Clozapine and visuospatial processing in treatment-resistant schizophrenia
Clozapine and visuospatial processing in treatment-resistant schizophrenia
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DOI：
10.1080/13546805.2012.760917
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发表时间：
2013-11-01
影响因子：
1.7
通讯作者：
Mendrek, Adrianna
中科院分区：
文献类型：
--
作者：
Bourque, Josiane;Lakis, Nadia;Mendrek, Adrianna
介绍：氯氮平是难治性精神分裂症最广泛使用的药物，在改善患者认知功能方面优于其他抗精神病药物。然而，结果并不一致，这种影响的机制尚未阐明。因此，本研究的目的是评估语言和非语言的认知（使用视觉空间处理测试）与氯氮平治疗的患者（最初治疗抵抗）和其他第二代抗精神病药物治疗，相对健康的对照组。此外，我们研究了神经相关的视觉空间处理在three groups.Methods。20例精神分裂症患者治疗氯氮平（TR-C组），23例稳定与非典型抗精神病药物比氯氮平（NTR组），和21名健康对照参与者完成了电池的口头和视觉空间认知测试。此外，参与者在进行一项视觉空间测试（心理旋转任务）时接受了功能性磁共振成像（fMRI）。使用统计参数映射软件（SPM5）分别对各组的fMRI数据进行分析。结果：总体而言，精神分裂症患者相对于健康对照组在言语和非言语加工方面表现出缺陷，但我们观察到两组患者之间存在一些有趣的差异。具体来说，NTR组比TR-C组在区组设计和瑞文推理测验中表现更好。关于大脑功能在心理旋转，NTR组显示出显着的激活区域的颞叶和枕叶皮层，而TR-C患者没有。与任务相关的相对失活也更强大的NTR相比，其他组的patients.Conclusion，尽管类似的性能。目前的结果表明，更好的视觉空间处理在NTR相对于TR-C组。这种差异可能归因于治疗阻力本身或缺乏有益的影响，氯氮平相对于其他非典型抗精神病药物在改善非语言能力。氯氮平与认知之间的关系，以及治疗抵抗与认知之间的关系，未来的研究是必要的。
Introduction.Clozapine, the most widely used option in treatment-resistant schizophrenia, has been shown to be superior to other antipsychotic medications in improving cognitive function in patients. However, the results have not been consistent and the mechanisms underlying this effect have not been elucidated. Thus, the purpose of the present study was to evaluate verbal and nonverbal cognition (using visuospatial processing tests) in patients treated with clozapine (initially treatment resistant) and those treated with other second-generation antipsychotics, relative healthy control subjects. Furthermore, we examined neural correlates of visuospatial processing in the three groups.Methods.Twenty schizophrenia patients treated with clozapine (TR-C group), 23 patients stabilised with atypical antipsychotics other than clozapine (NTR group), and 21 healthy control participants completed a battery of verbal and visuospatial cognitive tests. In addition, participants underwent functional magnetic resonance imaging (fMRI) while performing one of the visuospatial tests (the mental rotation task). The fMRI data were analysed separately in each group using Statistical Parametric Mapping software (SPM5).Results.Overall, schizophrenia patients exhibited deficit on verbal and nonverbal processing relative to the healthy controls, but we observed some interesting differences between the two groups of patients. Specifically, the NTR group performed better than the TR-C group on the Block Design and the Raven's Progressive Matrices. With respect to brain function during mental rotation, the NTR group showed significant activations in regions of the temporal and occipital cortex, whereas the TR-C patients did not. The relative deactivations associated with the task were also more robust in NTR compared to the other group of patients, despite a similar performance.Conclusion.Present results suggest better visuospatial processing in the NTR relative to the TR-C group. This difference could be attributed to the treatment resistance itself or a lack of beneficial effect of clozapine relative to other atypical antipsychotics in ameliorating nonverbal abilities. Future studies of the relationship between clozapine and cognition, as well as between treatment resistance and cognition, are warranted.