A naturalistic study of grey matter volume increase after early treatment in anti-psychotic na⟨ve, newly diagnosed schizophrenia
A naturalistic study of grey matter volume increase after early treatment in anti-psychotic na⟨ve, newly diagnosed schizophrenia
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DOI：
10.1007/s00213-009-1619-z
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发表时间：
2009-10-01
影响因子：
3.4
通讯作者：
Chua, Siew E.
中科院分区：
文献类型：
--
作者：
Deng, Michelle Y.;McAlonan, Grainne M.;Chua, Siew E.
抗精神病治疗似乎与纹状体体积增加有关，但这种变化发生的时间有多早仍不清楚。 一个由 20 名新诊断为精神分裂症的未接受过抗精神病药物的患者组成的前瞻性队列在基线时接受了磁共振成像脑部扫描。在长达 8 周的抗精神病治疗后重复这一过程。仅 3 周内就有 10 名患者接受了重复扫描。抗精神病药物的选择是自然主义的，即由临床医生主导。还对匹配良好的健康个体进行了扫描，以控制3周内的非特异性变化。经过3周的抗精神病治疗，发现右侧尾状核、额上回和额下回、中央前回和左顶下小叶的灰质体积显着增加。然而，经过8周的抗精神病治疗后，观察到右侧丘脑和双侧小脑的体积增加。在 3 周和 8 周的时间间隔内，检测到左侧额内侧回的灰质显着减少。纹状体体积变化早在抗精神病治疗后 3 周就出现了早期增加，而丘脑体积的增加则在治疗 8 周后出现明显。我们推测药物介导的神经可塑性可能为临床恢复提供生物标志物。
Anti-psychotic treatment appears to be associated with striatal volume increase, but how early this change occurs is still unknown.A single prospective cohort of 20 anti-psychotic-na < ve patients, newly diagnosed with schizophrenia, underwent magnetic resonance imaging brain scan at baseline. This was repeated following up to 8 weeks of anti-psychotic treatment. Ten patients had repeat scan within only 3 weeks. The choice of anti-psychotic medication was naturalistic, i.e., clinician-led. Well-matched healthy individuals were also scanned to control for non-specific changes over a 3-week period.After 3 weeks of anti-psychotic treatment, significant grey matter volume increase in the right caudate, superior and inferior frontal gyrus, precentral gyrus, and left inferior parietal lobule was noted. However, after 8 weeks of anti-psychotic treatment, volume increase in the right thalamus and bilateral cerebellum was observed. Significant grey matter reduction was detected in the left medial frontal gyrus at both 3- and 8-week intervals.Early increase in striatal volume change occurs as early as 3 weeks after anti-psychotic treatment, whilst thalamic volume increase is apparent later, by 8 weeks of treatment. We speculate that drug-mediated neuroplasticity may provide a biomarker for clinical recovery.