THE RESTING AND ACTIVATION ISSUE OF HYPOFRONTALITY - A SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY STUDY IN NEUROLEPTIC-NAIVE AND NEUROLEPTIC-FREE SCHIZOPHRENIC FEMALE-PATIENTS

Background: Functional neuroimaging findings of ''hypofrontality'' in schizophrenic patients is still controversial, due to the heterogeneit y of methods and patient samples. This study tries to prevent some of these concerns by studying neuroleptic-naive (NN) and neuroleptic-free (NF) young female patients both in resting conditions and during a fr ontal cognitive activation task. Methods: Regional cerebral blood flow (rCBF) was studied at rest and during the Wisconsin Card Sorting Test (WCST) in 25 young acute unmedicated schizophrenic female patients (1 4 NN and 11 NF) and 15 female controls, using single photon emission c omputed tomography. Results: The schizophrenic and control groups did not differ in rCBF during the baseline condition, but the schizophreni c group failed to activate the frontal lobe during the WCST condition. In addition, the left anterior temporal rCBF at rest correlated with the Scale for the Assessment of Positive Symptoms total score. Conclus ions: The results suggest that hypofrontality in young acute unmedicat ed schizophrenic patients is a result of an inability to activate fron tal regions during cognition, rather than a baseline decrease in front al activity. Furthermore, positive symptoms seem to be associated with left temporal cortex activity. Biol Psychiatry 1998;44:787-790 Publis hed 1998 Society of Biological Psychiatry.