title: FDG-PET scans in patients with Kraepelinian and non-Kraepelinian schizophrenia.
abstract: We recruited 14 unmedicated patients with Kraepelinian schizophrenia (12 men and 2 women; mean age = 47 years old), 27 non-Kraepelinian patients (21 men and 6 women; mean age = 36.4 years old) and a group of 56 age- and sex-matched healthy volunteers. FDG positron emission tomography and MRI scans were coregistered for both voxel-by-voxel statistical mapping and stereotaxic regions of interest analysis. While both Kraepelinian and non-Kraepelinian patients showed equally lower uptake than healthy volunteers in the frontal lobe, the temporal lobes (Brodmann areas 20 and 21) showed significantly greater decreases in Kraepelinian than in non-Kraepelinian patients. Kraepelinian patients had lower FDG uptake in parietal regions 39 and 40, especially in the right hemisphere, while non-Kraepelinian patients had similar reductions in the left. Only non-Kraepelinian patients had lower caudate FDG uptake than healthy volunteers. While both patient groups had lower uptake than healthy volunteers in the medial dorsal nucleus of the thalamus, Kraepelinian patients alone had higher uptake in the ventral nuclei of the thalamus. Kraepelinian patients also showed higher metabolic rates in white matter. Our results are consistent with other studies indicating that Kraepelinian schizophrenia is a subgroup of schizophrenia, characterized by temporal and right parietal deficits and normal rather than reduced caudate uptake. It suggests that Kraepelinian schizophrenia may be more primarily characterized by FDG uptake decreased in both the frontal and temporal lobes, while non-Kraepelinian schizophrenia may have deficits more limited to the frontal lobe. This is consistent with some neuropsychological and prognosis reports of disordered sensory information processing in Kraepelinian schizophrenia in addition to deficits in frontal lobe executive functions shared with the non-Kraepelinian subtype.
authors.affiliation: Crisalid Unit (FJ5), CHI Clermont de l'Oise, 2 rue des finets, 60607, Clermont, France.|Inserm Unit U669, Maison de Solenn, Universities Paris 5-11, 75014, Paris, France.|GDR 3557 Recherche Psychiatrie, Paris, France.
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Bralet
authors.affiliation: Departments of Psychiatry and Radiology, University of California, San Diego, 11388 Sorrento Valley Road, San Diego, CA, USA. monte.buchsbaum@gmail.com.
authors.forename: Monte S
authors.initials: MS
authors.lastname: Buchsbaum
authors.affiliation: Department of Psychiatry, University of California, San Diego, 11388 Sorrento Valley Road, San Diego, CA, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: DeCastro
authors.affiliation: Mount Sinai School of Medicine, New York, NY, 10029, USA.
authors.forename: Lina
authors.initials: L
authors.lastname: Shihabuddin
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|Department of Psychiatry, Elmhurst Hospital Center, 79-01 Broadway, Elmhurst, NY, 11373, USA.
authors.forename: Serge A
authors.initials: SA
authors.lastname: Mitelman
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D016022:Case-Control Studies; D002389:Catatonia / Q000150:complications* / Q000000981:diagnostic imaging*; D003704:Dementia / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D012559:Schizophrenia / Q000150:complications* / Q000000981:diagnostic imaging*; D012691:Serial Learning / Q000502:physiology
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: 18F-deoxyglucose; Kraepelinian schizophrenia; Poor outcome; Posteriorization; Sensory information processing; White matter