Authors' objectives:

This study aims to summarise the available evidence on the use of cerebral SPECT in the assessment of patients with schizophrenia.

Authors' results and conclusions: In relation to the diagnostic studies published, most reported that during the episodes of schizophrenia exacerbation, an increase in dopaminergic activity was observed in some areas of the brain such as the striated body, which is associated with positive symptoms and good treatment response. A most definite finding was a decrease in frontal cortex uptake associated to negative symptoms. An important restriction in the literature is the small number of patients included (in general less than 20 per group) and the difficulty to include patients without treatment. The disparity in the results observed among the different studies could be explained by the marked heterogeneity that there is as regards the number of patients included (with major depressive disorder many times, co-existent), and the technical differences used in the imaging acquisition and analysis (empirical semiquantitative analytical method to methods that use mathematical models) In relation to prognostic studies, no independent value has been settled for SPECT beyond the usual clinical evaluation. There are few SPECT studies evaluating its role as aid to take therapeutic decisions and they assess the drug occupation of receptors and their relation to adverse reactions and up until now they are of little value in decision making. To consider the role of SPECT for the assessment of patients with schizophrenia , it would be necessary to have the results of less specialized centers, multicentric studies, in defined populations of consecutive patients and standardized analytical methods.

Authors' recommendations: To consider the role of SPECT for the assessment of patients with schizophrenia , it would be necessary to have the results of less specialized centers, multicentric studies, in defined populations of consecutive patients and standardized analytical methods. Functional imaging methods do not play an important role in the diagnosis and treatment of schizophrenia and are still considered investigational methods, contributing to the knowledge about the pathophysiological base of this disease. Nowadays, important health organizations in the U.S.A. do not consider SPECT as an indication for patients with schizophrenia.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.iecs.org.ar/

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)