Impact on intracortical myelination trajectory of long acting injection versus oral risperidone in first-episode schizophrenia.
Impact on intracortical myelination trajectory of long acting injection versus oral risperidone in first-episode schizophrenia.
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DOI：
10.1016/j.schres.2012.06.036
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发表时间：
2012-09
影响因子：
4.5
通讯作者：
Nuechterlein KH
中科院分区：
文献类型：
--
作者：
Bartzokis G;Lu PH;Raven EP;Amar CP;Detore NR;Couvrette AJ;Mintz J;Ventura J;Casaus LR;Luo JS;Subotnik KL;Nuechterlein KH
影像学和尸检研究表明，精神分裂症患者的额叶皮质内髓鞘形成失调。先前的MRI研究表明，在SZ治疗的早期，抗精神病药物最初会增加额叶皮质内髓鞘（ICM）体积，随后在疾病的慢性阶段过早下降。如果慢性SZ患者的ICM下降轨迹是由于药物不依从性或药代动力学，则可以通过长效注射（LAI）制剂来改变。在一项为期六个月的首发SZ患者LAI （RLAI）与口服（RisO）随机试验中，评估利培酮制剂对ICM轨迹的影响。两组随机化前口服药物暴露匹配的SZ受试者（RLAI， N=9; RisO， N=13）在基线和6个月后与12名健康对照（hc）一起进行前瞻性检查。使用反转恢复（IR）和质子密度（PD） MRI图像评估额叶ICM体积。追踪药物依从性。ICM体积变化评分根据hc的变化进行调整。与健康对照组相比，RLAI组的ICM体积显著增加（p= 0.005），而RisO组的ICM体积无显著增加（p= 0.39）。组间治疗效果的差异处于趋势水平（p= 0.093）。接受RLAI的SZ组药物依从性较好，ICM增加较多（χ 2 p< 0.05）。结果提示RLAI可能促进首发SZ患者ICM的发展。LAI提供的更好的依从性和/或药代动力学可能改变ICM轨迹。体内MRI髓鞘测量可以帮助阐明药物治疗的作用机制。
Imaging and post-mortem studies suggest that frontal lobe intracortical myelination is dysregulated in schizophrenia (SZ). Prior MRI studies suggested that early in treatment of SZ, antipsychotic medications initially increase frontal lobe intracortical myelin (ICM) volume, which subsequently declines prematurely in chronic stages of the disease. Insofar as the trajectory of ICM decline in chronic SZ is due to medication non-adherence or pharmacokinetics, it may be modifiable by long acting injection (LAI) formulations. Assess the effect of risperidone formulation on the ICM trajectory during a six-month randomized trial of LAI (RLAI) versus oral (RisO) in first-episode SZ subjects. Two groups of SZ subjects (RLAI, N=9; and RisO, N=13) matched on pre-randomization oral medication exposure were prospectively examined at baseline and six months later, along with 12 healthy controls (HCs). Frontal lobe ICM volume was assessed using inversion recovery (IR) and proton density (PD) MRI images. Medication adherence was tracked. ICM volume change scores adjusted for the change in the HCs. ICM volume increased significantly (p=.005) in the RLAI and non-significantly (p=.39) in the RisO groups compared to the healthy controls. A differential between-group treatment effect was at a trend level (p=.093). SZ subjects receiving RLAI had better medication adherence and more ICM increases (chi-square p<.05). The results suggest that RLAI may promote ICM development in first-episode SZ patients. Better adherence and/or pharmacokinetics provided by LAI may modify the ICM trajectory. In vivo MRI myelination measures can help clarify pharmacotherapeutic mechanisms of action.
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影响因子：
4.5
作者：
Bartzokis, George;Lu, Po H.;Stewart, Stephanie B.;Oluwadara, Bolanle;Lucas, Andrew J.;Pantages, Joanna;Pratt, Erika;Sherin, Jonathan E.;Altshuler, Lori L.;Mintz, Jim;Gitlin, Michael J.;Subotnik, Kenneth L.;Nuechterlein, Keith H.
通讯作者：
Nuechterlein, Keith H.
影响因子：
10.6
作者：
Bartzokis, G;Nuechterlein, KH;Mintz, J
通讯作者：
Mintz, J
影响因子：
--
作者：
Alaerts, Maaike;Ceulemans, Shana;Del-Favero, Jurgen
通讯作者：
Del-Favero, Jurgen
影响因子：
--
作者：
Bartzokis, G;Beckson, M;Mintz, J
通讯作者：
Mintz, J
影响因子：
4.7
作者：
Bartzokis G
通讯作者：
Bartzokis G