Alteration of Cerebral Blood Flow Measured with SPECT in Patients with First Episode Psychosis

Abstract

IntroductionSingle-photon emission computed tomography (SPECT) is a valid method for measuring regional cerebral blood flow (rCBF). Recent studies regarding rCBF in patients with first episode psychosis (FEP) reported heterogeneous results, but were limited with small sample size. Neuroimaging can help us in setting the diagnosis of illness, as well as in following the progress and finding more effective treatment for psychotic disorders.ObjectivesTo compare, baseline alterations of the rCBF using SPECT with psychopathological status in FEP during acute phase.AimsTo investigate the changes of rCBF in patients with FEP during acute phase.MethodsWe conducted a study on 40 drug – naïve patients with FEP at acute phase of illness during their hospitalization at Zagreb University hospital centre. The diagnosis was confirmed using diagnostic and statistical manual of mental disorders, fifth edition. rCBF was measured with SPECT and psychopathological status rated with the Positive and Negative Syndrome Scale.ResultsOur findings showed moderate to severe parieto-temporal perfusion deficits, mild to moderate parieto-fronto-temporal perfusion deficits or borderline perfusion deficits in all but one patient.ConclusionOur results showed alteration in rCBF at the beginning of the illness that indicate a biological market of psychotic disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Reduced cortical cerebral blood flow in antipsychotic-free first-episode psychosis and relationship to treatment response

“…functional magnetic resonance imaging (fMRI)] and recently with ASL (Hill et al, 2004 ; Kindler et al, 2015 ). Interestingly previous studies using PET and SPECT in unmedicated FEP revealed reduced cortical perfusion and metabolism (Brewer et al, 2007 ; Makarić et al, 2017 ; Molina et al, 2005 ). Our results corroborate and extend this evidence by showing the existence of lower frontal cortical absolute perfusion in FEP without the potential confound of antipsychotic treatment using MRI.…”

“…The effect of antipsychotics on cortical perfusion is even less understood. Studies using PET and single photon emission computed tomography (SPECT) found consistently reduced perfusion and metabolism in the frontal cortex in both medicated and unmedicated patients with SCZ (Makarić et al, 2017 ; Molina et al, 2005 ). Viviani et al ( 2013 ) found decreased cortical perfusion after amisulpride administration in healthy volunteers.…”