Nigral Stress-Induced Dopamine Release in Clinical High Risk and Antipsychotic-Naive Schizophrenia

Striatal dopamine (DA) synthesis capacity and release are elevated in schizophrenia (SCZ) and its putative prodrome, the clinical high risk (CHR) state. Striatal DA function results from the activity of midbrain DA neurons projecting mainly from the substantia nigra (SN). Elevated stress-induced DA release in SCZ and CHR was observed in the striatum; however, whether it is also elevated in the SN is unclear. The current study aims to determine whether nigral DA release in response to a validated stress task is altered in CHR and in antipsychotic-na < ve SCZ. Further, we explore how DA release in the SN and striatum might be related. 24 CHR subjects, 9 antipsychotic-na < ve SCZ and 25 healthy volunteers (HV) underwent 2 positron emission tomography (PET) scans using the DA D-2/3 agonist radiotracer, [C-11]-(+)-PHNO, which allows simultaneous investigations of DA in the SN and striatum. Psychosocial stress-induced DA release was estimated as the percentage differences in BPND (%[C-11]-(+)-PHNO displacement) between stress and sensory-motor control sessions. We observed a significant diagnostic group by session interaction, such that SCZ exhibited greater stress-induced [C-11]-(+)-PHNO % displacement (25.90% +/- 32.2%; mean +/- SD), as compared to HVs (-10.94% +/- 27.1%). Displacement in CHRs (-1.13% +/- 32.2%) did not differ significantly from either HV or SCZ. Our findings suggest that elevated nigral DA responsiveness to stress is observed in antipsychotic-na < ve SCZ.