Preliminary evidence of striatal D2 receptor density as a possible biological marker of prognosis in naive schizophrenic patients

With the aim of investigating a possible biological marker of prognosis in schizophrenia, the relationship between striatal dopaminergic D2 receptor (D2R) density and clinical prognostic factors was studied in an initial sample of nine neuroleptic-naive schizophrenic patients. Previous psychosocial adaptation was evaluated by means of the Premorbid Adjustment Scale (PAS). Based on the four DSM-IV criteria in schizophreniform disorder for good prognosis, patients were divided in two groups: good prognosis if greater than or equal to2 criteria were met (n = 5) and poor prognosis if <2 criteria were met (n = 4). D2R density was assessed by means of 1231-IBZM single photon emission computed tomography (SPECT) and striatum/occipital uptake ratios (S/O). S/O ratios previously obtained from a control group of nine age- and sex-matched healthy volunteers were used for comparison. Results: Patients with poor prognosis showed a higher S/O ratio (mean = 1.94, range = 1.93-1.98) than patients with good prognosis (mean = 1.64, range = 1.52-1.79) and the control group (mean = 1.69, range = 1.51-1.85) [analysis of variance (ANOVA) F = 10.628, df = 2, P = .001, post hoc Scheffe P < .005]. PAS scores were significantly different between patients with Good and poor prognosis (40+/-9.39 vs. 84.25+/-26, Mann-Whitney U-test P = .014). A direct correlation of S/O ratios with PAS scores was found (Spearman r = .72, FL = .028). Conclusions: Striatal D2R density in naive schizophrenic patients may be related to DSM-IV prognostic factors and premorbid adjustment criteria (PAS). If these preliminary results are confirmed, striatal D2R density might predict premorbid and clinical features associated with poor prognosis in neuroleptic-naive patients. (C) 2003 Elsevier Science Inc. All rights reserved.