title: Does hypofrontality expand to global brain area in progression of schizophrenia?: a cross-sectional study between first-episode and chronic schizophrenia.
abstract: Although to date there have been no conclusive pathophysiological findings in support of the degenerative theory of the etiology of schizophrenia, the results of neuroimaging studies have suggested that progressive changes in the brain do occur during the clinical course of schizophrenia. However, there has been no report on alterations in regional cerebral blood flow (rCBF) under resting condition, which was compared between the first-episode and the chronic patients of schizophrenia and healthy controls. Therefore, in this study, we applied three-dimensional stereotactic surface projection analysis of resting SPECT (3D-SSP SPECT) in patients with first-episode (n=18) and chronic schizophrenia (n=23) and age-/sex-matched healthy controls (n=40). The rCBFs in the middle/inferior/medial frontal gyrus and the anterior cingulate gyrus were significantly decreased in both patient groups, relative to the respective controls (Z>3.0, P<0.001, uncorrected). The chronic group showed significant hypoperfused region in the left inferior parietal lobule and middle/inferior temporal gyrus. Furthermore, within-cases comparison between the first-episode and chronic schizophrenia, revealed that the significant hypoperfused regions in the chronic group, compared to the first-episode group, were not only the lateral and medial prefrontal cortex, but also the inferior parietal cortex, posterior part of the temporal lobe, and the cuneus. The present study suggested that the reduction in rCBF occurs in the posterior brain area in addition to the frontal lobe across all clinical stages of schizophrenia.
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Kanahara
authors.forename: Eiji
authors.initials: E
authors.lastname: Shimizu
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Sekine
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Uchida
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shibuya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Takuya
authors.initials: T
authors.lastname: Asaka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Miyatake
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ohkami
authors.forename: Goro
authors.initials: G
authors.lastname: Fukami
authors.forename: Mihisa
authors.initials: M
authors.lastname: Fujisaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Shirayama
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Asano
authors.forename: Masaomi
authors.initials: M
authors.lastname: Iyo
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D055815:Young Adult