Familial liability to psychosis is associated with attenuated dopamine stress signaling in ventromedial prefrontal cortex.
OBJECTIVE
Patients diagnosed with a psychotic disorder and their first-degree relatives display increased reactivity to stress. Theory predicts that experience of psychosocial stress is associated both with ventromedial prefrontal and mesolimbic dopamine neurotransmission. However, while there is evidence of aberrant striatal dopamine processing in psychotic disorder, the role of the prefrontal cortex remains under-researched. This study aimed at investigating stress-induced in vivo dopamine release in ventromedial prefrontal cortex (vmPFC) of individuals at familial risk for psychosis.


METHODS
Fourteen healthy first-degree relatives of patients with a diagnosis of psychotic disorder and 10 control subjects underwent a single dynamic positron emission tomography (PET) scanning session after intravenous administration of 183.2 (SD = 7.6) MBq [(18)F]fallypride. Psychosocial stress was initiated at 100 min postinjection using a computerized mental arithmetic task with social evaluative threat components. PET data were analyzed using the linearized simplified reference region model. Regression analyses were performed to compare the spatial extent of task-related ligand displacement between control subjects and relatives and to find how it related to self-rated experiences of psychosocial stress and psychosis.


RESULTS
First-degree relatives displayed hyporeactive dopamine signaling in the vmPFC in response to stress. Increased levels of subjectively rated stress were associated with increased intensity of psychotic experiences. This effect was particularly pronounced in first-degree relatives.


CONCLUSIONS
Although previous studies have hypothesized a role for prefrontal dopamine dysfunction in psychosis, this study, to our knowledge, is the first in vivo human imaging study showing attenuated (ie, hyporeactive) dopamine stress neuromodulation in vmPFC of individuals at familial risk for psychosis.
To whom correspondence should be addressed; Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200MD, Maastricht, the Netherlands; tel: +31 43 388 39 28, fax: +31433884122, e-mail: i.germeys@maastrichtuniversity.nl.
Johan
J
Lataster
Dina
D
Collip
Jenny
J
Ceccarini
Dennis
D
Hernaus
David
D
Haas
Linda
L
Booij
Jim
J
van Os
Jens
J
Pruessner
Koen
K
Van Laere
Inez
I
Myin-Germeys
D000328:Adult; D001549:Benzamides; D004298:Dopamine / Q000378:metabolism*; D005260:Female; D005462:Fluorine Radioisotopes; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods; D017397:Prefrontal Cortex / Q000378:metabolism / Q000503:physiopathology*; D011618:Psychotic Disorders / Q000235:genetics / Q000503:physiopathology*; D015398:Signal Transduction / Q000502:physiology*; D013315:Stress, Psychological / Q000378:metabolism / Q000503:physiopathology*; D055815:Young Adult
D001549:Benzamides; D005462:Fluorine Radioisotopes; C574003:fallypride; D004298:Dopamine
mesolimbic; neuromodulation; positron emission tomography; relatives; salience; schizophrenia