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Evidence of Disturbed CSF Circulation and Brain Atrophy in Cases of Schizophrenic Psychosis

Published online by Cambridge University Press:  29 January 2018

G. Bergstrand
Affiliation:
Department of Neuroradiology, Karolinska Institute
L. Bjerkenstedt
Affiliation:
Department of Psychiatry and Psychology, Karolinska Institute
G. Oxenstierna*
Affiliation:
Department of Psychiatry and Psychology, Karolinska Institute
G. Sedvall
Affiliation:
Department of Psychiatry and Psychology, Karolinska Institute
G. Wik
Affiliation:
Department of Psychiatry and Psychology, Karolinska Institute Karolinska Hospital, P.O. Box 60500, S-104 01 Stockholm, Sweden
*
Correspondence

Summary

The cerebrospinal fluid (CSF) circulation was studied with isotope cisternography in 30 patients with a schizophrenic type of psychosis. All had previously received neuroleptic treatment. Disturbed CSF circulation was found in 10 cases. In four of these, persistent intraventricular radioactivity was observed as well as partly obstructed CSF spaces. In the other six cases a slow CSF circulation was noted as well as evidence of partly obstructed CSF spaces especially of the upper posterior frontal region. Signs of atrophy of the cortex and vermis were found on CT scan in 10 cases. In four of these subjects a local atrophy was noticed in the upper posterior frontal cortex and around the frontal part of the interhemispheric fissure. Seventeen of the patients (57 per cent) had pathological findings at isotope cisternography and/or at CT. Disturbed circulation did not correlate with CT-findings, age, duration of psychosis, alcohol abuse, drug consumption or family history for psychosis. CT evidence of brain atrophy was significantly related to nonfamilial type of psychosis.

Type
Papers
Copyright
Copyright © 1984 The Royal College of Psychiatrists 

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References

Benes, F., Sunderland, P., Jones, B. D., LeMay, M., Cohen, B. M. & Lipinsky, J. F. (1982) Normal ventricles in young schizophrenics. British Journal of Psychiatry, 141, 90–3.Google Scholar
Bergstrand, G., Larsson, S., Bergström, M., Eriksson, L. & Edner, G. (1982) Cerebrospinal fluid circulation: Evaluation by single-photon and emission tomography. American Journal of Neuroradiology, 4, 557–9.Google Scholar
Bjerkenstedt, L., Gullberg, B., Härnryd, C. & Sedvall, G. (1977) Monoamine metabolite levels in cerebrospinal fluid of psychotic women treated with melperone or thiothixene. Archiv für Psychiatrie und Nerven-Krankenheiten, 224, 107–18.Google ScholarPubMed
Cserr, H., Fenstermacher, J. & Fencl, V. (eds.) (1975) Fluid Environment of the Brain. New York: Academic Press.Google Scholar
Glück, E., Radü, E. W., Mundt, C. & Gerhardt, P. (1980) A computed tomographic protective trohoc study of chronic schizophrenics. Neuroradiology, 20, 167–71.CrossRefGoogle Scholar
Gyldenstedt, C. (1977) Measurements of the normal ventricular system and hemispheric sulci of 100 adults with computed tomography. Neuroradiology, 14, 183–92.Google Scholar
Henriksson, L. & Voigt, K. (1976) Age-dependent differences of distribution and clearance patterns in normal RIHSA cisternograms. Neuroradiology, 12, 103–7.CrossRefGoogle ScholarPubMed
Hollister, L. E. (1974) Clinical Use of Psychotherapeutic Drugs. Springfield, Illinois: Charles C. Thomas.Google Scholar
Härnryd, C., Bjerkenstedt, L., Gullberg, B., Oxenstierna, G., Sedvall, G. & Wiesel, F.-A. (1984) Time course for effects of sulpiride and chlorpromazine on monoamine metabolite and prolactin levels in cerebrospinal fluid from schizophrenic patients. Acta Psychiatrica Scandinavica, Suppl. 311, 69, 7592.CrossRefGoogle Scholar
Jacobi, W. & Winkler, H. (1927) Encephalographische Studien an Chronisch Schizophrenen. Archiv für Psychiatrie und Nervenkrankenheiten, 81, 299332.Google Scholar
Johnstone, E. C., Frith, C. D., Crow, T. J., Husband, E. J. & Kreel, L. (1976) Cerebral ventricular size and cognitive impairment in chronic schizophrenia. Lancet, 11, 924–6.Google Scholar
van Kammen, D. P., Mann, L. S., Sternberg, D. E., Scheinin, M., Ninan, P. T., Marder, S. R., van Kammen, W. B., Reider, R. O. & Linnoila, M. (1983) Dopamine-beta-hydroxylase activity and homovanillic acid in spinal fluid of schizophrenics with brain atrophy. Science, 220, 974–6.CrossRefGoogle ScholarPubMed
Lowry, O. H., Rosebrough, N. J., Farr, A. L. & Randall, R. J. (1951) Protein measurement with the Folin phenol reagent. Journal of Biological Chemistry, 193, 265–75.CrossRefGoogle ScholarPubMed
Lying-Tunell, U. (1977) Cerebrospinal fluid turnover and convexity block in mental impairment. Neurology, 27, 460–70.Google Scholar
Nybäck, H., Wiesel, F.-A., Berggren, B.-M. & Hindmarsh, T. (1982) Computed tomography of the brain in patients with acute psychosis and in healthy volunteers. Acta Psychiatrica Scandinavica, 65, 403–14.Google Scholar
Nybäck, H., Berggren, B.-M., Hindmarsh, T., Sedvall, G. & Wiesel, F.-A. (1983) Cerebroventricular size and cerebrospinal fluid monoamine metabolites in schizophrenic patients and healthy volunteers. Psychiatry Research, In press.Google Scholar
Potkin, S. G., Weinberger, D. R., Linnoila, M. & Wyatt, R. J. (1983) Low CSF 5-hydroxyindoleacetic acid in schizophrenic patients with enlarged cerebral ventricles. American Journal of Psychiatry, 140, 21.Google ScholarPubMed
Sedvall, G., Fyrö, B., Gullberg, B., Nybäck, H., Wiesel, F.-A. & Wode-Helgodt, B. (1980) Relationships in healthy volunteers between concentrations of monoamine metabolites in cerebrospinal fluid and family history of psychiatric morbidity. British Journal of Psychiatry, 136, 366–74.Google Scholar
Sedvall, G. & Wode-Helgodt, B. (1980) Aberrant monoamine metabolite levels in CSF and family history of schizophrenia. Archives of General Psychiatry, 37, 1113–6.Google Scholar
Sedvall, G., Alfredsson, G., Bjerkenstedt, L., Eneroth, P., Fyrö, B., Härnryd, C., Swahn, C.-G., Wiesel, F.-A. & Wode-Helgodt, B. (1975) Selective effects of psychoactive drugs on levels of monoamine metabolites and prolactin in cerebrospinal fluid of psychiatric patients. In Proceedings of the Sixth Int. Congress of Pharmacology, 3, 255–67.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders. New York: Instrument No. = 59.Google Scholar
Swahn, C.-G., Sandgärde, B., Wiesel, F.-A. & Sedvall, G. (1976) Simultaneous determination of three major monoamine metabolites in brain tissue and body fluids by a mass fragmentographic method. Psychopharmacology, 48, 147–52.Google Scholar
Weinberger, D. R., Torrey, E. F., Neophytides, A. N. & Wyatt, R. J. (1979a) Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry, 36, 735–9.CrossRefGoogle ScholarPubMed
Weinberger, D. R., Torrey, E. F., Neophytides, A. N. & Wyatt, R. J. (1979b) Structural abnormalities in the cerebral cortex of chronic schizophrenic patients. Archives of General Psychiatry, 36, 935–9.CrossRefGoogle ScholarPubMed
Weinberger, D. R., DeLisi, L. E., Perman, G. P., Targum, S. & Wyatt, R. J. (1982) Computed tomography in schizophreniform disorder and other acute psychiatric disorders. Archives of General Psychiatry, 39, 778–83.CrossRefGoogle ScholarPubMed
Weinberger, D. R., DeLisi, L. E., Herlofson, J., Härnryd, C., Nybäck, H., Oxenstierna, G. & Sedvall, G. (1983) Psychiatric morbidity within the family and steady state levels of CSF monoamine metabolites. In Proceedings of the 5th Catecholamine Symposium in Gothenburg, Sweden, June 12–16, 1983 (ed. E. Usdin). New York: Alan R. Liss, Inc.Google Scholar
Wode-Helgodt, B., Fyrö, B., Gullberg, B. & Sedvall, G. (1977) Effects of chlorpromazine treatment on monoamine metabolite levels in cerebrospinal fluid of psychotic patients. Acta Psychiatrica Scandinavica, 56, 129–42.Google Scholar
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