title: Assessment of cerebral blood volume in schizophrenia: A magnetic resonance imaging study.
abstract: Brain atrophy has consistently been observed in schizophrenia, representing a 'gross' evidence of anatomical abnormalities. Reduced cerebral blood volume (CBV) may accompany brain size decrement in schizophrenia, as suggested by prior small SPECT studies. In this study, we non-invasively investigated the hemisphere CBV in a large sample of patients suffering from schizophrenia with perfusion-weighted imaging (PWI). PWI images were obtained, following intravenous injection of paramagnetic contrast agent (Gadolinium-DTPA), for 54 DSM-IV patients with schizophrenia (mean age+/-SD=39.19+/-12.20 years; 34 males, 20 females) and 24 normal controls (mean age+/-SD=44.63+/-10.43 years; 9 males, 15 females) with a 1.5T Siemens magnet using an echo-planar sequence (TR=2160 ms, TE=47 ms, slice thickness=5mm). The contrast of enhancement (CE), a semi-quantitative parameter inversely estimating the CBV, were calculated pixel by pixel as the ratio of the maximum signal intensity drop during the passage of contrast agent (Sm) by the baseline pre-bolus signal intensity (So) (CE=Sm/Sox100) for right and left hemisphere on two axial images. Specifically, higher CE values correspond to lower CBV and viceversa Compared to normal controls, patients with schizophrenia had significantly higher bilateral hemisphere CE values (p=0.02) and inverse CE laterality index (p=0.02). This study showed abnormally reduced and inverse hemisphere CBV in a large population of patients with schizophrenia. Hypothetically, chronic low CBV may sustain neural hypoactivation and concomitant increase of free radicals, ultimately resulting in neuronal loss and cognitive impairments. Thus, altered intracranial hemodynamics may accompany brain atrophy and cognitive deficits, being a crucial factor in the pathophysiology of schizophrenia.
authors.affiliation: Department of Pathology and Experimental and Clinical Medicine, Section of Psychiatry, University of Udine, Udine, Italy. paolo.brambilla@uniud.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Brambilla
authors.forename: Roberto
authors.initials: R
authors.lastname: Cerini
authors.forename: Paolo F
authors.initials: PF
authors.lastname: Fabene
authors.forename: Nicola
authors.initials: N
authors.lastname: Andreone
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rambaldelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Farace
authors.forename: Amelia
authors.initials: A
authors.lastname: Versace
authors.forename: Cinzia
authors.initials: C
authors.lastname: Perlini
authors.forename: Luisa
authors.initials: L
authors.lastname: Pelizza
authors.forename: Anna
authors.initials: A
authors.lastname: Gasparini
authors.forename: Rachele
authors.initials: R
authors.lastname: Gatti
authors.forename: Marcella
authors.initials: M
authors.lastname: Bellani
authors.forename: Nicola
authors.initials: N
authors.lastname: Dusi
authors.forename: Corrado
authors.initials: C
authors.lastname: Barbui
authors.forename: Michela
authors.initials: M
authors.lastname: Nosè
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Tournikioti
authors.forename: Andrea
authors.initials: A
authors.lastname: Sbarbati
authors.forename: Michele
authors.initials: M
authors.lastname: Tansella
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000033:anatomy & histology / Q000098:blood supply / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003287:Contrast Media; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology*; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA