This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Godfrey D. Pearlson, MBBS; Dean F. Wong, MD, PhD; Larry E. Tune, MD; Christopher A. Ross, MD, PhD; Gary A. Chase, PhD; Jonathan M. Links, PhD; Robert F. Dannals, PhD; Alan A. Wilson, PhD; Hayden T. Ravert, PhD; Henry N. Wagner, Jr, MD; J. Raymond DePaulo, MD

Arch Gen Psychiatry. 1995;52(6):471-477.

Abstract
Background
A prior positron emission tomographic study from The Johns Hopkins University, Baltimore, Md, using N-methylspiperone labeled with carbon 11 reported elevated basal ganglia D₂ dopamine receptor density (B_max) values in neuroleptic-naive schizophrenic patients compared with controls. We have now extended these studies to include patients with bipolar disorder.

Methods
Patients with bipolar disorder (n=14) either had never received neuroleptic medication or had been neuroleptic-free for more than 6 months, and they met DSM-III criteria for currently symptomatic affective disorder. Patients with bipolar disorder were compared with matched schizophrenic patients and normal controls. All received two positron emission tomographic scans, the second of which was preceded by oral administration of haloperidol lactate, to permit the calculation of D₂ dopamine receptor Bmax.

Results
Diagnostic groups differed in B_max by analysis of variance (P<.0001); post hoc tests showed higher B_max values for psychotic patients with bipolar disorder and schizophrenic patients compared with normal controls and for schizophrenic patients and psychotic patients with bipolar disorder compared with nonpsychotic patients with bipolar disorder. Among patients with bipolar disorder, B_max values correlated significantly with the severity of psychotic symptoms (r=.63) on the Present State Examination but not with the severity of nonpsychotic mood symptoms.

Conclusions
We conclude that, like schizoprenic patients, patients with psychotic bipolar disorder have elevations of D₂ dopamine receptor B_max values and that such elevations in affective disorder are more closely associated with the presence of psychosis than with mood abnormality. Elevations in dopamine receptor values thus may occur in psychiatric states that are characterized by psychotic symptoms rather than being specific to schizophrenia.

Author Affiliations
From the Departments of Psychiatry and Behavioral Sciences (Drs Pearlson, Tune, Ross, Chase, and DePaulo), Mental Hygiene (Drs Pearlson and Chase), Psychiatric Neuro-Imaging (Dr Pearlson), Radiology (Drs Wong, Links, Dannals, Wilson, Ravert, and Wagner), and Neuroscience (Dr Ross), The Johns Hopkins University, Baltimore, Md. Dr Tune is currently affiliated with Wesley Woods Geriatric Hospital, Emory University, Atlanta, Ga.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Increased striatal dopamine (D2/D3) receptor availability and delusions in Alzheimer disease
Reeves et al.
Neurology 2009;72:528-534.
ABSTRACT | FULL TEXT  

Mood-Incongruent Psychotic Features in Bipolar Disorder: Familial Aggregation and Suggestive Linkage to 2p11-q14 and 13q21-33
Goes et al.
Am. J. Psychiatry 2007;164:236-247.
ABSTRACT | FULL TEXT  

Brain Receptor Imaging
Heiss and Herholz
JNM 2006;47:302-312.
ABSTRACT | FULL TEXT  

Familial Aggregation of Delusional Proneness in Schizophrenia and Bipolar Pedigrees
Schurhoff et al.
Am. J. Psychiatry 2003;160:1313-1319.
ABSTRACT | FULL TEXT  

Psychosis as a State of Aberrant Salience: A Framework Linking Biology, Phenomenology, and Pharmacology in Schizophrenia
Kapur
Am. J. Psychiatry 2003;160:13-23.
ABSTRACT | FULL TEXT  

PET Study of the Effects of Valproate on Dopamine D2 Receptors in Neuroleptic- and Mood-Stabilizer-Naive Patients With Nonpsychotic Mania
Yatham et al.
Am. J. Psychiatry 2002;159:1718-1723.
ABSTRACT | FULL TEXT  

PET Study of [18F]6-Fluoro-L-Dopa Uptake in Neuroleptic- and Mood-Stabilizer-Naive First-Episode Nonpsychotic Mania: Effects of Treatment With Divalproex Sodium
Yatham et al.
Am. J. Psychiatry 2002;159:768-774.
ABSTRACT | FULL TEXT  

The Familial Aggregation of Psychotic Symptoms in Bipolar Disorder Pedigrees
Potash et al.
Am. J. Psychiatry 2001;158:1258-1264.
ABSTRACT | FULL TEXT  

Brain SPECT Imaging of Amphetamine-Induced Dopamine Release in Euthymic Bipolar Disorder Patients
Anand et al.
Am. J. Psychiatry 2000;157:1108-1114.
ABSTRACT | FULL TEXT  

Imaging strategies in depression
Grasby
J Psychopharmacol 1999;13:346-351.
ABSTRACT