The role of dopamine dysregulation and evidence for the transdiagnostic nature of elevated dopamine synthesis in psychosis: a positron emission tomography (PET) study comparing schizophrenia, delusional disorder, and other psychotic disorders

Pak Wing Calvin Cheng, Wing Chung Chang, Gladys G Lo, Kit Wa Sherry Chan, Ho Ming Edwin Lee, Lai Ming Christy Hui, Yi Nam Suen, Yim Lung Eric Leung, Kai Ming Paul Au Yeung, Sirong Chen, Ka Fung Henry Mak, Pak Chung Sham, Barbara Santangelo, Mattia Veronese, Chi-Lai Ho, Yu Hai Eric Chen, Oliver D Howes

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

There have been few studies performed to examine the pathophysiological differences between different types of psychosis, such as between delusional disorder (DD) and schizophrenia (SZ). Notably, despite the different clinical characteristics of DD and schizophrenia (SZ), antipsychotics are deemed equally effective pharmaceutical treatments for both conditions. In this context, dopamine dysregulation may be transdiagnostic of the pathophysiology of psychotic disorders such as DD and SZ. In this study, an examination is made of the dopamine synthesis capacity (DSC) of patients with SZ, DD, other psychotic disorders, and the DSC of healthy subjects. Fifty-four subjects were recruited to the study, comprising 35 subjects with first-episode psychosis (11 DD, 12 SZ, 12 other psychotic disorders) and 19 healthy controls. All received an 18F-DOPA positron emission tomography (PET)/magnetic resonance (MR) scan to measure DSC (Kocc;30-60 value) within 1 month of starting antipsychotic treatment. Clinical assessments were also made, which included Positive and Negative Syndrome Scale (PANSS) measurements. The mean Kocc;30-60 was significantly greater in the caudate region of subjects in the DD group (ES = 0.83, corrected p = 0.048), the SZ group (ES = 1.40, corrected p = 0.003) and the other psychotic disorder group (ES = 1.34, corrected p = 0.0045), compared to that of the control group. These data indicate that DD, SZ, and other psychotic disorders have similar dysregulated mechanisms of dopamine synthesis, which supports the utility of abnormal dopamine synthesis in transdiagnoses of these psychotic conditions.

Original languageEnglish
Pages (from-to)1870-1876
Number of pages7
JournalNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
Volume45
Issue number11
Early online date1 Jul 2020
DOIs
Publication statusPublished - 1 Oct 2020

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