Abstract

ObjectiveThe mitochondrial 18-kDa translocator protein (TSPO) is expressed by activated microglia and positron emission tomography enables the measurement of TSPO levels in the brain. Findings in schizophrenia have shown to vary depending on the outcome measure used and this discrepancy in TSPO results could be explained by lower non-displaceable binding (VND) in schizophrenia, which could obscure increases in specific binding. In this study, we have used the TSPO ligand XBD173 to block the TSPO radioligand [11C]-PBR28 and used an occupancy plot to quantify VND in patients with schizophrenia.MethodsA total of 7 patients with a diagnosis of schizophrenia were recruited for this study. Each patient received two separate PET scans with [11C]PBR28, one at baseline and one after the administration of the TSPO ligand XBD173. All patients were high-affinity binders (HABs) for the TSPO gene. We used an occupancy plot to quantify the non-displaceable component (VND) using 2TCM kinetic estimates with and without vascular correction. Finally we computed the VND at a single subject level using the SIME method.ResultsAll patients showed a global and generalized reduction in [11C]PBR28 uptake after the administration of XBD173. Constraining the VND to be equal for all patients, the population VND was estimated to be 1.99 mL/cm3 (95% CI 1.90 to 2.08). When we used vascular correction, the fractional TSPO occupancy remained similar.ConclusionsIn schizophrenia patients, a substantial component of the [11C]PBR28 signal represents specific binding to TSPO. Furthermore, the VND in patients with schizophrenia is similar to that previously reported in healthy controls. These results suggest that changes in non-specific binding between schizophrenia patients and healthy controls do not account for discrepant PET findings in this disorder.

Highlights

  • Schizophrenia is the result of a complex interplay between multiple pathophysiological mechanisms [18]

  • These results suggest that changes in non-specific binding between schizophrenia patients and healthy controls do not account for discrepant

  • Binding potential uses a reference region to account for binding of the tracer to other brain constiuents other than translocator protein (TSPO), often termed non-displaceable binding, while volume of distribution (VT) represents both specific binding to TSPO and nondisplaceable binding by the tracer [20]

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Summary

Introduction

Schizophrenia is the result of a complex interplay between multiple pathophysiological mechanisms [18]. Recent studies have produced converging evidence supporting a role of inflammation and immune response as an important contributor to the pathogenesis of this disorder [17]. They increase the expression of the mitochondrial 18-kDa translocator protein (TSPO) [6]. Multiple studies have used PET tracers for TSPO to investigate this marker in schizophrenia-spectrum disorders ([2, 4, 11, 15, 41, 10, 16, 37, 5, 9, 29, 32, 40, 41]).

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