Down-regulation of 5-HT2A receptors in the prodromal phase of schizophrenia

The empiric efficiency of serotonergic drugs in the psychotic type of mental disease suggested to image serotonergic receptors (here the 5-HT2A subtype) for the early detection of serotoninergic changes in schizophrenie. A sample of 14 subjects in at-risk mental states was recruited at the Department of Psychiatry of the University in Bonn. All subjects were strictly drug naïve. We detected decreased binding of the 5-HT2A radioligand [18F]altanserin by 15% in the right posterior insula and by 35% in the left amygdala (compared to 21 age matched healthy controls). The findings were highly significant at the group level and confirmed current pathobiochemical concepts of schizophrenia.      

Figure: Parametric images of [18F]altanserin binding potential (BPP) corrected for partial volume effects in controls (top) and persons at early (middle) and late (bottom) prodromal state of schizophrenia. Note the decrease of [18F]altanserin binding in the striatum and posterior insula.