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Striatal Size and Relative Glucose Metabolic Rate in Schizotypal Personality Disorder and Schizophrenia
Lina Shihabuddin, MD;
Monte S. Buchsbaum, MD;
Erin A. Hazlett, PhD;
Jeremy Silverman, PhD;
Antonia New, MD;
Adam M. Brickman;
Vivian Mitropoulou, MA;
Melissa Nunn;
Michael B. Fleischman;
Cheuk Tang, PhD;
Larry J. Siever, MD
Arch Gen Psychiatry. 2001;58:877-884.
Background Schizotypal personality disorder (SPD) shares social deficits and cognitive
impairment with schizophrenia, but is not typically characterized by frank
psychosis. Because striatal size and functional activity have both been shown
to be associated with psychotic symptoms, we carried out the first study of
SPD to assess the caudate and putamen for comparison with findings in schizophrenia.
Methods Patients with SPD (n = 16), schizophrenic patients (n = 42), and age-
and sex-matched normal control subjects (n = 47) were assessed with magnetic
resonance imaging. All of the patients with SPD and subsamples of the schizophrenic
patients (n = 27) and control subjects (n = 32) were also assessed with positron
emission tomography using fluorodeoxyglucose F-18.
Results The relative size of the putamen in controls was significantly larger
than in patients with SPD and significantly smaller than in schizophrenic
patients, while the relative size of the caudate was similar in all 3 groups.
Compared with control values, relative glucose metabolic rate in the ventral
putamen was significantly elevated in patients with SPD and reduced in schizophrenic
patients. When subsamples of schizophrenic patients (n = 10) and patients
with SPD (n = 10) both of whom never received medication were compared, this
pattern was more marked, with the highest value for the putamen being found
in patients with SPD for the ventral slice and the lowest value for the right
dorsal putamen.
Conclusions Patients with SPD showed reduced volume and elevated relative glucose
metabolic rate of the putamen compared with both schizophrenic patients and
controls. These alterations in volume and activity may be related to the sparing
of patients with SPD from frank psychosis.
From the Psychiatry Service, Bronx Veterans Affairs Medical Center,
Bronx, NY (Drs Shihabuddin, Silverman, New, and Siever, Mr Brickman, and Mss
Mitroupoulou and Nunn); and the Department of Psychiatry, Mount Sinai School
of Medicine, New York, NY (Drs Shihabuddin, Buchsbaum, Hazlett, Silverman,
New, Tang, and Siever, and Messrs Brickman and Fleischman).
Reprints: Lina Shihabuddin, MD, Bronx Veterans Affairs Medical Center,
Mental Health Patient Care Center, 130 W Kingsbridge Rd, Bronx, NY 10468 (e-mail: Lina.Shihabuddin{at}med.va.gov).
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