항정신병 약물 비복용 정신분열증 환자의 99m-Tc-ECD SPECT로 측정한 국소뇌혈류량과 증상과의 관계

Abstract

Symptom profiles in schizophrenia consists of positive and negative symptom dimensions which are considered to be related to different underlying pathophysiologies and neural substrates. The purpose of the study was to identify the possible relationship between relative regional cerebral perfusion and positive and negative symptom dimension in unmedicated patients with schizophrenia. Twenty-seven unmedicated patients with schizophrenia(13 patients who were antipsychotic drugnaive and 14 patients who had been drug-free for at least 1 week) were included in the study. Regional cerebral perfusion was studied with the single-photon emission computed tomography(SPECT). Symptom dimensions were assessed with positive and negative syndrome scale(PANSS). The scores of each symptom dimension were correlated with regional cerebral perfusion. The results were 1) positive symptom dimension score was significantly related to decreased perfusion in the medial temporal lobe and increased perfusion in the frontal lobe, 2) negative symptom dimension score was significantly related to decreased perfusion in the basal ganglia, thalamus and increased perfusion in the frontal lobe. These results suggest that positive symptom dimension is associated with the dysfunction of the link between the frontal lobe and the medial temporal lobe and that negative symptom dimension is related with the impairment of frontal-basal ganglia circuit.