3 CLINICAL SYNDROMES OF SCHIZOPHRENIA IN UNTREATED SUBJECTS - RELATION TO BRAIN GLUCOSE ACTIVITY MEASURED BY POSITRON EMISSION TOMOGRAPHY (PET)

A number of studies of chronically ill, medicated patients have found that the clinical symptoms of schizophrenia segregate into three syndr omes which can be labelled poverty, disorganization, and reality disto rtion. It has been previously found that each of these syndromes is as sociated with a specific pattern of perfusion (rCBF) in paralimbic and association cortex and in related subcortical nuclei. We replicated t he symptom factors in 20 untreated subjects. Utilizing positron emissi on tomography with -F-18-fluorodeoxyglucose as a tracer for glucose me tabolism, we reconstructed a map of the entire cortical activity from 16 to 20 tomographic slices. Each of the three syndromes was associate d with a different pattern of regional glucose metabolism. Findings in common with previous studies were an association of poverty with left cortical metabolic activity in prefrontal and superior parietal areas , reality distortion with left temporal activity, and disorganization with left inferior parietal lobule. This is the first report of an ass ociation between regional metabolic activity and clinical syndromes in untreated patients, strengthening previous models of distributed neur al networks in this disorder.