Hazlett Erin A, Vaccaro Daniel H, Haznedar M Mehmet, Goldstein Kim E
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States.
Psychiatry Res. 2019 Jul;277:39-44. doi: 10.1016/j.psychres.2019.06.014. Epub 2019 Jun 20.
This is a selective review of the work of Buchsbaum and colleagues. It revisits and pays tribute to four decades of publications employing positron emission tomography (PET) with fluorodeoxyglucose (FDG) to examine the neurobiology of schizophrenia-spectrum disorders (including schizotypal personality disorder (SPD) and schizophrenia). Beginning with a landmark FDG-PET study in 1982 reporting hypofrontality in unmedicated schizophrenia patients, Buchsbaum and colleagues published high-impact work on regional glucose metabolic rate (GMR) abnormalities in the spectrum. Several key discoveries were made, including the delineation of schizophrenia-spectrum abnormalities in frontal and temporal lobe, cingulate, thalamus, and striatal regions using three-dimensional mapping with coregistered MRI and PET. These findings indicated that SPD patients have less marked frontal lobe and striatal dysfunction compared with schizophrenia patients, possibly mitigating frank psychosis. Additionally, these investigations were among the first to conduct early seed-based functional connectivity analyses with FDG-PET, showing aberrant cortical-subcortical circuitry and, in particular, revealing a thalamocortical circuitry abnormality in schizophrenia. Finally, pioneering work employing the first double-blind randomized antipsychotic (haloperidol) vs. placebo FDG-PET study design in schizophrenia indicated that GMR in the striatum, more than in any other region, was related to clinical response.
这是对布克斯鲍姆及其同事工作的一篇选择性综述。它回顾并致敬了四十年来运用正电子发射断层扫描（PET）结合氟脱氧葡萄糖（FDG）来研究精神分裂症谱系障碍（包括分裂型人格障碍（SPD）和精神分裂症）神经生物学的相关出版物。从1982年一项具有里程碑意义的FDG - PET研究报告未用药精神分裂症患者存在额叶功能低下开始，布克斯鲍姆及其同事发表了关于该谱系中区域葡萄糖代谢率（GMR）异常的高影响力研究成果。取得了几项关键发现，包括使用与磁共振成像（MRI）配准的PET进行三维映射，描绘出额叶、颞叶、扣带回、丘脑和纹状体区域的精神分裂症谱系异常。这些发现表明，与精神分裂症患者相比，SPD患者的额叶和纹状体功能障碍不太明显，这可能减轻了明显的精神病症状。此外，这些研究是最早利用FDG - PET进行基于种子点的早期功能连接分析的研究之一，显示出皮质 - 皮质下回路异常，特别是揭示了精神分裂症患者丘脑 - 皮质回路异常。最后，在精神分裂症研究中采用首个双盲随机抗精神病药物（氟哌啶醇）与安慰剂FDG - PET研究设计的开创性工作表明，纹状体中的GMR比其他任何区域都更与临床反应相关。
