Striatal dopamine D 2/3 receptors in medication-naïve schizophrenia: an [123I] IBZM SPECT study

Kao Chin Chen, Yen Kuang Yang, Oliver D. Howes, I. Hui Lee, Tzung Lieh Yeh, Nan Tsing Chiu, Po See Chen, Anthony S. David, Elvira Bramon

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: The hyper-function of the striatal dopamine system has been suggested to underlie key pathophysiological mechanisms in schizophrenia. Moreover, patients have been observed to present a significant elevation of dopamine receptor availability compared to healthy controls. Although it is difficult to measure dopamine levels directly in humans, neurochemical imaging techniques such as single-photon emission computed tomography (SPECT) provide indirect indices of in vivo dopamine synthesis and release, and putative synaptic levels. Methods: We focused on the role of dopamine postsynaptic regulation using [123I] iodobenzamide (IBZM) SPECT. We compared D2/3 receptor availability between 53 healthy controls and 21 medication-naive patients with recent-onset schizophrenia. Result: The mean specific striatal binding showed no significant difference between patients and controls (estimated difference = 0.001; 95% CI -0.11 to 0.11; F = 0.00, df = 1, 69; p = 0.99). There was a highly significant effect of age whereby IBZM binding declined with advancing age [estimated change per decade of age = -0.01(binding ratio); 95% CI -0.01 to -0.004; F = 11.5, df = 1, 69; p = 0.001]. No significant correlations were found between the mean specific striatal binding and psychopathological or cognitive rating scores. Conclusions: Medication-naïve patients with recent-onset schizophrenia have similar D2/3 receptor availability to healthy controls. We suggest that, rather than focusing exclusively on postsynaptic receptors, future treatments should target the presynaptic control of dopamine synthesis and release.

Original languageEnglish
Pages (from-to)3251-3259
Number of pages9
JournalPsychological Medicine
Issue number14
Publication statusPublished - 2022 Oct 8

All Science Journal Classification (ASJC) codes

  • Applied Psychology
  • Psychiatry and Mental health


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