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The British Journal of Psychiatry (2005) 186: 203-208
© 2005 The Royal College of Psychiatrists

Hypofrontality in men with first-episode psychosis

V. Molina, PhD

Department of Psychiatry, Hospital Cliníco Universitario de Salamanca

J. Sanz, MD

Department of Psychiatry, Hospital Doce de Octubre, Madrid

S. Reig, PhD and R. Martínez, PhD

Department of Experimental Medicine, Hospital Gregorio Marañón, Madrid

F. Sarramea, PhD and R. Luque, MD

Department of Psychiatry, Hospital Reina Sofía, Còrdoba

C. Benito, MD

Clínica Monterprinciple, Hospital de Madrid

J. D. Gispert, PhD, J. Pascau, MSc and M. Desco, PhD

Department of Experimental Medicine, Hospital Gregorio Marañón, Madrid, Spain

Correspondence: Dr V. Molina, Department of Psychiatry, Hospital Clínico de Salamanca, Paseo de San Vicente, 58-182, 37007b Salamanca, Spain. Tel: +34 923 291383; Fax: +34 923 229158; e-mail: vmolina{at}usal.es

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Decreased metabolic activity in the prefrontal cortex during cognitive activation is a recurrent finding and a likely functional marker of schizophrenia.

Aims To investigate the occurrence of hypofrontality in patients with first-episode psychosis, with or without evolution to schizophrenia.

Method We used fluorodeoxyglucose positron emission tomography during the performance of an attention task and magnetic resonance imaging to study the dorsolateral prefrontal region in 13 men with a first episode of psychosis. Data from patients who progressed to schizophrenia were compared with those of patients who did not meet criteria for this diagnosis after 2 years.

Results Patients who developed schizophrenia demonstrated a significant hypofrontality in the dorsolateral prefrontal cortex in comparison with the non-schizophrenia and control groups.

Conclusions Our results suggest that hypofrontality could be a marker of schizophrenia at the time of the first psychotic episode, in agreement with neurodevelopmental theories of schizophrenia.




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