Magnetic Resonance Imaging and Single Photon Emission Tomography in Treatment-Responsive and Treatment-Resistant Schizophrenia

1995 ◽  
Vol 167 (2) ◽  
pp. 202-210 ◽  
Author(s):  
Stephen M. Lawrie ◽  
Gordon T. Ingle ◽  
Celestine G. Santosh ◽  
Andrew C. Rogers ◽  
J. Ewen Rimmington ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Treatment Response ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Treatment Resistant ◽  
Single Photon Emission ◽  
Patient Groups ◽  
Photon Emission Tomography

BackgroundPatients with schizophrenia differ from controls in several measures of brain structure and function, but it is uncertain how these relate to clinical features of the illness. We dichotomised patient groups by treatment response to test the hypothesis that treatment-resistant patients exhibit more marked biological abnormalities than treatment-responsive parients.MethodTwenty treatment-responsive and 20 treatment-resistant patients with schizophrenia, matched for sex, age, and illness duration, were compared by magnetic resonance imaging, single photon emission tomography, and detailed neuropsychological assessment.ResultsBrain-imaging variables were not statistically related to treatment response, although poorly responsive patients had lower volumes of most brain structures. Several highly significant differences emerged between patient groups on neuropsychological testing. Episodic memory functioning distinguished patient groups even after we controlled for global cognitive impairment.ConclusionsCerebral structure and blood flow have a limited effect on treatment response in schizophrenia, but long-term episodic memory impairment is associated with, and may predict, poor prognosis.

scholarly journals Neuroimaging in schizophrenia: what does it tell the clinician?

2005 ◽  
Vol 11 (3) ◽  
pp. 195-202 ◽  
Author(s):  
James Woolley ◽  
Philip McGuire
Keyword(s):  
Magnetic Resonance Imaging ◽  
Clinical Utility ◽  
Patient Management ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Tomography ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Single Photon Emission ◽  
Photon Emission Tomography

Neuroimaging has been used in clinical practice for over 30 years, but it is still perceived as rarely offering the psychiatrist much help in direct patient management. As newer imaging modalities are introduced (from computed tomography and positron and single photon emission tomography to magnetic and functional magnetic resonance imaging), the promise of imminent clinical utility is reawakened, only to fade as the innovation is shown to be another, albeit useful, research tool. The aim of this article is to update readers on some recent advances that are starting to align the research and clinical functions of neuroimaging. As imaging becomes more accessible and affordable there is real promise that both clinicians and patients will begin to benefit more directly.

Combined Magnetic Resonance Imaging and Single-Photon Emission Tomography Scanning in the Discrimination of Alzheimer's Disease From Age-Matched Controls

2001 ◽  
Vol 13 (2) ◽  
pp. 149-161 ◽  
Author(s):  
John T. O'Brien ◽  
David Ames ◽  
Patricia Desmond ◽  
Meir Lichtenstein ◽  
David Binns ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Alzheimer’S Disease ◽  
Magnetic Resonance ◽  
Single Photon ◽  
Photon Emission ◽  
Single Photon Emission Tomography ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Single Photon Emission ◽  
Photon Emission Tomography

Objective: To compare the utility of temporal lobe magnetic resonance imaging (MRI) and single-photon emission tomography (SPET) scanning in discriminating between subjects with Alzheimer's disease (AD) and age-matched controls. Methods: Thirty subjects with NINCDS-ADRDA AD (23 probable AD, 5 possible AD, 2 definite AD) and 22 age- and sex-matched controls underwent T1-weighted coronal MRI scanning (0.3 T) and technetium 99m-HMPAOSPET scanning. MRI scans were analyzed using a digitizer system with volumes of hippocampus, amygdala, entorhinal cortex, parahippocampal gyrus, and whole cerebral cortex calculated. From SPET scans, regional cerebral blood flow (rCBF) was assessed in anterior and posterior frontal, parietal, occipital, and mesial temporal cortex using a region of interest analysis with the cerebellum as a reference area. Results: Using MRI, the areas that best separated groups were left hippocampal and left amygdala volume, resulting in correct classification (patient vs. control) in 79% of cases (sensitivity 77%, specificity 82%). Exactly the same proportion of subjects were correctly classified by SPET, with the most discriminating rCBF changes being left parietal and right posterio frontal. Combining information from both scans improved the proportion of correctly classified subjects in a discriminant function to 90% (sensitivity 93%, specificity 86%, only 2AD and 3 controls misclassified). All AD subjects had abnormalities on MRI and/or SPET (sensitivity for combined examinations 100%), while abnormalities on both MRI and SPET had a positive predictive value of 100% for dementia (including the detection of one control subject who later had dementia). Significant correlations between MRI and SPET measures were seen in control subjects but not in patients. Conclusion: Both 0.3 T MRI and single rotating gamma camera SPET were equally useful in separating AD subjects from age-matched controls, although the combination of both significantly enhanced discrimination. In particular, all AD subjects had abnormalities on either MRI or SPET and both techniques may have an important role in assisting with clinical diagnosis, though replication in other centers and examination of differentiation of AD from other causes of dementia need to be examined.

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