Prefrontal dopamine D1 receptors and working memory in schizotypal personality disorder: A PET study with [¹¹C]NNC112

Rationale: Schizotypal personality disorder (SPD) is associated with working memory (WM) impairments that are similar to those observed in schizophrenia. Imaging studies have suggested that schizophrenia is associated with alterations in dopamine D1 receptor availability in the prefrontal cortex (PFC) that may be related to the WM impairments that characterize this disorder.

Objectives: The aim of this study was to characterize prefrontal D1 receptor availability and its relation to WM performance in SPD.

Methods: We used positron emission tomography (PET) and the radiotracer [¹¹C]NNC112 with 18 unmedicated SPD and 21 healthy control participants; as an index of D1 receptor availability, binding potential (BP) measures (BP_F, BP_ND, and BP_P) were calculated for prefrontal and striatal subregions. To assess WM, SPD participants completed the 2-back and Paced Auditory Serial Addition Test (PASAT).

Results: There were no significant group differences in PFC BP. BP_F and BP_P in the medial PFC were significantly negatively related to PASAT performance (r _s ∈=∈-0.551, p∈=∈.022 and r _s ∈=∈-0.488, p∈=∈.047, respectively), but BP was not related to 2-back performance.

Conclusions: In contrast to what has been found in schizophrenia, SPD was not associated with significant alterations in prefrontal D1 receptor availability. Similar to previous schizophrenia findings, however, higher prefrontal D1 receptor availability was associated with poorer WM performance (as measured by the PASAT) in SPD. These findings suggest that schizophrenia and SPD may share a common pathophysiological feature related to prefrontal dopamine functioning that contributes to WM dysfunction, but that in SPD, alterations in D1 may occur only in a subset of individuals and/or to an extent that is minor relative to what occurs in schizophrenia.