Studies of Frontal Lobe Brain Functioning in Schizophrenia

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• Participants in this study will reflect the diversity of the community. No one will be excluded or discriminated against on the grounds of race, gender, religion or ethnic background. Every attempt will be made to include women and minorities in the study population. Children will not be studied because of radiation exposure limits on this group.
• Normal control subjects will be recruited through the NIH normal volunteer program, through advertisement in the community and primarily through the "Genetic Study" under protocol 95-M-0150. An additional control group of non-schizophrenic siblings of patients with schizophrenia will also be recruited (from the community and protocol 95-M-0150, A Neurobiological Investigation of Patients with Schizophrenia Spectrum Disorders and Their Siblings). Control subjects will be matched to the patient groups by age, sex, and handedness. Control subjects with a history of psychiatric or neurologic disorders or medical illnesses or surgeries that might have relevance to the investigation of brain physiology will be excluded. Control subjects requiring continuous treatment with prescribed medications that impact cerebral blood flow and metabolism will be excluded. Control subjects unable to refrain from nicotine or caffeine for at least 4 hours or alcohol for at least 12 hours prior to the PET study will be excluded. Control subjects with exposure to other substances with relevance to cerebral blood flow and metabolism, such as some over-the-counter medications, will be reviewed in each individual case, to ensure that an adequate period of abstinence will precede the performance of the PET study.
• Patients with schizophrenia spectrum disorder will be recruited from the inpatient population of the NIMH Wards at the NIH Clinical Center and from the sibling study protocol 95-M-0150. Diagnoses will be made by the NIMH clinical staff in accordance with DSM-IV(R). Patients with history of neurological illness other than those of interest to the study, or other medical illness or surgery that might have impact on the study of brain physiology, will be excluded. Inpatients on the NIMH Schizophrenia Ward will have signed protocol 89-M-0160 ("Inpatient Evaluation of Neuropsychiatric Patients") and will be studied after being free of neuroleptic treatment for at least two weeks. They may also be studied when they are stabilized on medication; however, no treatment decisions, for inpatients or outpatients, will be based upon this study. All inpatients will be carefully monitored on the NIMH/NIH wards as per protocol 89-M-0160.
• Additional neuropsychiatric patients (such as those with affective disorder, Parkinson's Disease, special genetic disorders (e.g. William's Syndrome), and other neuropsychiatric disorders) will be recruited from the medical community, from NIH inpatient and outpatient services, and through the National Alliance for the Mentally Ill (NAMI). Patients will be identified by the presence of typical symptoms and signs elicited by history and examination. Diagnoses will conform to accepted diagnostic guidelines where applicable. Such patients will be excluded from study for 1) history of psychiatric or neurologic disorders other than those under investigation, 2) medical illnesses or surgeries that might have relevance to the investigation of brain physiology, 3) current medications that are not under investigation and that have relevance to cerebral blood flow and metabolism, and 4) IQ less than 70. Patients unable to refrain from nicotine or caffeine for at least 4 hours or alcohol for at least 12 hours prior to the PET study will be excluded. Patients with exposure to other substances with relevance to cerebral blood flow and metabolism, such as some over-the-counter medications, will be reviewed in each individual case, to ensure that an adequate period of abstinence will precede the performance of the PET study. Outpatients may be admitted overnight if necessary or otherwise applicable (e.g. those from out of town).
• No cognitively impaired nonschizophrenic subjects are studied in this protocol. For Parkinson's Disease patients, information is obtained from referring physicians, from NIH medical records for participants already enrolled in the NIH system, and by phone from the potential participant. Further assessment is carried out by a neurologist or psychiatrist upon arrival at the NIH. For Williams syndrome patients, IQ testing is done off-site by a certified clinical neurophysiologist who refers patients for our study and who has followed large numbers of these rare individuals for years.