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Decreased Dopamine D2 Receptor Binding in the Anterior Cingulate Cortex in Schizophrenia
Tetsuya Suhara, MD, PhD;
Yoshiro Okubo, MD, PhD;
Fumihiko Yasuno, MD, PhD;
Yasuhiko Sudo, MD, PhD;
Makoto Inoue, MD;
Tetsuya Ichimiya, MD;
Yoshifumi Nakashima, MD, PhD;
Kazuhiko Nakayama, MD, PhD;
Shuji Tanada, MD, PhD;
Kazutoshi Suzuki, PhD;
Christer Halldin, PhD;
Lars Farde, MD, PhD
Arch Gen Psychiatry. 2002;59:25-30.
Background The clinical efficacy of dopamine D2 receptor antagonism
on the psychotic symptoms of schizophrenia has been widely demonstrated. However,
most in vivo imaging studies have not been able to detect significant changes
in striatal D2 receptors in schizophrenia. On the other hand, a
number of studies have reported abnormalities in the cerebral cortex of schizophrenia.
The aim of this study was to examine the extrastriatal D2 receptors
of patients with schizophrenia.
Methods Eleven drug-naive male patients with schizophrenia were examined with
positron emission tomography using carbon 11–labeled FLB 457. Symptoms
were assessed using the Brief Psychiatric Rating Scale. Eighteen healthy controls
were used for comparison. Region-of-interest analysis was performed using
the reference tissue method, and binding potential (BP) was used for the index
of dopamine D2 receptor binding.
Results The BP value was significantly lower, by about 12.5%, in the anterior
cingulate cortex in drug-naive patients with schizophrenia than in healthy
controls. A significant negative correlation was observed between BP in the
anterior cingulate cortex and the positive symptom score on Brief Psychiatric
Rating Scale.
Conclusions The lower BP values indicate fewer D2 receptors in the anterior
cingulate cortex in patients with schizophrenia. Alterations in D2
receptor function in the extrastriatal region may underlie the positive symptoms
of schizophrenia.
From the Division of Advanced Technology for Medical Imaging, National
Institute of Radiological Sciences, Chiba, Japan (Drs Suhara, Okubo, Yasuno,
Sudo, Inoue, Ichimiya, Nakashima, Tanada, and Suzuki); CREST, Japan Science
and Technology Corporation, Saitama, Japan (Drs Suhara, Okubo, Yasuno, Sudo,
Inoue, Ichimiya, Nakashima, Tanada, and Suzuki); Clinical Physiology, Faculty
of Medicine, Tokyo Medical and Dental University, Tokyo, Japan (Dr Okubo);
Department of Psychiatry, Jikei University School of Medicine, Tokyo (Dr Nakayama);
and Psychiatry Section, Department of Clinical Neuroscience, Karolinska Institute,
Stockholm, Sweden (Drs Halldin and Farde).
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