Abstract

Background: Converging evidence indicates that the prefrontal cortex is critically involved in executive control and that executive dysfunction is implicated in schizophrenia. Reduced dopamine D2/D3 receptor binding potential has been reported in schizophrenia, and the correlations with neuropsychological test scores have been positive and negative for different tasks. The aim of this study was to examine the relation between dopamine D2/D3 receptor levels with frontal and temporal neurocognitive performance in schizophrenia.

Methods: Resting-state 18F-fallypride positron emission tomography was performed on 20 medication-naive and 5 previously medicated for brief earlier periods patients with schizophrenia and 19 age- and sex-matched normal controls. Striatal and extra-striatal dopamine D2/D3 receptor levels were quantified as binding potential using fallypride imaging. Magnetic resonance images in standard Talairach position and segmented into gray and white matter were co-registered to the fallypride images, and the AFNI stereotaxic atlas was applied. Two neuropsychological tasks known to activate frontal and temporal lobe function were chosen, specifically the Wisconsin Card Sorting Test (WCST) and the California Verbal Learning Test (CVLT).

Results: Images of the correlation coefficient between fallypride binding and WCST and CVLT performance showed a negative correlation in contrast to positive correlations in healthy volunteers. Prefrontal Brodmann area 10 and striatal areas showed the greatest differences. Heat maps of correlation patterns of fallypride binding potential and neuropsychological performance were obtained. Differences in correlation patterns between healthy volunteers and patients were confirmed with Monte Carlo permutation analysis. Correlation coefficient histograms also showed significant differences in shape.

Conclusion: The results of this study demonstrate that lower fallypride binding potential in patients with schizophrenia may be associated with better performance and consistent with previous studies that failed to find cognitive improvement with typical dopamine-blocking medications.

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