1. Alteration of cerebral blood flow measured with SPECT in patients with first episode psychosis
Makaric, P. 1, Bosnjak, D. 1, Kekin, I. 2, Brecic, P. 1, Jelacic, P. 1, Haupert, M. 1, Perusic, D. 1, Sisek Sprem, M. 1, Đuran, N. 1, Petrovic, R. 2, Rojnic Kuzman, M. 2
1University Psychiatric Hospital Vrapče, Zagreb, Croatia
2Zagreb University Hospital Centre, Department of Psychiatry, Croatia
INTRODUCTION:
Single-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.
METHODS:
We 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, DSM V. Psychopathological status was rated by psychiatry specialist with the Positive and Negative Syndrome Scale (PANSS). After initial assessement and stabilization, SPECT was performed and interpretadet by specialist of nuclear medicine.
RESULTS:
The pilot results of the study included 40 drug- naïve FEP patients aged ± 11.9 years, of which 19 were male (47.5%), 11 were employed (27.5%), 26 were single (65%), 9 had children (22.5%), 21 had positive psychiatric heredity (52.5%), 22 were smokers (55%), only 3 (7.5%) abused alcohol, 20 (50%) never consumed drugs, while almost half of the sample tried or consumed marijuana occasionally. They were mainly high school graduates, 24 (60%) and 7 of them were students at college/ university (17.5%). The PANSS - positive was 25,38 ± 8,22, - negative 23,75 ± 7,45, - general 49,08 ± 9,96, - overall 98,20 ± 22,86 but there was no statistically significant correlation with rCBF. The most common alteration was hypoperfusion in left temporal area, which was present in 23 participants (Chart 1).
Chart 1. Alteration of cerebral blood flow in FEP
LTH - Left temporal hypoperfusion; RTH - Right temporal hypoperfusion; LOFH - Left orbitofrotal hypoperfusion; ROFH - Right orbitofrotal hypoperfusion; LFH - Left frontal hypoperfusion; RFH - Right frontal hypoperfusion; LPFH - Left prefrontal hypoperfusion; RPFH - Right prefrontal hypoperfusion; LPH - Left parietal hypoperfusion; RPH - Right parietal hypoperfusion; LOH - Left occipital hypoperfusion; ROH - Right occipital hypoperfusion.
Table 1. Differences in distribution of rCBF between those who had positive psychiatric heredity and those who did not
LOF
ROF
LPF
RPF LO RO
YES NO χ2
HEREDITY 12 9
3,879 10 11
6,535
4,177
5,230 8 13
6,166
7,519 5 14 2 17 4 15 1 18
p<0.05
CONCLUSION:
The results of our pilot study showed that alterations in blood flow of various brain regions (LT, RT, LOF, ROF, LF, RF, LPF, RPF, LP, RP, LO, RO) are present at the acute phase of illness, during the first episode of psychosis. Also, we found statistically significant differences in distributions of rCBF depending on patients psychiatric heredity.
Contacts:
This work was funded by the grant of the Croatian Science Foundation No UIP‐2014‐09‐1245 Biomarkers in schizophrenia – integration of complementary methods in longitudinal follow up of first episode psychosis patients