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Original Article |
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Neuropsychopharmacology (1999) 21 632-640.10.1038/sj.npp.1395389
The Brain Metabolic Patterns of Clozapine- and Fluphenazine-Treated Female Patients with Schizophrenia: Evidence of a Sex Effect
Robert M Cohen1 Ph.D, MD, Thomas E Nordahl2 Ph.D, MD, William E Semple3 Ph.D and David Pickar1 MD |
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1Laboratory of Cerebral Metabolism, National Institute of Mental Health and Experimental Therapeutics Branch, National Institute of Mental Health, Bethesda, MD USA
2University of California Medical Center, Davis, Napa State Hospital, Napa, California, and the Lawrence Berkeley National Laboratory, Berkeley, CA USA
3Case Western Reserve University and the VAMC, Cleveland, OH USA
Correspondence: Dr Robert M Cohen, Clinical Brain Imaging Section, LCM, NIH, Bldg. 36, Room 1A05, 36 Convent Dr. MSC 4030, Bethesda, MD, 20892-4030
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ABSTRACT
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The regional cerebral glucose metabolic rates of clozapine-treated and fluphenazine-treated women with schizophrenia and normal controls were obtained by positron emission tomography (PET) using [18F]-2-fluoro-2-deoxy-D-glucose (FDG) as the tracer. The regional metabolic patterns were compared to each other and to the changes previously observed in men. In women, as in men, both clozapine- and fluphenazine-treatment were associated with lower metabolism in the superior prefrontal cortex and higher metabolism in the medial temporal lobe. In both men and women, clozapine treatment led to a greater lowering of inferior prefrontal cortex activity than fluphenazine, which was statistically significant in the larger male cohort. Fluphenazine led to higher metabolic rates in the lateral temporal lobe than clozapine did, but the differences between the two neuroleptics were not statistically significant in either group. The greatest differences in the female as compared to the male responses to fluphenazine and clozapine were in the cingulate and striatum. As compared to controls, the cingulate metabolic rates of women were reduced by 9.1% and 11.4% on clozapine and fluphenazine, respectively; whereas, men have a statistically nonsignificant reduction of 0.1% with clozapine and a 3.2% increase with fluphenazine. In men, fluphenazine was associated with a much greater elevation in basal ganglia metabolic rates than was clozapine, 23.5 % as compared to 3.75%; whereas, in women, basal ganglia metabolic rates are nearly equally increased by fluphenazine (21.6%) and clozapine (15.1%).
Keywords: Striatum; Cingulate; Deoxyglucose; Cerebral metabolic rates; Positron emission tomography; Neuroleptics |
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