Skip to main content Accessibility help

Regional cerebral blood flow (rCBF) in schizophrenia during verbal memory activation: a 99mTc-HMPAO single photon emission tomography (SPET) study

  • G. F. Busatto (a1), D. C. Costa (a1), P. J. Ell (a1), L. S. Pilowsky (a1), A. S. David (a1) and R. W. Kerwin (a1)...


Regional cerebral blood flow (rCBF) was investigated in a group of medicated DSM-III-R schizophrenic patients and age, sex and handedness matched normal volunteers using a split-dose 99mTc-HMPAO Single Photon Emission Tomography (SPET) protocol. Measures were taken during the performance of a verbal memory task aimed at activating the left medial temporal lobe, a region repeatedly suggested to be structurally abnormal in schizophrenia. In normal subjects, the performance of the task was associated with significant rCBF increases in the left medial temporal, left inferior frontal and anterior cingulate cortices, and right cerebellum. Despite their significantly poorer performance on the memory task, the degree of medial temporal activation measured in the schizophrenic patients was not significantly different from that found in the control group. This finding suggests that memory deficits in schizophrenia do not necessarily imply failure to activate the left medial temporal lobe as assessed by 99mTc-HMPAO SPET.


Corresponding author

1 Address for correspondence: Dr Geraldo F Busatto, Department of Neuroscience and Psychiatric Genetics, Institute of Psychiatry, De Crespigny Park, London SE5 8AF


Hide All
Altschuler, L. L., Conrad, A., Kovelman, J. A. & Scheibel, A. (1987). Hippocampal pyramidal cell orientation in schizophrenia. Archives of General Psychiatry 44, 10941098.
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revised. American Psychiatric Association: Washington, DC.
Annett, M. (1970). A classification of hand preference by association analysis. British Journal of Psychology 61, 303321.
Berman, K. F. (1988). Cortical ‘stress tests’ in schizophrenia: regional cerebral blood flow studies. Biological Psychiatry 22, 13041326.
Bogerts, B., Meertz, F. & Schonfeldt-Bausch, R. (1985). Basal ganglia and limbic system pathology in schizophrenia: a morpho-metric study of brain volume and shrinkage. Archives of General Psychiatry 42, 784791.
Bogerts, B., Ashtari, M., Degreef, G. J., Alvir, J., Bilder, R. M. & Lieberman, J. A. (1990). Reduced temporal limbic structure volumes on magnetic resonance images in first episode schizophrenia. Psychiatry Research: Neuroimaging 35, 113.
Brown, R., Colter, N., Corsellis, J. A. N., Crow, T. J., Frith, C. D., Jagoe, R., Johnstone, E. C. & Marsh, L. (1986). Post-mortem evidence of structural brain changes in schizophrenia: differences in brain weight, temporal horn and parahippocampal gyrus compared with affective disorder. Archives of General Psychiatry 43, 3642.
Buchsbaum, M. S., Nuechterlein, K. H., Haier, R. J., Wu, J., Sicotte, N., Hazlett, E., Asarnow, R., Potkin, S. & Guich, S. (1990). Glucose metabolic rate in normals and schizophrenics during the continuous performance test assessed by positron emission tomography. British Journal of Psychiatry 156, 216227.
Christison, G. W., Casanova, M. F., Weinberger, D. R., Rawlings, R. & Kleinman, J. E. (1989). A quantitative investigation of parahippocampal pyramidal cell size, shape and variability of orientation in schizophrenia. Archives of General Psychiatry 46, 10271032.
Costa, D. C., Ell, P. J., Burns, A., Philpot, M. & Levy, R. (1988). CBF tomograms with 99mTc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease-initial results. Journal of Cerebral Blood Flow and Metabolism 8, S109S115.
Costa, D. C. (1990). Single photon emission tomography (SPET) with 99mTc-hexamethylpropyleneamineoxime (HMPAO) in research and clinical practice – a useful tool. Vascular Medicine Review 1, 179201.
DeLisi, L. E., Holcomb, H. H., Cohen, R. M., Pickar, D., Carpenter, W., Morihisa, J. M., King, A. C., Kessler, R. & Buchsbaum, M. S. (1985). Positron emission tomography in schizophrenic patients with and without neuroleptic medication. Journal of Cerebral Blood Flow and Metabolism 5, 201206.
Ell, P. J., Cullum, I. & Costa, D. C. (1985). Regional cerebral blood flow mapping with a new Tc-99m-labelled compound. Lancet ii, 5051.
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview. The schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837844.
Fazio, F., Perani, D., Gilardi, M. C., Colombo, F., Cappa, S. F., Vallar, G., Bettinardi, V., Paulesu, E., Alberoni, M., Bressi, S., Franceschi, M. & Lenzi, G. L. (1992). Metabolic impairment in human amnesia: a PET study of memory networks. Journal of Cerebral Blood Flow and Metabolism 12, 353358.
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Minimental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.
Frackowiak, R. S. J., Pozzilli, C., Legg, N. J., Du Boulay, G. H., Marshall, J., Lenzi, G. L. & Jones, T. (1981). Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography. Brain 104, 753778.
Friston, K. J., Liddle, P. F., Frith, C. D., Hirsch, S. R. & Frackowiak, R. S. J. (1992). The medial temporal region in schizophrenia. A PET study. Brain 115, 367382.
Frith, C. D., Friston, K. J., Liddle, P. F. & Frackowiak, R. S. J. (1991). A PET study of word finding. Neuropsychologia 29, 11371148.
George, M. S., Ring, H. A., Costa, D. C., Ell, P. J., Kouris, K. & Jarritt, P. (1991). Neuroactivation and Neuroimaging with SPET. Springer-Verlag: London.
George, M. S., Trimble, M. R., Costa, D. C., Robertson, M. M., Ring, H. A. & Ell, P. J. (1992). Elevated frontal cerebral blood flow in Gilles de la Tourette syndrome: a 99Tcm-HMPAO SPECT study. Psychiatry Research: Neuroimaging 45, 143151.
Goldberg, T. E., Ragland, D., Fuller Torrey, E., Gold, J. M., Bigelow, L. B. & Weinberger, D. R. (1990). Neuropsychological assessment of monozygotic twins discordant for schizophrenia. Archives of General Psychiatry 47, 10391042.
Goldstein, L. H., Canavan, A. G. M. & Polkey, C. E. (1988). Verbal and abstract designs paired associated learning after unilateral temporal lobectomy. Cortex 24, 4152.
Gur, R. C., Gur, R. E., Resnick, S. M., Skolnick, B. E., Alavi, A. & Reivich, M. (1987). The effect of anxiety on cortical cerebral blood flow and metabolism. Journal of Cerebral Blood Flow and Metabolism 7, 173177.
Holm, S., Madsen, P. L., Rubin, P., Sperling, B., Friberg, L. & Lassen, N. A. (1991). Tc-99m HMPAO activation studies: validation of the split-dose, image subtraction approach. Journal of Cerebral Blood Flow and Metabolism 11 (Suppl 2), S766.
Jakob, H. & Beckman, H. (1986). Prenatal developmental disturbances in the limbic allocortex in schizophrenics. Journal of Neural Transmission 65, 303326.
Jeste, D. & Lohr, J. B. (1989). Hippocampal pathologic findings in schizophrenia. A morphometric study. Archives of General Psychiatry 46, 10191024.
Kouris, K., Jarrit, P. H., Costa, D. C. & Ell, P. J. (1992). Physical assessment of the GE/CGR NEUROCAM and comparison to a single rotating gamma camera. European Journal of Nuclear Medicine 19, 236242.
Kovelman, J. A. & Scheibel, A. B. (1984). A neurohistological correlate of schizophrenia. Biological Psychiatry 191, 16011621.
Ingvar, D. H. & Franzén, G. (1974). Distribution of cerebral activity in chronic schizophrenia. Lancet ii, 14841486.
Leiner, H. C., Leiner, A. L. & Dow, R. S. (1989). Reappraising the cerebellum: what does the hindbrain contribute to the forebrain? Behavioral Neuroscience 103, 9981008.
Lewis, S. W., Ford, R. A., Syed, G. M., Reveley, A. M. & Toone, B. K. (1992). A controlled study of 99mTc-HMPAO single-photon emission imaging in chronic schizophrenia. Psychological Medicine 22, 2735.
Mazziotta, J. C., Valentino, D., Pelizzari, C. A., Chen, G. T. & Bookstein, F. (1990). Structure-function correlation of the living human brain with MRI and PET: a means of anatomical and functional localization. Clinical Neuropharmacology 13 (Suppl. 2), 460461.
Mesulam, M-M (1990). Neurocognitive networks and distributed processing for attention, language and memory. Annals of Neurology 28, 597613.
Nelson, H. E. (1982). The National Adult Reading Test (NART) Test Manual. NFER-Nelson Publishing Co.: Windsor.
Petersen, S. E., Fox, P. T., Posner, M. I., Mintum, M. A. & Raichle, M. E. (1989). Positron emission tomographic studies of the processing of single words. Journal of Cognitive Neuroscience 1, 153170.
Roberts, G. W. (1991). Schizophrenia: a neuropathological perspective. British Journal of Psychiatry 158, 817.
Rubin, P., Holm, S., Friberg, L., Videbech, P., Andersen, H. S., Bendsen, B. B., Stromso, N., Larsen, J. K., Lassen, N. A. & Hemminsen, R. (1991). Altered modulation of prefrontal and subcortical brain activity in newly diagnosed schizophrenia and schizophreniform disorder. A regional cerebral blood flow study. Archives of General Psychiatry 48, 987995.
Shedlack, K. J., Hunter, R., Wyper, D., McLuskie, R., Fink, G. & Goodwin, G. M. (1991). The pattern of cerebral activity underlying verbal fluency shown by split-dose single photon emission tomography (SPET or SPECT) in normal volunteers. Psychological Medicine 21, 687696.
Shenton, M. E., Kikinis, R., Jolesz, F. A., Pollak, S. D., LeMay, M., Wible, C. G., Hokama, H., Martin, J., Metcalf, D., Coleman, M. & McCarley, R. W. (1992). Abnormalities of the left temporal lobe and thought disorder in schizophrenia. A quantitative magnetic resonance imaging study. New England Journal of Medicine 327, 604612.
Sheppard, G., Gruzelier, J., Manchanda, R., Hirsch, S., Wise, R., Frackowiak, R., Jones, B. & Jones, T. (1983). 15O-Positron emission tomography scanning in predominantly never treated acute schizophrenics. Lancet ii, 14481452.
Smith, M. L. (1989). Memory disorders associated with temporal lobe lesions. In Handbook of Neuropsychology 3 (ed. Boller, F. and Grafman, J.), pp. 91106. Elsevier: Amsterdam.
Suddath, R. L., Christison, G. W., Torrey, E. F., Casanova, M. F. & Weinberger, D. R. (1990). Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine 322, 789794.
Tamlyn, D., McKenna, P. J., Mortimer, A. M., Lund, C. E., Hammond, S. & Baddeley, A. D. (1992). Memory impairment in schizophrenia: its extent, affiliations and neuropsychological character. Psychological Medicine 22, 101115.
Tamminga, C. A., Thaker, G. K., Buchanan, R., Kirkpatrick, B., Alphs, L. D., Chase, T. N. & Carpenter, W. T. (1992). Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluorodeoxyglucose and neocortical alterations with deficit syndrome. Archives of General Psychiatry 49, 522530.
Thorndike, E. L. & Lorge, I. (1944). The Teacher's Word Book of 30,000 words. Teacher College Press: New York.
Van Hoesen, G. W. (1982). The parahippocampal gyrus. New observations regarding its cortical connections in the monkey. Trends in Neurosciences 5, 345350.
Volkow, N. D., Brodie, J. D., Wolf, A. P., Gomez-Mont, F. & Cancro, R. (1986). Brain organization in schizophrenia. Journal of Cerebral Blood Flow and Metabolism 6, 441446.
Volkow, N. D., Wolf, A. P., Van Gelder, P., Brodie, J. D., Overall, J., Cancro, R. & Gomez-Mont, F. (1987). Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia. American Journal of Psychiatry 144, 151158.
Wechsler, D. & Stone, C. (1945). Wechsler Memory Scale. The Psychological Corporation: New York.
Weinberger, D. R., Berman, K. F. & Zec, R. F. (1986). Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia. I. Regional cerebral blood flow evidence. Archives of General Psychiatry 43, 114125.
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.
Wolkin, A., Jaeger, J., Brodie, J. D., Wolf, A. P., Fowler, J., Rotrosen, J., Gomez-Mont, F. & Cancro, R. (1985). Persistence of cerebral metabolic abnormalities in chronic schizophrenia as determined by positron emission tomography. American Journal of Psychiatry 142, 564571.

Regional cerebral blood flow (rCBF) in schizophrenia during verbal memory activation: a 99mTc-HMPAO single photon emission tomography (SPET) study

  • G. F. Busatto (a1), D. C. Costa (a1), P. J. Ell (a1), L. S. Pilowsky (a1), A. S. David (a1) and R. W. Kerwin (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed