Neuropsychological performances and brain perfusion patterns in patients with first episode psychosis

Abnormalities in cognition are a pronounced feature in primary psychotic disorders and may appear long before the manifestation of the first-episode psychosis (FEP). Although brain functional changes may precede structural alterations, brain perfusion patterns in FEP and most importantly their correlations with cognition remain poorly understood. In the present study we assessed neurocognitive functions and regional cerebral blood flow (rCBF) in 53 patients with a diagnosis of FEP. A special emphasis was placed on the assessment of basic executive functions. Cerebral perfusion patterns were measured by SPECT rCBF scintigraphy in cerebral lobes bilaterally and Brodmann Areas (BAs). Patients showed impairments in long-term verbal memory, processing speed/response latency and executive cognition. Pathological perfusion was prominent in the limbic lobes bilaterally. BAs with the largest hypoperfusion, were the subgenual area (BA25) and hippocampal areas (BA 28 and 36). The left temporal lobe was also hypoperfused, and specifically the inferior temporal gyrus (BA 20), the left middle (BA 21) and superior (BA 22) temporal gyrus, and the temporal pole (BA 38). Hypoperfusion was limited in the frontal regions, although specific BAs displayed pathological perfusion (i.e., BA 24). Cerebral lobe perfusion was not correlated with compromised cognitive abilities.