ABSTRACT
Objective@#Striatal dopamine dysfunction caused by cortical abnormalities is a leading hypothesis of schizophrenia. Although prefrontal cortical pathology is negatively correlated with striatal dopamine synthesis, the relationship between structural frontostriatal connectivity and striatal dopamine synthesis has not been proved in patients with schizophrenia with different treatment response. We therefore investigated the relationship between frontostriatal connectivity and striatal dopamine synthesis in treatment-responsive schizophrenia (non-TRS) and compared them to treatment-resistant schizophrenia (TRS) and healthy controls (HC). @*Methods@#Twenty-four patients with schizophrenia and twelve HC underwent [18F] DOPA PET scans to measure dopamine synthesis capacity (the influx rate constant Kicer) and diffusion 3T MRI to measure structural connectivity (fractional anisotropy, FA). Connectivity was assessed in 2 major frontostriatal tracts. Associations between Kicer and FA in each group were evaluated using Spearman’s rho correlation coefficients. @*Results@#Non-TRS showed a negative correlation (r=-0.629, p=0.028) between connectivity of dorsolateral prefrontal cortex-associative striatum (DLPFC-AST) and dopamine synthesis capacity of associative striatum but this was not evident in TRS (r=-0.07, p=0.829) and HC (r=-0.277, p=0.384). @*Conclusion@#Our findings are consistent with the hypothesis of dysregulation of the striatal dopaminergic system being related to prefrontal cortex pathology localized to connectivity of DLPFC-AST in non-TRS, and also extend the hypothesis to suggest that different mechanisms underlie the pathophysiology of non-TRS and TRS.
ABSTRACT
OBJECTIVES: This study investigated the prescribing patterns of atypical antipsychotics for the various psychiatric disorders in the psychiatric ward of a University hospital. METHODS: We reviewed the medical records of patients who were discharged from an open psychiatric ward from May, 2003 through April, 2014. The association between psychiatric disorders and prescription pattern of atypical antipsychotics was analyzed. RESULTS: The study included 3091 patients' prescription of psychiatric medication. 60% of prescription included antipsychotics; quetiapine was the most frequently prescribed antipsychotics, but the average dosage was the lowest among all the atypical antipsychotics. According to the diagnoses, prescription rates and dosage of antipsychotics were different. Prescription rates of antipsychotics were the lowest in patients with anxiety disorders, and the mean dosage were the lowest in those with delirium, dementia, and amnestic and other cognitive disorders. CONCLUSION: This observational study shows prescription patterns of atypical antipsychotics for the treatment of psychiatric disorders in a University hospital; atypical antipsychotics were widely used for the treatment of the various disorders, and there were differences in prescription patterns for each disorders. The results of this study may be used to identify the proper atypical antipsychotics effective on certain psychiatric disorders and to propose expanding the indications of each atypical antipsychotics in the future.