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Molecular imaging studies of the striatal dopaminergic system in psychosis and predictions for the prodromal phase of psychosis

Institute of Psychiatry, Camberwell, London, UK

ANDREW J. MONTGOMERY, PhD, MRCP, MRCPsych

Clinical Sciences Centre, Hammersmith Hospital, London, UK

MARIECLAUDE ASSELIN, PhD

Hammersmith Imanet, Hammersmith Hospital, London, UK

ROBIN M. MURRAY, FRCPsych, DSc

Institute of Psychiatry, London, UK

PAUL M. GRASBY, MRCPsych, MD, FRCP, FMedSci, MRC

Cinical Sciences Centre, Hammersmith Hospital, London, UK

PHILIP K. McGUIRE, FRCPsych, MD, PhD

Institute of Psychiatry, London, UK

Correspondence: Oliver D. Howes, Institute of Psychiatry, Camberwell, London SE5 8AF, UK. Email: o.howes{at}iop.kcl.ac.uk

Declaration of interest None.

The dopamine hypothesis has been the major pathophysiological theory of psychosis in recent decades. Molecular imaging studies have provided in vivo evidence of increased dopamine synaptic availability and increased presynaptic dopamine synthesis in the striata of people with psychotic illnesses. These studies support the predictions of the dopamine hypothesis, but it remains to be determined whether dopaminergic abnormalities pre-date or are secondary to the development of psychosis. We selectively review the molecular imaging studies of the striatal dopaminergic system in psychosis and link this to models of psychosis and the functional subdivisions of the striatum to make predictions for the dopaminergic system in the prodromal phase of psychosis.