Structural brain changes associated with antipsychotic treatment in schizophrenia as revealed by voxel-based morphometric MRI: an activation likelihood estimation meta-analysis

Torres, Ulysses S.; Portela-Oliveira, Eduardo; Borgwardt, Stefan; Busatto, Geraldo F.

doi:10.1186/1471-244x-13-342

Cited by 65 publications

(47 citation statements)

References 111 publications

(167 reference statements)

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“…Studies in rodents indicate a direct neurotoxic effect of haloperidol (32,33) leading to a decreased dopamine turnover (33), and other studies have observed permanent effects of haloperidol on the equivalent of the basal ganglia in rat brains (34,35) As for human, results found for structural brain changes by antipsychotics are not consistent (36,37) On the other hand, previous studies suggest that drug-induced parkinsonism can persist even with a normal DAT imaging. (38).…”

Section: Parkinsonism and Tremorcontrasting

confidence: 49%

“…However, there is an increasing amount of evidence linking MD to the underlying neuropathology of psychiatric disorders (1,2,6,31,(31)(32)(33)(34)(35)(36)(37). This is evidenced by the fact that subtle MD are present in AP naïve patients with first episode schizophrenia and in ultra-high risk patients, who have also never received AP (31,32,34,35,37). Also, healthy family members of patients with schizophrenia with no clinical diagnoses have higher rates of subtle MD (31).…”

Section: Movement Disorder Pathophysiologymentioning

confidence: 99%

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The course recognition and treatment of movement disorders in severe mental illness

Mentzel¹

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ovement disorders (MD) occur frequently in psychiatric patients both as a part of the psychiatric illness and as a side effect of medication used to treat psychiatric disorders (1,2). Because of their visibility MD can be a source of shame for patients (3). They are also linked to poorer treatment adherence (4), poorer psychiatric prognosis, and increased mortality (5).MD occur in patients with (all types of) psychiatric disorders with varying incidence and prevalence rates depending on MD type, underlying psychiatric disorder, and risk factors. In general, MD tend to occur more severely and more frequently in patients with more severe psychiatric disorders (6). Severe mental illness (SMI) in-patient populations have the highest frequency at 68% (7) to 74% (8). The prevalence of at least one movement disorder in an out-patient population with schizophrenia is lower at 37.9% (9) and 57.5% (10). Types of movement disordersMD are a group of disorders that affect the ability to produce and control movement. Most are involuntary, though patients can consciously exert a limited amount of influence over them (1,2). This thesis focuses on MD found in patients with psychiatric disorders, namely dyskinesia and dystonia, parkinsonism, resting and action tremor and akathisia. Other MD are beyond the scope of this thesis such as simulation, functional MD, tic disorders, myoclonus, intention tremor, and catatonia. ParkinsonismParkinsonism is often seen in patients with psychiatric disorders (7,8). It is phenomenologically similar to Parkinson's disease (PD): both disorders have bradykinesia, tremor, and rigidity as core motor symptoms. In parkinsonism, the bradykinesia is often not as severe as in PD, although bradykinesia and tremor are usually the most prominent features (11). Both disorders are caused by a shortage of postsynaptic dopamine 2 (D2) receptor activation in the basal ganglia: in PD this shortage is caused by the degeneration of D2 producing cells in the substantia nigra (12) and in parkinsonism by blocking of postsynaptic D2 receptor by antipsychotics (11). TremorThe most frequently seen tremors in psychiatric patients are resting, postural action, and intention tremors (13,14). Resting tremor (RT) is usually seen as part of the parkinsonism phenomenology. Postural action tremor (AT) is a common side effect of M Chapter 1 12 drugs used in psychiatry such as selective serotonin reuptake inhibitors (SSRIs), natrium valproate, and lithium (15). The third group, the drug-induced intention tremors, are most often seen as the result of an (accidental) intoxication with either drugs of misuse, such as alcohol, or prescribed medication such as lithium or clozapine (14). Intention tremors are not included in this thesis. AkathisiaAkathisia, generally defined as drug-induced motor restlessness, is most often caused by antipsychotics (16-18), though it can also be caused by antidepressants, antiemetics, and some other types of medication (17,19). It is comprised of a subjective component of inner restlessness with the urg...

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Section: Parkinsonism and Tremorcontrasting

confidence: 49%

Section: Movement Disorder Pathophysiologymentioning

confidence: 99%

The course recognition and treatment of movement disorders in severe mental illness

Mentzel¹

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“…Unfortunately, no study has investigated Research Edith J Liemburg changes in brain volume after treatment with aripiprazole as yet. While GMV reductions are indeed generally seen in frontal and other cortical regions, increased striatal volume has also been observed by other studies [13,14]. Moreover, it has been suggested that atypical may have a neuroprotective effect [12].…”

Section: Researchmentioning

confidence: 69%

“…Because we mainly included young first episode patients, the patterns we observed in aripiprazole may be natural patterns occurring, though the follow-up period is possibly too small to detect such effects. Importantly, previous studies have observed a relationship between prior degree of structural alterations and treatment-induced changes [14,47]. In this relatively young group this knowledge would have provided valuable information.…”

Section: Researchmentioning

confidence: 99%

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The Effect of Aripiprazole versus Risperidone on Prefrontal Brain Metabolite Levels and Brain Volume in Psychotic Disorders: An Exploratory Study

Liemburg¹,

Sibeijn-Kuiper²,

Knegtering³

et al. 2018

Neuropsychiatry

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ObjectiveGiven that aripiprazole acts as a partial agonist on the dopamine receptor, it may have unique effects on brain neuro-metabolism, specifically in the prefrontal cortex. In this exploratory study, we investigated the effect of aripiprazole compared to risperidone on prefrontal metabolite levels (Glx, NAA, Creatine, Choline and myo-Inositol) and changes in gray and white matter volume (GMV and WMV) in patients with a psychotic disorder. We hypothesized that patients treated with aripiprazole would show increased levels of Glx and NAA and preserved brain volumes, in contrast to risperidone. MethodsIn this randomized, single blind study, patients (n=24) treated with either risperidone or aripiprazole underwent magnetic resonance spectroscopy ( 1 H-MRS) and high-resolution anatomical scans (3T) at baseline and after 9 weeks. LC Model was used to determine the absolute spectral metabolite levels and SPM12 was to perform voxel based morphometry analyses. Both metabolite levels and brain volumes were compared between treatment groups. ResultsWe found a trend for a different effect of both antipsychotics on Glx levels, whereby risperidone reduced Glx levels compared to aripiprazole. Moreover, patients treated with aripiprazole showed a decreased GMV in the precentral gyrus, caudate and lateral frontal regions and increased WMV in the precentral gyrus and a non-significant but consistent pattern of prefrontal WM increases, in contrast to risperidone. ConclusionOur results point to possibility of different effects of aripiprazole on brain volume and metabolism compared to risperidone. Studies in larger samples are needed to shed more light on the robustness and nature of such differences.

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Identification of a Common Neurobiological Substrate for Mental Illness

et al. 2015

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Structural brain changes associated with antipsychotic treatment in schizophrenia as revealed by voxel-based morphometric MRI: an activation likelihood estimation meta-analysis

Cited by 65 publications

References 111 publications

The course recognition and treatment of movement disorders in severe mental illness

The course recognition and treatment of movement disorders in severe mental illness

The Effect of Aripiprazole versus Risperidone on Prefrontal Brain Metabolite Levels and Brain Volume in Psychotic Disorders: An Exploratory Study

Identification of a Common Neurobiological Substrate for Mental Illness

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