Evaluation of fronto-striatal networks during cognitive control in unmedicated patients with schizophrenia and the effect of antipsychotic medication.
Evaluation of fronto-striatal networks during cognitive control in unmedicated patients with schizophrenia and the effect of antipsychotic medication.
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DOI：
10.1038/s41537-018-0051-y
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发表时间：
2018-05-07
影响因子：
5.4
通讯作者：
Lahti AC
中科院分区：
文献类型：
--
作者：
Cadena EJ;White DM;Kraguljac NV;Reid MA;Lahti AC
To understand the mechanism of cognitive control dysfunction in schizophrenia, it is critical to characterize brain function without the confounding effect of medication. It is also important to establish the extent to which antipsychotic medication restores brain function and whether those changes are related to psychosis improvement. Twenty-two patients with schizophrenia, initially unmedicated and after a 6-week course of risperidone, and 20 healthy controls (HC) studied twice, 6 weeks apart, performed an fMRI task. We examined group and longitudinal differences in anterior cingulate cortex (ACC), striatum, and midbrain functional activity during performance of a Stroop color task as well as activity patterns associated with improvement in psychosis symptoms. Unmedicated patients showed reduced functional activity in the ACC, striatum, and midbrain compared to HC. Post hoc contrasts from significant group-by-time interactions indicated that, in patients, drug administration was associated with both activity increases and decreases. In unmedicated patients, greater baseline functional activity in the striatum and midbrain predicted subsequent better treatment response. Greater changes in functional activity in ACC and ventral putamen over the course of 6 weeks positively correlated with better treatment response. Unmedicated patients show reduced activity in brain networks pivotal for cognitive control and medication is associated with functional changes in these regions. These results suggest a mechanism by which antipsychotic medication has a beneficial effect on cognition. Our results also support the notion that treatment response is determined by a combination of the baseline pattern of brain function and by the pharmacological modulation of these regions. Functional imaging reveals brain regions altered in schizophrenia and how their pretreatment states can predict patient outcomes. As antipsychotic medications modify brain activity, a lack of studies on unmedicated patients makes it difficult to ascertain brain changes in schizophrenia itself or assess their clinical relevance. Adrienne Lahti, of the University of Alabama at Birmingham, and colleagues from the United States compared functional MRI scans of patients before and after 6 weeks of risperidone medication. Before treatment, they found significantly less activity, compared to healthy participants, in several brain areas during the performance of a stimulatory task. In unmedicated schizophrenia, a greater level of activity in certain brain networks correlated with positive treatment response, as did the levels of medication-mediated brain activity change. This study provides further evidence that medication response is partially determined by baseline neural function.
To understand the mechanism of cognitive control dysfunction in schizophrenia, it is critical to characterize brain function without the confounding effect of medication. It is also important to establish the extent to which antipsychotic medication restores brain function and whether those changes are related to psychosis improvement. Twenty-two patients with schizophrenia, initially unmedicated and after a 6-week course of risperidone, and 20 healthy controls (HC) studied twice, 6 weeks apart, performed an fMRI task. We examined group and longitudinal differences in anterior cingulate cortex (ACC), striatum, and midbrain functional activity during performance of a Stroop color task as well as activity patterns associated with improvement in psychosis symptoms. Unmedicated patients showed reduced functional activity in the ACC, striatum, and midbrain compared to HC. Post hoc contrasts from significant group-by-time interactions indicated that, in patients, drug administration was associated with both activity increases and decreases. In unmedicated patients, greater baseline functional activity in the striatum and midbrain predicted subsequent better treatment response. Greater changes in functional activity in ACC and ventral putamen over the course of 6 weeks positively correlated with better treatment response. Unmedicated patients show reduced activity in brain networks pivotal for cognitive control and medication is associated with functional changes in these regions. These results suggest a mechanism by which antipsychotic medication has a beneficial effect on cognition. Our results also support the notion that treatment response is determined by a combination of the baseline pattern of brain function and by the pharmacological modulation of these regions. Functional imaging reveals brain regions altered in schizophrenia and how their pretreatment states can predict patient outcomes. As antipsychotic medications modify brain activity, a lack of studies on unmedicated patients makes it difficult to ascertain brain changes in schizophrenia itself or assess their clinical relevance. Adrienne Lahti, of the University of Alabama at Birmingham, and colleagues from the United States compared functional MRI scans of patients before and after 6 weeks of risperidone medication. Before treatment, they found significantly less activity, compared to healthy participants, in several brain areas during the performance of a stimulatory task. In unmedicated schizophrenia, a greater level of activity in certain brain networks correlated with positive treatment response, as did the levels of medication-mediated brain activity change. This study provides further evidence that medication response is partially determined by baseline neural function.
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DOI：
10.1016/j.nicl.2015.11.015
发表时间：
2016
期刊：
NeuroImage. Clinical
影响因子：
--
作者：
Kraguljac NV;White DM;Hadley JA;Visscher K;Knight D;ver Hoef L;Falola B;Lahti AC
通讯作者：
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影响因子：
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影响因子：
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通讯作者：
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影响因子：
7.6
作者：
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DOI：
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发表时间：
2012-05-23
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
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通讯作者：
London ED