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The relationship between excitement symptom severity and extrastriatal dopamine D2/3 receptor availability in patients with schizophrenia: a high-resolution PET study with [18F]fallypride

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Abstract

The purpose of this study was to investigate the relationship between specific symptom severity and D2/3 receptor availability in extrastriatal regions in outpatients with schizophrenia to shed light on the role of extrastriatal dopaminergic neurotransmission in the pathophysiology of symptoms of schizophrenia. Sixteen schizophrenia patients receiving relatively low-dose maintenance atypical antipsychotics and seventeen healthy controls underwent 3-Tesla magnetic resonance imaging and high-resolution positron emission tomography with [18F]fallypride. For D2/3 receptor availability, the binding potential with respect to non-displaceable compartment (BPND) was derived using the simplified reference tissue model. The BPND values were lower in patients on antipsychotic treatment than in controls across all regions with large effect sizes (1.03–1.42). The regions with the largest effect size were the substantia nigra, amygdala, and insula. Symptoms of schizophrenia were assessed using a five-factor model of the Positive and Negative Syndrome Scale (PANSS). The region of interest-based analysis showed that PANSS excitement factor score had a significant positive correlation with the [18F]fallypride BPND in the insula. The equivalent dose of antipsychotics was not significantly correlated with PANSS factor scores or regional BPND values. The voxel-based analysis also revealed a significant positive association between the PANSS excitement factor and the [18F]fallypride BPND in the insula. The present study revealed a significant association between excitement symptom severity and D2/3 receptor availability in the insula in schizophrenia, suggesting a possible important role of D2/3 receptor-mediated neurotransmission in the insula and related limbic system in the pathophysiology of this specific symptom cluster.

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Acknowledgements

This research was supported by the Brain Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (2016M3C7A1914451) and by a grant of the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (number: HI14C2750). This research was also supported by the Gachon University Research Fund of 2015 (number: GCU-2015-5031).

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  1. Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea

    Yo-Han Joo, Jeong-Hee Kim, Young-Don Son, Hang-Keun Kim, Yeon-Jeong Shin, Sang-Yoon Lee & Jong-Hoon Kim

  2. Research Institute for Advanced Industrial Technology, Korea University, Sejong, Republic of Korea

    Jeong-Hee Kim

  3. Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea

    Young-Don Son & Hang-Keun Kim

  4. Department of Radiological Science, College of Health Science, Gachon University, Incheon, Republic of Korea

    Sang-Yoon Lee

  5. Department of Psychiatry, Neuroscience Research Institute, Gil Medical Center, Gachon University School of Medicine, Gachon University, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea

    Jong-Hoon Kim

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Joo, YH., Kim, JH., Son, YD. et al. The relationship between excitement symptom severity and extrastriatal dopamine D2/3 receptor availability in patients with schizophrenia: a high-resolution PET study with [18F]fallypride. Eur Arch Psychiatry Clin Neurosci 268, 529–540 (2018). https://doi.org/10.1007/s00406-017-0821-y

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