In Vivo D2 Dopamine Receptor Density in Psychotic and Nonpsychotic Patients With Bipolar Disorder
Abstract
BACKGROUND: A prior positron emission tomographic study from The Johns Hopkins University, Baltimore, Md, using N-methylspiperone labeled with carbon 11 reported elevated basal ganglia D2 dopamine receptor density (Bmax) values in neuroleptic-naive schizophrenic patients compared with controls. We have now extended these studies to include patients with bipolar disorder. METHODS: Patients with bipolar disorder (n = 14) either had never received neuroleptic medication or had been neuroleptic-free for more than 6 months, and they met DSM-III criteria for currently symptomatic affective disorder. Patients with bipolar disorder were compared with matched schizophrenic patients and normal controls. All received two positron emission tomographic scans, the second of which was preceded by oral administration of haloperidol lactate, to permit the calculation of D2 dopamine receptor Bmax. RESULTS: Diagnostic groups differed in Bmax by analysis of variance (P < .0001); post hoc tests showed higher Bmax values for psychotic patients with bipolar disorder and schizophrenic patients compared with normal controls and for schizophrenic patients and psychotic patients with bipolar disorder compared with nonpsychotic patients with bipolar disorder. Among patients with bipolar disorder, Bmax values correlated significantly with the severity of psychotic symptoms (r = .63) on the Present State Examination but not with the severity of nonpsychotic mood symptoms. CONCLUSIONS: We conclude that, like schizophrenic patients, patients with psychotic bipolar disorder have elevations of D2 dopamine receptor Bmax values and that such elevations in affective disorder are more closely associated with the presence of psychosis than with mood abnormality. Elevations in dopamine receptor values thus may occur in psychiatric states that are characterized by psychotic symptoms rather than being specific to schizophrenia.
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The presence of psychosis may moderate patterns of DA receptor binding; striatal D2 receptor signaling seems greater in psychotic patients with bipolar disorder, whereas no differences in D2 availability were found between non-psychotic patients with bipolar disorder and controls.
“There is also evidence that the presence of psychosis may moderate patterns of DA receptor binding. Specifically, striatal D2 receptor signaling seems to be greater in psychotic patients with bipolar disorder [286,287], whereas no differences in D2 availability were found between non-psychotic patients with bipolar disorder and controls [288,289].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [286]
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- Authors
- Pearlson, G. D.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Pearlson, Godfrey D.
- ORCID
- Pearlson, Godfrey D.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 1995-06-01
- Volume
- 52
- Issue
- 6
- Pages
- 471
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2138538568
- Cited by
- 235
- References
- 42
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 27 · 2020: 3 · 2019: 4 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 4 · 2014: 13 · 2013: 6 · 2012: 15
- FWCI
- 7.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh040391-02, 5r01mh042821-07)
- National Institute of Mental Health (MH 42821, MH-40391, MH43775)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- bipolar disorder, psychosis, schizophrenia, basal ganglia, neuroleptic-naive patients, psychotic symptom severity, dopamine receptor binding
- MeSH terms
- Adult, Bipolar Disorder, Brain, Carbon Radioisotopes, Caudate Nucleus, Female, Haloperidol, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychotic Disorders, Putamen, Receptors, Dopamine, Schizophrenia, Spiperone, Tomography, Emission-Computed
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