Progressive Structural Brain Abnormalities and Their Relationship to Clinical Outcome

Abstract

There are ongoing changes in the brains of schizophrenic patients during the initial years after diagnosis despite ongoing antipsychotic drug treatment. These progressive changes seem to be most evident in the frontal lobes and to correlate with functional impairment. Disruptions in neurodevelopment or neural plasticity may act alone or in combination to bring about these progressive brain deficits in schizophrenia.

Cerebellum volume and eyeblink conditioning in schizophrenia

“…For example, Ettinger et al (2004) showed that, although no volumetric differences were found between patient and control groups, different brain region volumes related differently to antisaccadic eye movements between the groups; suggesting abnormal structure-function relationships within the patient group. In addition, a plethora of research has found specific structural abnormalities to be associated with the cognitive/behavioral diagnostic criteria for schizophrenia, which are not found in healthy controls (e.g., Ho et al, 2003;Szeszko et al, 2003).…”

“…The cerebellum also has been implicated in psychiatric disorders including schizophrenia (Andreasen, Paradiso and O'Leary, 1998;Andreasen, 1999), bipolar disorder (Lauterbach, 1996), and autism (Carper and Courchesne, 2000). In schizophrenia abnormalities in the cerebellar node of the cortico-cerebellar-thalamic-cortical (CCTC) circuit are indicated by both structural and functional findings (e.g., Stephan et al, 2001;Ho et al, 2003;Keller et al, 2003). Furthermore, cognitive disturbances associated with neurologic lesions affecting the cerebellum are similar to cognitive deficits reported in schizophrenia, including executive functioning deficits (Gimenez, et al, 2003) and affective deficits (Earnst and Kring, 1997) (c.f., Schmahmann and Sherman,1998).…”

“…Schizophrenia also has been associated with smaller whole cerebellum (Keller et al, 2003) and vermal volume Ichimiya et al, 2001;Loeber et al, 2001). Interestingly, cerebellar volume may be associated with poor long-term outcome (Wassink et al, 1999) and cognitive dysfunction (Levitt et al, 1999;Wassink et al, 1999;Ho et al, 2003). However, findings from studies of gross cerebellum volume have not gone unchallenged and often vary both within and between studies (e.g., Ichimiya et al, 2001;Szesko et al, 2003a;Szesko et al, 2003b;Keller et al 2003;James et al, 2004;Shin et al, 2005).…”

Frontale Hirnvolumenminderung durch Antipsychotika?

“…Moreover, treatment approaches which can help to minimize antipsychotic medication or even administer them only selectively are of increasing importance. [25,26,27,28,29,30,31,32,33,34,35,36,37,38,39]. Eine Studie wurde dreifach [30,31,32], eine weitere Studie doppelt publiziert [33,34].…”

“…Zwei Studien finden keine solche Korrelation [26,36]. Ho et al [36] In einer weiteren Studie, in der Patienten mittels SGA behandelt wurden, zeigte sich eine Korrelation zwischen der täg-lichen Antipsychotikadosis und der frontalen und sonstigen kortikalen grauen Substanz lediglich, wenn nicht für multiples Testen nach Bonferroni korrigiert wurde [33]. Mehrfach Erkrankte, Behandlung mit Antipsychotika der 1.…”