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Lina Shihabuddin, MD; Monte S. Buchsbaum, MD; Erin A. Hazlett, PhD; M. Mehmet Haznedar, MD; Philip D. Harvey, PhD; Alan Newman, MD; David B. Schnur, MD; Jacqueline Spiegel-Cohen, MS; Tsechung Wei, PhD; Josef Machac, MD; Karin Knesaurek, PhD; Shankar Vallabhajosula, PhD; Melissa A. Biren; Tina M. Ciaravolo; Christina Luu-Hsia

Arch Gen Psychiatry. 1998;55:235-243.

Background  Magnetic resonance imaging and positron emission tomography were used to study the size and metabolic rate of the caudate and the putamen in 18 patients with schizophrenia (n=16) or schizo-affective disorder (n=2) and 24 age- and sex-matched control subjects.

Methods  The patients were either never medicated (n=7) or drug free (n=11) for a median of 3 weeks. During uptake of fludeoxyglucose F 18, all patients performed a serial verbal learning test. Positron emission tomographic and magnetic resonance imaging scans were coregistered, and the caudate and the putamen were traced on the magnetic resonance image.

Results  The striatum had a significantly lower relative metabolic rate in schizophrenics than in controls. Never-medicated patients had lower metabolic rates in the right putamen (ventral part of the dorsal striatum) than previously medicated patients. The caudate was significantly smaller in never-medicated patients than in controls and largest in previously medicated patients. Patients with higher relative metabolic rates in the putamen scored higher on the Abnormal Involuntary Movements Scale.

Conclusions  The findings are consistent with reports of striatal enlargement in previously medicated patients and size increases after neuroleptic treatment. Never-medicated patients, in contrast, had ventral striatal structures that were smaller and less active than those observed in controls and previously medicated patients.

From the Neuroscience PET Laboratory and the Department of Psychiatry, Mount Sinai School of Medicine (Drs Shihabuddin, Buchsbaum, Hazlett, Haznedar, Harvey, Newman, Schnur, and Wei and Mss Spiegel-Cohen, Biren, Ciaravolo, and Luu-Hsia), and the Division of Nuclear Medicine, Department of Radiology, Mount Sinai Hospital (Drs Machac, Knesaurek, and Vallabhajosula), New York, NY.

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