Study of childhood onset schizophrenia (COS) using SPECT and neuropsychological assessment

BACKGROUND: In recent years, the development of positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging has enhanced our understanding of the physiological functioning of the intact brain. AIM: To study cerebral cortical perfusion defects in patients with childhood onset schizophrenia (COS) and to assess their neuropsychological functioning. METHODS: This cross-sectional study comprised 14 patients with COS with onset at or before 14 years of age, diagnosed as per ICD-10 DCR criteria, attending a tertiary care centre in North India. All the patients were assessed on sociodemographic, clinical profile sheet, Positive and Negative Symptom Scale (PANSS) and Edinburgh Handedness Inventory (EHI). The Wisconsin Card Sorting Test (WCST) was used to assess their neuropsychological functioning. All patients underwent SPECT. A control group of 10 healthy subjects was studied with SPECT for comparison. RESULTS: Nine patients (64.3%) showed perfusion anomaly on SPECT scan specifically in the left temporal and frontal areas of the brain. On WCST score these 9 patients showed a higher percentage of total errors (64.49%±9.42%) as compared to the other 5 patients (48.54%±12.70%) who showed no abnormality on SPECT scan. All normal control subjects showed no abnormality on SPECT. CONCLUSION: The results from WCST show that COS patients have difficulty in executive functioning. Also, patients had perfusion anomaly in the left temporal, frontal and parietal areas. Deficits found in COS are similar to those found in adult onset schizophrenia (AOS). In view of the findings, the nature of COS and its relationship with AOS are discussed.