RELATIONSHIP BETWEEN BRAIN STRUCTURE AND FUNCTION IN DISORDERS OF THESCHIZOPHRENIC SPECTRUM - SINGLE POSITRON EMISSION COMPUTERIZED-TOMOGRAPHY, COMPUTERIZED-TOMOGRAPHY AND PSYCHOPATHOLOGY OF FIRST EPISODES

Fifty newly diagnosed, briefly treated or drug-naive patients with sch izophrenia or schizophreniform disorder were examined by psychopatholo gy scales for positive (SAPS), negative (SANS) and overall psychotic s ymptoms (PSE and BPRS). CT-scan and regional cerebral blood flow (rCBF ) measurement by Tc-99m-HMPAO SPECT during rest and mental activation by Wisconsin Card Sorting Test was performed as well. Twenty-five age- matched normal healthy volunteers served as controls. Thought disorder s and fundamental symptoms correlated positively with relatively high, though subnormal prefrontal (PFC) rCBF and high rCBF in temporal cort ex; positive symptoms correlated positively with high rCBF in the stri atum and temporal cortex during activation. Negative symptoms correlat ed with high prefrontal rCBF. The patients had sulcal enlargement and smaller brain volume compared with the healthy volunteers. There were no signs of ventricular enlargement. Neither total negative symptoms, thought disorder nor fundamental symptoms correlated with any CT measu rements. Total positive symptoms correlated negatively with the size o f the temporal horns. The relatively high rCBF in PFC and temporal cor tex of cases with pronounced positive and negative symptoms and though t disorder may imply that an aberrant cortical network has to be activ e to express a malattuned clinical output. The striatal hyperfunction mainly in productive cases may be a secondary phenomenon and more pron ounced in cases where no signs of subcortical atrophy has (yet?) ensue d.