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Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB

BACKGROUND: Previous studies suggested a link between serotonergic neurotransmission and impaired insight in schizophrenia. In this study, we examined the relationship between serotonin transporter (SERT) availability in regions of the prefrontal cortex (dorsolateral, ventrolateral, ventromedial, an...

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Autores principales: Kim, Jeong-Hee, Son, Young-Don, Kim, Hang-Keun, Kim, Jong-Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544267/
https://www.ncbi.nlm.nih.gov/pubmed/34707358
http://dx.doi.org/10.2147/NDT.S336126
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author Kim, Jeong-Hee
Son, Young-Don
Kim, Hang-Keun
Kim, Jong-Hoon
author_facet Kim, Jeong-Hee
Son, Young-Don
Kim, Hang-Keun
Kim, Jong-Hoon
author_sort Kim, Jeong-Hee
collection PubMed
description BACKGROUND: Previous studies suggested a link between serotonergic neurotransmission and impaired insight in schizophrenia. In this study, we examined the relationship between serotonin transporter (SERT) availability in regions of the prefrontal cortex (dorsolateral, ventrolateral, ventromedial, and orbitofrontal cortices) and insight deficits in antipsychotic-free patients with schizophrenia using high-resolution positron emission tomography (PET) with [(11)C]DASB. METHODS: Nineteen patients underwent [(11)C]DASB PET and 7-Tesla magnetic resonance imaging scans. To assess SERT availability, the binding potential with respect to non-displaceable compartment (BP(ND)) was derived using the simplified reference tissue model. Patients’ level of insight was assessed using the Insight and Treatment Attitude Questionnaire (ITAQ). The relationship between ITAQ scores and [(11)C]DASB BP(ND) values was examined using the region-of-interest (ROI)- and voxel-based analyses with relevant variables as covariates. The prefrontal cortex and its four subregions were selected as a priori ROIs since the prefrontal cortex has been implicated as the critical neuroanatomical substrate of impaired insight in schizophrenia. RESULTS: The ROI-based analysis revealed that the ITAQ illness insight dimension had significant negative correlations with the [(11)C]DASB BP(ND) in the left dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ treatment insight dimension had significant negative correlations with the [(11)C]DASB BP(ND) in the bilateral dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ total score showed significant negative correlations with the [(11)C]DASB BP(ND) in the bilateral prefrontal cortex and three subregions (dorsolateral, ventrolateral, and orbitofrontal cortices). A supplementary voxel-based analysis corroborated a significant negative association between the ITAQ score and the [(11)C]DASB BP(ND) in the prefrontal cortices. CONCLUSION: Our study provides in vivo evidence of significant negative correlations between insight deficits and prefrontal SERT availability in patients with schizophrenia, suggesting significant involvement of prefrontal serotonergic signaling in impaired insight, one of the core symptoms of schizophrenia.
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spelling pubmed-85442672021-10-26 Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB Kim, Jeong-Hee Son, Young-Don Kim, Hang-Keun Kim, Jong-Hoon Neuropsychiatr Dis Treat Original Research BACKGROUND: Previous studies suggested a link between serotonergic neurotransmission and impaired insight in schizophrenia. In this study, we examined the relationship between serotonin transporter (SERT) availability in regions of the prefrontal cortex (dorsolateral, ventrolateral, ventromedial, and orbitofrontal cortices) and insight deficits in antipsychotic-free patients with schizophrenia using high-resolution positron emission tomography (PET) with [(11)C]DASB. METHODS: Nineteen patients underwent [(11)C]DASB PET and 7-Tesla magnetic resonance imaging scans. To assess SERT availability, the binding potential with respect to non-displaceable compartment (BP(ND)) was derived using the simplified reference tissue model. Patients’ level of insight was assessed using the Insight and Treatment Attitude Questionnaire (ITAQ). The relationship between ITAQ scores and [(11)C]DASB BP(ND) values was examined using the region-of-interest (ROI)- and voxel-based analyses with relevant variables as covariates. The prefrontal cortex and its four subregions were selected as a priori ROIs since the prefrontal cortex has been implicated as the critical neuroanatomical substrate of impaired insight in schizophrenia. RESULTS: The ROI-based analysis revealed that the ITAQ illness insight dimension had significant negative correlations with the [(11)C]DASB BP(ND) in the left dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ treatment insight dimension had significant negative correlations with the [(11)C]DASB BP(ND) in the bilateral dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ total score showed significant negative correlations with the [(11)C]DASB BP(ND) in the bilateral prefrontal cortex and three subregions (dorsolateral, ventrolateral, and orbitofrontal cortices). A supplementary voxel-based analysis corroborated a significant negative association between the ITAQ score and the [(11)C]DASB BP(ND) in the prefrontal cortices. CONCLUSION: Our study provides in vivo evidence of significant negative correlations between insight deficits and prefrontal SERT availability in patients with schizophrenia, suggesting significant involvement of prefrontal serotonergic signaling in impaired insight, one of the core symptoms of schizophrenia. Dove 2021-10-21 /pmc/articles/PMC8544267/ /pubmed/34707358 http://dx.doi.org/10.2147/NDT.S336126 Text en © 2021 Kim et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Kim, Jeong-Hee
Son, Young-Don
Kim, Hang-Keun
Kim, Jong-Hoon
Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB
title Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB
title_full Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB
title_fullStr Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB
title_full_unstemmed Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB
title_short Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [(11)C]DASB
title_sort association between lack of insight and prefrontal serotonin transporter availability in antipsychotic-free patients with schizophrenia: a high-resolution pet study with [(11)c]dasb
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544267/
https://www.ncbi.nlm.nih.gov/pubmed/34707358
http://dx.doi.org/10.2147/NDT.S336126
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