An MRI study of basal ganglia volumes in first-episode schizophrenia patients treated with risperidone
An MRI study of basal ganglia volumes in first-episode schizophrenia patients treated with risperidone
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DOI：
10.1176/appi.ajp.158.4.625
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发表时间：
2001-04-01
影响因子：
17.7
通讯作者：
Honer, WG
中科院分区：
文献类型：
--
作者：
Lang, DJ;Kopala, LC;Honer, WG
目的：基底节区可能与精神分裂症患者锥体外系运动障碍、情感障碍和认知障碍有关。据推测，基底神经节体积受抗精神病药物的影响。本研究的目的是确定利培酮治疗一组首发精神分裂症患者的长期效果。方法：选取30例首发精神分裂症患者，12例慢性典型抗精神病药物治疗患者，23例健康对照。他们在基线时接受了核磁共振成像扫描。首发患者接受持续1年的利培酮治疗，之后与对照组重新进行扫描。通过冠状图像测定尾状核、壳核和苍白球体积。结果：慢性治疗患者的基线尾状核、壳核和苍白球体积明显大于未治疗的首发患者和对照组。这些体积在首发患者和健康对照受试者之间没有差异。在首次发作的受试者中，暴露于利培酮1年后基底神经节体积没有变化。锥体外系运动障碍存在于大多数长期治疗的患者和超过三分之一的未用药首发患者。结论：这组首发患者没有表现出基底神经节体积异常，也没有暴露于利培酮影响基底神经节体积。在首发和长期治疗的患者中均观察到运动障碍，提示疾病和药物的双重作用。
Objective: The basal ganglia may contribute to extrapyramidal movement disorders, affective disturbances, and cognitive deficits in schizophrenia. Basal ganglia volumes are putatively affected by antipsychotic medications. The purpose of this study was to determine the long-term effects of risperidone treatment in a cohort of first-episode patients with schizophrenia.Method: The subjects were 30 patients with first-episode schizophrenia, 12 patients chronically treated with typical antipsychotics, and 23 healthy comparison subjects. They were scanned by magnetic resonance imaging at baseline. The first-episode patients received 1 year of continuous risperidone treatment, after which they and the comparison subjects were rescanned. Caudate, putamen, and globus pallidus volumes were determined from coronal images.Results: The baseline caudate, putamen, and globus pallidus volumes were significantly larger in the chronically treated patients than in the untreated first-episode subjects and comparison subjects. These volumes did not differ between the first-episode patients and healthy comparison subjects. Basal ganglia volumes were unchanged after 1 year of exposure to risperidone in the first-episode subjects. Extrapyramidal movement disorders were present in the majority of chronically treated patients and more than one-third of the never-medicated first-episode patients at baseline.Conclusions: This group of first-episode patients did not exhibit abnormalities of basal ganglia volumes, nor were basal ganglia volumes affected by exposure to risperidone. Movement disorders were observed in both first-episode and chronically treated patients, suggesting effects of both illness and medications.