Increased dopamine synthesis rate in medial prefrontal cortex and striatum in schizophrenia indicated by L-(β-11C) DOPA and PET

Background: The aim of the present study was to investigate dopamine synthesis in the brain of drug-free schizophrenic patients, not only in the striatum but also in extrastriatal areas like the prefrontal cortex, brain areas that for a long time has been in focus of interest in the pathophysiology of schizophrenia. Methods: PET was performed in 12 drug;free (10 drug-naive) psychotic schizophrenic patients and 10 healthy volunteers matched for age and gender using (11)C-labelled L-DOPA as the tracer The time-radioactivity curve from occipital cortex (located within Brodman area 17 and 18) was used as input function to calculate L-DOPA influx rate, K(i) images, that were matched to a common brain atlas. A significant overall increase of the K(i) values was found in the schizophrenic group as compared with healthy controls. Results: In particular, significantly higher K(i) were found in the schizophrenic patients compared to the controls in the caudate nucleus, putamen and in parts of medial prefrontal cortex (Brod 24). The K(i) value reflect an increased utilization of L-DOPA, presumably due to increased activity of the amino acid decarboxylate enzyme. Conclusions: The results indicate that the synthesis of dopamine is elevated within the striatum and parts of medial prefrontal cortex in schizophrenia. Biol Psychiatry 1999;46:681-688 (C) 1999 Society of Biological Psychiatry.