Resting-State Perfusion in Nonmedicated Schizophrenic Patients: A Continuous Arterial Spin-labeling 3.0-T MR Study

Purpose: To determine whether well-described patterns of altered perfusion in schizophrenia can be identified by using continuous arterial spin labeling (CASL) with a whole-brain imaging sequence. Materials and Methods: This study was approved by the ethics committee of the local institutional review board, and written informed consent was obtained from all subjects. CASL was used to compare cerebral perfusion between 11 nonmedicated patients with schizophrenia and 25 healthy control subjects. Since antipsychotic medication may affect perfusion, only drug-free subjects were examined. Resting-state perfusion, as measured in terms of regional cerebral blood flow, was compared voxel wise by using an analysis of variance design in a statistical parametric mapping program, with patient age and sex as covariates. Results: Compared with the healthy control subjects, the schizophrenic patients had extensive areas of hypoperfusion in the frontal lobes bilaterally, in the anterior and medial cingulate gyri, and in the parietal lobes bilaterally. Increased perfusion was observed in the cerebellum, brainstem, and thalamus of the schizophrenic patients as compared with the perfusion in these areas in the control subjects. Conclusion: CASL in schizophrenia revealed patterns of hypo-and hyperperfusion similar to the perfusion patterns in previously published positron emission tomographic and single photon emission computed tomographic studies. The advantages of CASL, including independence from injected contrast agents, no irradiation, and fast acquisition time, may facilitate intensive perfusion studies of the early recognition of schizophrenia and other psychiatric disorders, as well as longitudinal disease-monitoring research of these conditions.