Abstract
Schizophrenia is a severe mental illness diagnosed on the basis of particular symptoms and characterised by a fluctuating time course. Its pathophysiology is incompletely understood and this has hampered the development of new drug treatments. It has proven challenging to produce convincing animal models of the illness, which has also limited the development of new treatments. These two factors highlight the value of PET and SPECT imaging for research in the disorder in providing in vivo measures of brain function and relating this to clinical features and outcome. PET imaging can be applied to study regional variation in neural activity at rest or during performance of cognitive tasks that are impaired in schizophrenia. A major application of PET imaging in schizophrenia is the use of neuroreceptor measures. Several methodological factors warrant particular consideration in PET studies of schizophrenia. In particular, the role of partial volume effects, movement and the clinical heterogeneity of the disorder. Whilst it is not always possible to avoid these effects, there are approaches to minimising their effects, such as partial volume and movement correction. There are also a number of common potential confounding factors that warrant consideration—in particular the effect of current and prior exposure to medications and other psychoactive drugs.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
van Os J, Kapur S (2009) Schizophrenia. Lancet 374:635–645
Rossler W, Salize HJ, van Os J, Riecher-Rossler A (2005) Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 15:399–409
Lewis DA, Gonzalez-Burgos G (2006) Pathophysiologically based treatment interventions in schizophrenia. Nat Med 12:1016–1022
Howes OD, Egerton A, Allan V, McGuire P, Stokes P, Kapur S (2009) Mechanisms underlying psychosis and antipsychotic treatment response in schizophrenia: insights from PET and SPECT imaging. Curr Pharm Des 15:2550–2559
Howes OD, McDonald C, Cannon M, Arseneault L, Boydell J, Murray RM (2004) Pathways to schizophrenia: the impact of environmental factors. Int J Neuropsychopharmacol 7(Suppl 1):S7–S13
Andreasen NC, O’Leary DS, Flaum M, Nopoulos P, Watkins GL, Boles Ponto LL, Hichwa RD (1997) Hypofrontality in schizophrenia: distributed dysfunctional circuits in neuroleptic-naive patients. Lancet 349:1730–1734
Hazlett EA, Buchsbaum MS (2001) Sensorimotor gating deficits and hypofrontality in schizophrenia. Front Biosci 6:D1069–D1072
Hazlett EA, Buchsbaum MS, Jeu LA, Nenadic I, Fleischman MB, Shihabuddin L, Haznedar MM, Harvey PD (2000) Hypofrontality in unmedicated schizophrenia patients studied with PET during performance of a serial verbal learning task. Schizophr Res 43:33–46
Parsey RV, Mann JJ (2003) Applications of positron emission tomography in psychiatry. Semin Nucl Med 33:129–135
Mannell MV, Franco AR, Calhoun VD, Canive JM, Thoma RJ, Mayer AR (2010) Resting state and task-induced deactivation: a methodological comparison in patients with schizophrenia and healthy controls. Hum Brain Mapp 31:424–437
Heinrichs RW, Zakzanis KK (1998) Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12:426–445
Desco M, Gispert JD, Reig S, Sanz J, Pascau J, Sarramea F, Benito C, Santos A, Palomo T, Molina V (2003) Cerebral metabolic patterns in chronic and recent-onset schizophrenia. Psychiatry Res 122:125–135
Molina V, Gispert JD, Reig S, Sanz J, Pascau J, Santos A, Desco M, Palomo T (2005) Cerebral metabolic changes induced by clozapine in schizophrenia and related to clinical improvement. Psychopharmacology (Berl) 178:17–26
Howes OD, Montgomery AJ, Asselin MC, Murray RM, Grasby PM, McGuire PK (2007) Molecular imaging studies of the striatal dopaminergic system in psychosis and predictions for the prodromal phase of psychosis. Br J Psychiatry Suppl 51:s13–s18
Kumakura Y, Cumming P (2009) PET studies of cerebral levodopa metabolism: a review of clinical findings and modeling approaches. Neuroscientist 15:635–650
Kumakura Y, Cumming P, Vernaleken I, Buchholz HG, Siessmeier T, Heinz A, Kienast T, Bartenstein P, Grunder G (2007) Elevated [18F]fluorodopamine turnover in brain of patients with schizophrenia: an [18F]fluorodopa/positron emission tomography study. J Neurosci 27:8080–8087
Egerton A, Mehta MA, Montgomery AJ, Lappin JM, Howes OD, Reeves SJ, Cunningham VJ, Grasby PM (2009) The dopaminergic basis of human behaviors: a review of molecular imaging studies. Neurosci Biobehav Rev 33:1109–1132
Laruelle M (2000) Imaging synaptic neurotransmission with in vivo binding competition techniques: a critical review. J Cereb Blood Flow Metab 20:423–451
Breier A, Su TP, Saunders R, Carson RE, Kolachana BS, de Bartolomeis A, Weinberger DR, Weisenfeld N, Malhotra AK, Eckelman WC, Pickar D (1997) Schizophrenia is associated with elevated amphetamine-induced synaptic dopamine concentrations: evidence from a novel positron emission tomography method. Proc Natl Acad Sci USA 94:2569–2574
Laruelle M, Abi-Dargham A (1999) Dopamine as the wind of the psychotic fire: new evidence from brain imaging studies. J Psychopharmacol 13:358–371
Abi-Dargham A, Gil R, Krystal J, Baldwin RM, Seibyl JP, Bowers M, van Dyck CH, Charney DS, Innis RB, Laruelle M (1998) Increased striatal dopamine transmission in schizophrenia: confirmation in a second cohort. Am J Psychiatry 155:761–767
Laruelle M, Abi-Dargham A, Gil R, Kegeles L, Innis R (1999) Increased dopamine transmission in schizophrenia: relationship to illness phases. Biol Psychiatry 46:56–72
Abi-Dargham A, Rodenhiser J, Printz D, Zea-Ponce Y, Gil R, Kegeles LS, Weiss R, Cooper TB, Mann JJ, Van Heertum RL, Gorman JM, Laruelle M (2000) Increased baseline occupancy of D2 receptors by dopamine in schizophrenia. Proc Natl Acad Sci USA 97:8104–8109
Kegeles LS, Abi-Dargham A, Frankle WG, Gil R, Cooper TB, Slifstein M, Hwang DR, Huang Y, Haber SN, Laruelle M (2010) Increased synaptic dopamine function in associative regions of the striatum in schizophrenia. Arch Gen Psychiatry 67:231–239
Abi-Dargham A, Giessen EV, Slifstein M, Kegeles LS, Laruelle M (2009) Baseline and amphetamine-stimulated dopamine activity are related in drug-naive schizophrenic subjects. Biol Psychiatry 65(12):1091–1093
Skinbjerg M, Liow JS, Seneca N, Hong J, Lu S, Thorsell A, Heilig M, Pike VW, Halldin C, Sibley DR, Innis RB (2010) D2 dopamine receptor internalization prolongs the decrease of radioligand binding after amphetamine: a PET study in a receptor internalization-deficient mouse model. Neuroimage 50:1402–1407
Paterson LM, Tyacke RJ, Nutt DJ, Knudsen GM (2010) Measuring endogenous 5-HT release by emission tomography: promises and pitfalls. J Cereb Blood Flow Metab 30:1682–1706
Seeman P, Lee T (1975) Antipsychotic drugs: direct correlation between clinical potency and presynaptic action on dopamine neurons. Science 188:1217–1219
Zakzanis KK, Hansen KT (1998) Dopamine D2 densities and the schizophrenic brain. Schizophr Res 32:201–206
Laruelle M (1998) Imaging dopamine transmission in schizophrenia. A review and meta-analysis. Q J Nucl Med 42:211–221
Kestler LP, Walker E, Vega EM (2001) Dopamine receptors in the brains of schizophrenia patients: a meta-analysis of the findings. Behav Pharmacol 12:355–371
Seeman P, Schwarz J, Chen JF, Szechtman H, Perreault M, McKnight GS, Roder JC, Quirion R, Boksa P, Srivastava LK, Yanai K, Weinshenker D, Sumiyoshi T (2006) Psychosis pathways converge via D2high dopamine receptors. Synapse 60:319–346
Graff-Guerrero A, Mizrahi R, Agid O, Marcon H, Barsoum P, Rusjan P, Wilson AA, Zipursky R, Kapur S (2009) The dopamine D2 receptors in high-affinity state and D3 receptors in schizophrenia: a clinical [11C]-(+)-PHNO PET study. Neuropsychopharmacology 34:1078–1086
Buchsbaum MS, Christian BT, Lehrer DS, Narayanan TK, Shi B, Mantil J, Kemether E, Oakes TR, Mukherjee J (2006) D2/D3 dopamine receptor binding with [F-18]fallypride in thalamus and cortex of patients with schizophrenia. Schizophr Res 85:232–244
Kessler RM, Woodward ND, Riccardi P, Li R, Ansari MS, Anderson S, Dawant B, Zald D, Meltzer HY (2009) Dopamine D2 receptor levels in striatum, thalamus, substantia nigra, limbic regions, and cortex in schizophrenic subjects. Biol Psychiatry 65:1024–1031
Karlsson P, Farde L, Halldin C, Sedvall G (2002) PET study of D(1) dopamine receptor binding in neuroleptic-naive patients with schizophrenia. Am J Psychiatry 159:761–767
Abi-Dargham A, Mawlawi O, Lombardo I, Gil R, Martinez D, Huang Y, Hwang DR, Keilp J, Kochan L, Van Heertum R, Gorman JM, Laruelle M (2002) Prefrontal dopamine D1 receptors and working memory in schizophrenia. J Neurosci 22:3708–3719
Okubo Y, Suhara T, Suzuki K, Kobayashi K, Inoue O, Terasaki O, Someya Y, Sassa T, Sudo Y, Matsushima E, Iyo M, Tateno Y, Toru M (1997) Decreased prefrontal dopamine D1 receptors in schizophrenia revealed by PET. Nature 385:634–636
Ekelund J, Slifstein M, Narendran R, Guillin O, Belani H, Guo NN, Hwang Y, Hwang DR, Abi-Dargham A, Laruelle M (2007) In vivo DA D(1) receptor selectivity of NNC 112 and SCH 23390. Mol Imaging Biol 9:117–125
Farde L, Wiesel FA, Halldin C, Sedvall G (1988) Central D2-dopamine receptor occupancy in schizophrenic patients treated with antipsychotic drugs. Arch Gen Psychiatry 45:71–76
Kapur S, Zipursky R, Jones C, Remington G, Houle S (2000) Relationship between dopamine D(2) occupancy, clinical response, and side effects: a double-blind PET study of first-episode schizophrenia. Am J Psychiatry 157:514–520
Pilowsky LS, Costa DC, Ell PJ, Murray RM, Verhoeff NP, Kerwin RW (1992) Clozapine, single photon emission tomography, and the D2 dopamine receptor blockade hypothesis of schizophrenia. Lancet 340:199–202
Grunder G, Landvogt C, Vernaleken I, Buchholz HG, Ondracek J, Siessmeier T, Hartter S, Schreckenberger M, Stoeter P, Hiemke C, Rosch F, Wong DF, Bartenstein P (2006) The striatal and extrastriatal D2/D3 receptor-binding profile of clozapine in patients with schizophrenia. Neuropsychopharmacology 31:1027–1035
Reimold M, Solbach C, Noda S, Schaefer JE, Bartels M, Beneke M, Machulla HJ, Bares R, Glaser T, Wormstall H (2007) Occupancy of dopamine D(1), D (2) and serotonin (2A) receptors in schizophrenic patients treated with flupentixol in comparison with risperidone and haloperidol. Psychopharmacology (Berl) 190:241–249
Frankle WG, Narendran R, Huang Y, Hwang DR, Lombardo I, Cangiano C, Gil R, Laruelle M, Abi-Dargham A (2005) Serotonin transporter availability in patients with schizophrenia: a positron emission tomography imaging study with [11C]DASB. Biol Psychiatry 57:1510–1516
Laakso A, Vilkman H, Alakare B, Haaparanta M, Bergman J, Solin O, Peurasaari J, Rakkolainen V, Syvalahti E, Hietala J (2000) Striatal dopamine transporter binding in neuroleptic-naive patients with schizophrenia studied with positron emission tomography. Am J Psychiatry 157:269–271
Laruelle M, Abi-Dargham A, van Dyck C, Gil R, D’Souza DC, Krystal J, Seibyl J, Baldwin R, Innis R (2000) Dopamine and serotonin transporters in patients with schizophrenia: an imaging study with [(123)I]beta-CIT. Biol Psychiatry 47:371–379
Fusar-Poli P, Howes OD, Allen P, Broome M, Valli I, Asselin MC, Montgomery AJ, Grasby PM, McGuire P (2011) Abnormal prefrontal activation directly related to pre-synaptic striatal dopamine dysfunction in people at clinical high risk for psychosis. Mol Psychiatry 16(1):67–75
Meyer-Lindenberg A, Miletich RS, Kohn PD, Esposito G, Carson RE, Quarantelli M, Weinberger DR, Berman KF (2002) Reduced prefrontal activity predicts exaggerated striatal dopaminergic function in schizophrenia. Nat Neurosci 5:267–271
Montgomery AJ, Thielemans K, Mehta MA, Turkheimer F, Mustafovic S, Grasby PM (2006) Correction of head movement on PET studies: comparison of methods. J Nucl Med 47:1936–1944
Rousset OG, Deep P, Kuwabara H, Evans AC, Gjedde AH, Cumming P (2000) Effect of partial volume correction on estimates of the influx and cerebral metabolism of 6-[(18)F]fluoro-L-dopa studied with PET in normal control and Parkinson’s disease subjects. Synapse 37:81–89
Shidahara M, Tsoumpas C, Hammers A, Boussion N, Visvikis D, Suhara T, Kanno I, Turkheimer FE (2009) Functional and structural synergy for resolution recovery and partial volume correction in brain PET. Neuroimage 44:340–348
Glahn DC, Laird AR, Ellison-Wright I, Thelen SM, Robinson JL, Lancaster JL, Bullmore E, Fox PT (2008) Meta-analysis of gray matter anomalies in schizophrenia: application of anatomic likelihood estimation and network analysis. Biol Psychiatry 64(9):774–781
Tost H, Braus DF, Hakimi S, Ruf M, Vollmert C, Hohn F, Meyer-Lindenberg A (2010) Acute D2 receptor blockade induces rapid, reversible remodeling in human cortical-striatal circuits. Nat Neurosci 13:920–922
Tarazi FI, Baldessarini RJ, Kula NS, Zhang K (2003) Long-term effects of olanzapine, risperidone, and quetiapine on ionotropic glutamate receptor types: implications for antipsychotic drug treatment. J Pharmacol Exp Ther 306:1145–1151
Grunder G, Vernaleken I, Muller MJ, Davids E, Heydari N, Buchholz HG, Bartenstein P, Munk OL, Stoeter P, Wong DF, Gjedde A, Cumming P (2003) Subchronic haloperidol downregulates dopamine synthesis capacity in the brain of schizophrenic patients in vivo. Neuropsychopharmacology 28:787–794
Vernaleken I, Kumakura Y, Cumming P, Buchholz HG, Siessmeier T, Stoeter P, Muller MJ, Bartenstein P, Grunder G (2006) Modulation of [18F]fluorodopa (FDOPA) kinetics in the brain of healthy volunteers after acute haloperidol challenge. Neuroimage 30:1332–1339
Tiihonen J, Vilkman H, Rasanen P, Ryynanen OP, Hakko H, Bergman J, Hamalainen T, Laakso A, Haaparanta-Solin M, Solin O, Kuoppamaki M, Syvalahti E, Hietala J (1998) Striatal presynaptic dopamine function in type 1 alcoholics measured with positron emission tomography. Mol Psychiatry 3:156–161
Bossong MG, van Berckel BN, Boellaard R, Zuurman L, Schuit RC, Windhorst AD, van Gerven JM, Ramsey NF, Lammertsma AA, Kahn RS (2009) Delta 9-tetrahydrocannabinol induces dopamine release in the human striatum. Neuropsychopharmacology 34:759–766
Martinez D, Gil R, Slifstein M, Hwang DR, Huang Y, Perez A, Kegeles L, Talbot P, Evans S, Krystal J, Laruelle M, Abi-Dargham A (2005) Alcohol dependence is associated with blunted dopamine transmission in the ventral striatum. Biol Psychiatry 58:779–786
Montgomery AJ, Lingford-Hughes AR, Egerton A, Nutt DJ, Grasby PM (2007) The effect of nicotine on striatal dopamine release in man: a [(11)C]raclopride PET study. Synapse 61:637–645
Shergill SS, Brammer MJ, Williams SC, Murray RM, McGuire PK (2000) Mapping auditory hallucinations in schizophrenia using functional magnetic resonance imaging. Arch Gen Psychiatry 57:1033–1038
McGuire PK, Shah GM, Murray RM (1993) Increased blood flow in Broca’s area during auditory hallucinations in schizophrenia. Lancet 342:703–706
Hietala J, Syvalahti E, Vilkman H, Vuorio K, Rakkolainen V, Bergman J, Haaparanta M, Solin O, Kuoppamaki M, Eronen E, Ruotsalainen U, Salokangas RK (1999) Depressive symptoms and presynaptic dopamine function in neuroleptic-naive schizophrenia. Schizophr Res 35:41–50
Howes OD, Montgomery AJ, Asselin MC, Murray RM, Valli I, Tabraham P, Bramon-Bosch E, Valmaggia L, Johns L, Broome M, McGuire PK, Grasby PM (2009) Elevated striatal dopamine function linked to prodromal signs of schizophrenia. Arch Gen Psychiatry 66:13–20
Hariri AR, Weinberger DR (2003) Imaging genomics. Br Med Bull 65:259–270
Meyer-Lindenberg A, Weinberger DR (2006) Intermediate phenotypes and genetic mechanisms of psychiatric disorders. Nat Rev Neurosci 7:818–827
Hirvonen J, van Erp TG, Huttunen J, Aalto S, Nagren K, Huttunen M, Lonnqvist J, Kaprio J, Hietala J, Cannon TD (2005) Increased caudate dopamine D2 receptor availability as a genetic marker for schizophrenia. Arch Gen Psychiatry 62:371–378
Hirvonen J, van Erp TG, Huttunen J, Nagren K, Huttunen M, Aalto S, Lonnqvist J, Kaprio J, Cannon TD, Hietala J (2006) Striatal dopamine D1 and D2 receptor balance in twins at increased genetic risk for schizophrenia. Psychiatry Res 146:13–20
Pruessner JC, Champagne F, Meaney MJ, Dagher A (2004) Dopamine release in response to a psychological stress in humans and its relationship to early life maternal care: a positron emission tomography study using [11C]raclopride. J Neurosci 24:2825–2831
Howes OD, Kapur S (2009) The dopamine hypothesis of schizophrenia: version III – the final common pathway. Schizophr Bull 35:549–562
Treyer V, Streffer J, Wyss MT, Bettio A, Ametamey SM, Fischer U, Schmidt M, Gasparini F, Hock C, Buck A (2007) Evaluation of the metabotropic glutamate receptor subtype 5 using PET and 11C-ABP688: assessment of methods. J Nucl Med 48:1207–1215
Dao-Castellana MH, Paillere-Martinot ML, Hantraye P, Attar-Levy D, Remy P, Crouzel C, Artiges E, Feline A, Syrota A, Martinot JL (1997) Presynaptic dopaminergic function in the striatum of schizophrenic patients. Schizophr Res 23:167–174
Elkashef AM, Doudet D, Bryant T, Cohen RM, Li SH, Wyatt RJ (2000) 6-(18)F-DOPA PET study in patients with schizophrenia. Positron emission tomography. Psychiatry Res 100:1–11
Hietala J, Syvalahti E, Vuorio K, Rakkolainen V, Bergman J, Haaparanta M, Solin O, Kuoppamaki M, Kirvela O, Ruotsalainen U (1995) Presynaptic dopamine function in striatum of neuroleptic-naive schizophrenic patients. Lancet 346:1130–1131
Lindstrom LH, Gefvert O, Hagberg G, Lundberg T, Bergstrom M, Hartvig P, Langstrom B (1999) Increased dopamine synthesis rate in medial prefrontal cortex and striatum in schizophrenia indicated by L-(beta-11C) DOPA and PET. Biol Psychiatry 46:681–688
McGowan S, Lawrence AD, Sales T, Quested D, Grasby P (2004) Presynaptic dopaminergic dysfunction in schizophrenia: a positron emission tomographic [18F]fluorodopa study. Arch Gen Psychiatry 61:134–142
Nozaki S, Kato M, Takano H, Ito H, Takahashi H, Arakawa R, Okumura M, Fujimura Y, Matsumoto R, Ota M, Takano A, Otsuka A, Yasuno F, Okubo Y, Kashima H, Suhara T (2009) Regional dopamine synthesis in patients with schizophrenia using L-[beta-(11)C]DOPA PET. Schizophr Res 108:78–84
Reith J, Benkelfat C, Sherwin A, Yasuhara Y, Kuwabara H, Andermann F, Bachneff S, Cumming P, Diksic M, Dyve SE, Etienne P, Evans AC, Lal S, Shevell M, Savard G, Wong DF, Chouinard G, Gjedde A (1994) Elevated dopa decarboxylase activity in living brain of patients with psychosis. Proc Natl Acad Sci USA 91:11651–11654
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media New York
About this protocol
Cite this protocol
Howes, O. (2012). Molecular Imaging in Schizophrenia. In: Gründer, G. (eds) Molecular Imaging in the Clinical Neurosciences. Neuromethods, vol 71. Humana Press, Totowa, NJ. https://doi.org/10.1007/7657_2012_57
Download citation
DOI: https://doi.org/10.1007/7657_2012_57
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-61779-988-4
Online ISBN: 978-1-61779-989-1
eBook Packages: Springer Protocols