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DIFFERENCES IN CEREBAL
BLOOD FLOW SEEN IN SCHIZOPHRENIA SUBGROUPS
New Approaches to Research & Treatment May Be Needed
New York, NY (December 15)—According to a study in today’s
Biological Psychiatry, researchers have shown for the first time that
differences in resting brain activity distinguish two distinct schizophrenia
subgroups, namely those with a family history of the disease and those
without.
Dr. Dolores Malaspina, the lead investigator and a research psychiatrist
at the New York State Psychiatric Institute at Columbia University Medical
Center, said that though the heterogeneity of schizophrenia patients is
well-established and previous studies have shown symptomatic and physiologic
differences between the subgroups, no other study has until now used neuroimaging
to compare resting brain activity in the two groups.
She added, “Most current studies try to tease out the differences
in brain activity by asking subjects to perform a cognitive task. However,
differences one might find as a result may actually be masking the true
fundamental markers that distinguish familial schizophrenia from non-familial
schizophrenia.”
With this in mind, Dr. Malaspina and colleagues looked at brain activity
among three groups: a group of 10 patients with a family history of schizophrenia,
a group of 16 without a family history (sometimes referred to as sporadic
schizophrenia) and a group of 9 healthy people. They all underwent SPECT
imaging while at rest. (SPECT provides a highly accurate measure of blood
flow in the brain.)
As they expected, both subgroups showed different resting blood flow patterns.
More compelling, though, was evidence indicating decreased blood flow
(decreased brain activity) in the familial group in regions associated
with negative symptoms. According to the authors “Familial, but
not sporadic, cases have treatment-resistant negative symptoms, particularly
emotional withdrawal, poor rapport…whereas these symptoms improve
with antipsychotic treatment in sporadic cases.” This seems to further
support the view that familial and sporadic schizophrenia are indeed distinct
subgroups each of which will require different research and treatment
strategies to ensure positive outcomes. This study is another step towards
understanding the poorly understood concept of sporadic schizophrenia.
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