항정신병약물 비노출과 비투여 정신분열증 환자의 99m-Tc-ECD SPECT로 측정한 상대적 뇌혈류량 차이

Abstract

Objectives: In schizophrenics, regional cerebral blood flow(rCBF) are affected by various confounding variables, i.e., age, sex, duration of illness, and clinical status. The pharmacological condition of patients is also a particular important variable to be taken into consideration. However, few data are available regarding the differences between the relative rCBF findings in drug-free and drug-naive schizophrenic patients. Currently, numerous studies have included drug-free and drug-naive schizophrenic patients in the same ’unmedicated’ group under the assumption that the rCBF is identical between drug-free and drug-naive cases. Therefore, the aim of this study was to compare the rCBF between a group of drug-free schizophrenic patients and a group of drug-naive schizophrenic patients about the effects of age, sex, duration of illness, and clinical status(positive and negative symptoms) under control.

Methods: Eighteen drug-naive schizophrenics and fifteen drug-free schizophrenics were in-cluded in the study. Regional cerebral blood flow was studied with the single-photon emission computed tomography(SPECT) under resting state. Symptoms were assessed with Positive and Negative Syndrome Scale(PANSS). Regions of interest were both inferior temporal lobe, inferior frontal lobe, superior temporal lobe, thalamus, basal ganglia, parieto-occipital lobe, superior frontal lobe, and parietal lobe.

Results: No significant differences of relative rCBF were found between drug-free and drug-naive schizophrenic patients in left inferior temporal lobe, right inferior frontal lobe, both superior temporal lobe, both thalamus, both basal ganglia, right parieto-occipital lobe, and both superior frontal lobe. But, drug-free schizophrenic patients had a significant increase of perfusion in the right inferior temporal lobe and left inferior frontal lobe and a significant decrease of perfusion in both parietal lobes and left parieto-occipital lobe.

Conclusion: Relative rCBF in drug-free schizophrenic patients is different from that in drug-naive schizophrenic patients. So, in the relative rCBF studies of schizophrenic patients, it must be considered whether the patients were previously medicated or not.