Basal ganglia volumes in drug-naive first-episode schizophrenia patients before and after short-term treatment with either a typical or an atypical antipsychotic drug

Glenthøj, Andreas; Glenthøj, Birte; Mackeprang, Torben; Pagsberg, Anne Katrine; Hemmingsen, Ralf; Jernigan, Terry L.; Baaré, William F.C.

doi:10.1016/j.pscychresns.2006.10.002

Cited by 117 publications

(94 citation statements)

References 51 publications

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“…Women were excluded from the current study because PPI fluctuates through the menstrual cycle. 32 All participants underwent a comprehensive examination program, including psychopathological ratings, psychophysiological 5,33,34 and neuropsychological examinations, 35,36 singlephoton emission computed tomography (SPECT) 37 or positron emission tomography, 38,39 structural MRI 40,41 and fMRI. 42 We report only on the combined PPI and structural MRI data.…”

Section: Participantsmentioning

confidence: 99%

Structural brain correlates of sensorimotor gating in antipsychotic-naive men with first-episode schizophrenia

Hammer

Oranje

Skimminge

et al. 2013

J Psychiatry Neurosci

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Section: Participantsmentioning

confidence: 99%

Structural brain correlates of sensorimotor gating in antipsychotic-naive men with first-episode schizophrenia

Hammer

Oranje

Skimminge

et al. 2013

J Psychiatry Neurosci

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“…15 Striatal volume reductions are not consistently found in medicated first-episode patients, likely because antipsychotic treatment in itself can induce alterations in the striatum (for review see 16 ). Nevertheless, a recent metaanalysis of voxel-based structural MRI studies in firstepisode patients found the presence of caudate nucleus reductions as compared with chronic schizophrenia patients.…”

Section: Introductionmentioning

confidence: 99%

Hippocampal and caudate volume reductions in antipsychotic-naive first-episode schizophrenia

Ebdrup

Glenthøj

Rasmussen

et al. 2010

jpn

111

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95Background: Enlarged ventricles and reduced hippocampal volume are consistently found in patients with first-episode schizophrenia. Studies investigating brain structure in antipsychotic-naive patients have generally focused on the striatum. In this study, we examined whether ventricular enlargement and hippocampal and caudate volume reductions are morphological traits of antipsychotic-naive firstepisode schizophrenia. Methods: We obtained high-resolution 3-dimensional T 1 -weighted magnetic resonance imaging scans for 38 antipsychotic-naive first-episode schizophrenia patients and 43 matched healthy controls by use of a 3-T scanner. We warped the brain images to each other by use of a high-dimensional intersubject registration algorithm. We performed voxel-wise group comparisons with permutation tests. We performed small volume correction for the hippocampus, caudate and ventricles by use of a false discovery rate correction (p < 0.05) to control for multiple comparisons. We derived and analyzed estimates of brain structure volumes. We grouped patients as those with (n = 9) or without (n = 29) any lifetime substance abuse to examine the possible effects of substance abuse. Results: We found that hippocampal and caudate volumes were decreased in patients with first-episode schizophrenia. We found no ventricular enlargement, differences in global volume or significant associations between tissue volume and duration of untreated illness or psychopathology. The hippocampal volume reductions appeared to be influenced by a history of substance abuse. Exploratory analyses indicated reduced volume of the nucleus accumbens in patients with first-episode schizophrenia. Limitations: This study was not a priori designed to test for differences between schizophrenia patients with or without lifetime substance abuse, and this subgroup was small. Conclusion: Reductions in hippocampal and caudate volume may constitute morphological traits in antipsychotic-naive first-episode schizophrenia patients. However, the clinical implications of these findings are unclear. Moreover, past substance abuse may accentuate hippocampal volume reduction. Magnetic resonance imaging studies addressing the potential effects of substance abuse in antipsychoticnaive first-episode schizophrenia patients are warranted.

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“…This is the first MRI study separating groups of first episode patients according to the presence or absence of pre-treatment EPS. Some studies of the basal ganglia in first episode psychosis show no differences in volume from healthy subjects [31,33,[47][48][49][50][51][52][53], and others report smaller volumes [54][55][56]. One report of adolescent offspring of parents with schizophrenia demonstrated smaller caudate volumes in the at-risk probands [57].…”

Section: Discussionmentioning

confidence: 99%

“…Schizotypal subjects may provide a "trait" reference point, and interestingly appear to have smaller caudate and putamen volumes [78,79]. In contrast, in most studies of first episode subjects, striatal volumes do not show statistically significant differences from healthy subjects [31,33,[47][48][49][50][51][52][53]. Extrapyramidal symptoms and signs, as well as related cognitive dysfunction may be dimensional rather than typological features of schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment

et al. 2011

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Extrapyramidal movement disorders are common in chronic schizophrenia, and may be an intrinsic feature of the illness as well as related to antipsychotic drug treatment. Similar dysfunctions at illness onset may have implications for outcome, and for understanding the mechanisms of illness. The objectives were to examine the clinical correlates of pre-treatment movement disorders at first episode of psychosis, and determine associations with neuropsychological function and striatal structure. Never medicated subjects were recruited from consecutive admissions to Early Psychosis Programs with defined catchment areas in Hong Kong, China, and Halifax, Canada. Standardized clinical, neuropsychological and brain imaging assessments were carried out at baseline and following acute and long term treatment with typical or atypical antipsychotic drugs. At the Hong Kong site, we studied 84 subjects with first episode psychosis (n = 10 with EPS). At the Halifax site, we studied 40 subjects with first episode psychosis (n = 17 with EPS), and 23 healthy comparison subjects. Subjects with movement disorders prior to treatment (EPS+) had higher total PANSS scores at baseline (mean elevation 19.9% Hong Kong, P = 0.016; 14.7% Halifax, P = 0.049). In subjects treated with atypical antipsychotics (all Halifax), EPS+ status at baseline predicted more movement disorders at long term follow up (P = 0.0005). In both cohorts, EPS+ subjects had poorer acute symptomatic treatment response assessed with the PANSS (Hong Kong P = 0.005; Halifax P = 0.017). Neuropsychological impairment related to executive dysfunction appeared greater in a small sample of EPS+ subjects (Hong Kong, effect size 0.26-0.27, P < 0.05). Caudate volumes were 4.5% larger in EPS+ compared with EPS-subjects (Halifax P = 0.042), and correlations between striatal volumes and age were different in the EPS+ group. In conclusion, pre-treatment EPS is present in a substantial minority of subjects with first episode psychosis, appears to persist at long term follow up, and is associated with poorer response of symptoms to treatment. Selective impairment of executive function and striatal enlargement provides evidence of abnormalities of brain function and structure associated with this aspect of early psychosis. schizophrenia, movement disorder, basal ganglia, antipsychotics, cognitive, psychosis Citation:Honer W G, Lang D J, Kopala L C, et al. First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment.

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Basal ganglia volumes in drug-naive first-episode schizophrenia patients before and after short-term treatment with either a typical or an atypical antipsychotic drug

Cited by 117 publications

References 51 publications

Structural brain correlates of sensorimotor gating in antipsychotic-naive men with first-episode schizophrenia

Structural brain correlates of sensorimotor gating in antipsychotic-naive men with first-episode schizophrenia

Hippocampal and caudate volume reductions in antipsychotic-naive first-episode schizophrenia

First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment

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