional saccade. Accuracy of saccade performance was approximately 100% in every trial, so it might be due to the pathophysiology of the disease rather than poor performance of subject.
PET STUDY USING TASK-EVOKED rCBF PARADIGM. II. COUPLING OF FLOW AND METABOLISM Y. Nakashima*, T. Momose, I. Sano, S. Katayama, T. Nakajima, M. Matsushita. Department of Neuropsychiatry and Department University of Tokyo, Tokyo 113, Japan
of Radiology,
7 normal volunteers and 7 schizophrenic patients were examined for regional cerebral bloodflow (rCBF) during resting state and during free saccade task by O-15 water-PET scans followed by F-18 FDG scan for cerebral metabolic rate for glucose (CMRGlc) either during resting state or during free saccade task. In resting state, cerebellum showed higher flow than glucose metabolism. On the other hand, areas like inferior frontal cortex showed higher glucose metabolism than flow. In task condition, activated areas like frontal eye field and primary visual cortex showed larger increase in flow than in metabolism. Normal and schizophrenic groups did not differ in flow and metabolism relationship. So it may be reasonable to compare both groups by applying task-evoked rCBF paradigm.
INCREASED CAUDATE VOLUME IN SCHIZOPHRENIA: A CONTROLLED MRI STUDY H.A. Nasrallah*, 0. Chu, S.C. Olson, R. Martin Department of Psychiatry, OH 43210, USA
The Ohio State University, Columbus,
Several cortical and subcortical abnormalities have been described in schizophrenia on magnetic resonance imaging (MRI) brain scans. Basal ganglia findings in schizophrenia have included
increases in pallidal, striatal and lenticular volumes, although some studies found no differences. Here, we present a controlled MRI study that shows an increase in the volume of the caudate nucleus in schizophrenia. Coronal MRI scans, 5 mm thick, were obtained on 40 consenting DSMIII-R schizophrenic patients (mean age 32.4f6.05) and 26 healthy volunteers (mean age 30.3k7.92) using a GE 1.5 Tesla scanner, using TI = 800 ms and TR = 1500 ms. The right and left caudate nucleus volumes were measured using a sun-pixar image analysis system program. The data was statistically analyzed using the cerebral hemisphere volume(s) and age as covariates. Schizophrenic patients had a significantly larger mean right caudate volume (4.63M.37) compared to controls (4.32ti.35) (ANCOVA F=4.37, P=O.O41). There was also a strong trend for a diagnosis by gender effect (p=O.O65) on the left caudate. The data are of interest in light of the role of the caudate in neuropsychiatric disorders such as Huntington’s Disease, obsessivecompulsive disorder and major depression. The caudate nucleus is connected to several cortical and limbic brain areas and plays an important role in functions that are disrupted in schizophrenia such as complex social behaviour, problem solving and initiation of action. The implications and “meaning” of an enlarged caudate nucleus will be discussed in the context of basal ganglia dysfunction in schizophrenia.
CT MORPHOLOGY SCHIZOPHRENIA
AND OUTCOME
IN
Philip T. Ninan*, Kashinath Yadalam, John Sweeney, Jeffrey Lieberman, Marc Jacobs, Joanne Severe Department of Psychiatry, 30322. USA
The Emory Clinic, Atlanta, GA
The relationship between CT morphology and schizophrenia treatment outcome is explored in this preliminary report of a large multicentre study of schizophrenia. The parent study prospectively evaluates the effectiveness of randomly assigned double-blind two year treatment with standard dose, low dose and intermittent dose strategies of fluphenazine decanoate as the medication component of the study. The patients and their families of origin are also randomly assigned to applied or supportive family management strategies. The aim of the parent study is to evaluate these different treatment strategies and explore the interaction of the pharmacological and family management conditions. This report examines the impact of CT morphology on differential treatment outcome in schizophrenia. Two hundred and thirteen patients had head CT scans which were assessed for lateral ventricular brain ratio and third ventricular width in a semi-automated computerized method. Scans were read twice and averaged. The repeat reliability for VBRs was 0.99 (p
13 normal volunteers and 20 ICD-9 schizophrenic patients (IO with medication and 10 without medication) were examine for regional cerebral bloodflow (rCBF) during 4 conditions; 1) resting state, 2) reflexive saccade task, 3) volitional saccade task, 4) memory-guided saccade task. O-l.5 water-PET (haKlife=123sec, resolution =8 mm) was used. Frontal eye field (FEF), Primary visual cortex (PVC), Dorsolateral prefrontal cortex (DLPFC) and Posterior Parietal cortex (PPC) were analyzed. Absolute rCBF values of each regions during 4 conditions were normalized and then compared. Normal volunteer study revealed left DLPFC activation during volitional saccade task, which suggests left DLPFC played a role in performing visually-guided saccade while ignoring distractible stimuli. Schizophrenia study revealed that left DLPFC activation was lacked during volitional saccade. Accuracy of saccade performance was approximately 100% in every trial, so it might be due to the pathophysiology of the disease rather than poor performance of subject.
PET STUDY USING TASK-EVOKED rCBF PARADIGM. II. COUPLING OF FLOW AND METABOLISM Y. Nakashima*, T. Momose, I. Sano, S. Katayama, T. Nakajima, M. Matsushita. Department of Neuropsychiatry and Department University of Tokyo, Tokyo 113, Japan
of Radiology,
7 normal volunteers and 7 schizophrenic patients were examined for regional cerebral bloodflow (rCBF) during resting state and during free saccade task by O-15 water-PET scans followed by F-18 FDG scan for cerebral metabolic rate for glucose (CMRGlc) either during resting state or during free saccade task. In resting state, cerebellum showed higher flow than glucose metabolism. On the other hand, areas like inferior frontal cortex showed higher glucose metabolism than flow. In task condition, activated areas like frontal eye field and primary visual cortex showed larger increase in flow than in metabolism. Normal and schizophrenic groups did not differ in flow and metabolism relationship. So it may be reasonable to compare both groups by applying task-evoked rCBF paradigm.
INCREASED CAUDATE VOLUME IN SCHIZOPHRENIA: A CONTROLLED MRI STUDY H.A. Nasrallah*, 0. Chu, S.C. Olson, R. Martin Department of Psychiatry, OH 43210, USA
The Ohio State University, Columbus,
Several cortical and subcortical abnormalities have been described in schizophrenia on magnetic resonance imaging (MRI) brain scans. Basal ganglia findings in schizophrenia have included
increases in pallidal, striatal and lenticular volumes, although some studies found no differences. Here, we present a controlled MRI study that shows an increase in the volume of the caudate nucleus in schizophrenia. Coronal MRI scans, 5 mm thick, were obtained on 40 consenting DSMIII-R schizophrenic patients (mean age 32.4f6.05) and 26 healthy volunteers (mean age 30.3k7.92) using a GE 1.5 Tesla scanner, using TI = 800 ms and TR = 1500 ms. The right and left caudate nucleus volumes were measured using a sun-pixar image analysis system program. The data was statistically analyzed using the cerebral hemisphere volume(s) and age as covariates. Schizophrenic patients had a significantly larger mean right caudate volume (4.63M.37) compared to controls (4.32ti.35) (ANCOVA F=4.37, P=O.O41). There was also a strong trend for a diagnosis by gender effect (p=O.O65) on the left caudate. The data are of interest in light of the role of the caudate in neuropsychiatric disorders such as Huntington’s Disease, obsessivecompulsive disorder and major depression. The caudate nucleus is connected to several cortical and limbic brain areas and plays an important role in functions that are disrupted in schizophrenia such as complex social behaviour, problem solving and initiation of action. The implications and “meaning” of an enlarged caudate nucleus will be discussed in the context of basal ganglia dysfunction in schizophrenia.
CT MORPHOLOGY SCHIZOPHRENIA
AND OUTCOME
IN
Philip T. Ninan*, Kashinath Yadalam, John Sweeney, Jeffrey Lieberman, Marc Jacobs, Joanne Severe Department of Psychiatry, 30322. USA
The Emory Clinic, Atlanta, GA
The relationship between CT morphology and schizophrenia treatment outcome is explored in this preliminary report of a large multicentre study of schizophrenia. The parent study prospectively evaluates the effectiveness of randomly assigned double-blind two year treatment with standard dose, low dose and intermittent dose strategies of fluphenazine decanoate as the medication component of the study. The patients and their families of origin are also randomly assigned to applied or supportive family management strategies. The aim of the parent study is to evaluate these different treatment strategies and explore the interaction of the pharmacological and family management conditions. This report examines the impact of CT morphology on differential treatment outcome in schizophrenia. Two hundred and thirteen patients had head CT scans which were assessed for lateral ventricular brain ratio and third ventricular width in a semi-automated computerized method. Scans were read twice and averaged. The repeat reliability for VBRs was 0.99 (p