Robin Emsley1, Laila Asmal2, Stéfan du Plessis2, Bonginkosi Chiliza2, Martin Kidd3, Jonathan Carr4, Matthijs Vink5. 1. Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. Electronic address: rae@sun.ac.za. 2. Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. 3. Centre for Statistical Consultation, Stellenbosch University, South Africa. 4. Division of Neurology, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. 5. Department of Psychiatry, University Medical Centre Utrecht, The Netherlands.
Abstract
BACKGROUND: Studies of pre-and post-treatment striatal volume in schizophrenia have reported conflicting results. MATERIALS AND METHODS: We assessed dorsal striatal (caudate and putamen) volumes bilaterally in 22 never-treated, non-substance-abusing patients with first-episode schizophrenia or schizophreniform disorder and 23 healthy controls matched for age, sex and educational status. Patients received either risperidone or flupenthixol long acting injection and were compared by structural MRI with controls at weeks 0, 4 and 13. T1-weighted data on a 3T MRI scanner were obtained and images were reconstructed using FreeSurfer. Treatment outcome was assessed by changes in psychopathology, insight, functionality, cognitive performance and motor symptoms. RESULTS: Caudate, but not putamen volumes was significantly larger in patients bilaterally at baseline (P=0.01). Linear mixed effects repeated measures found no significant group × time interactions for any of the regions. Caudate volume was not significantly associated with improvements in psychotic symptoms. Also, the findings of a regression model were inconsistent insofar as larger caudate volume was associated with less improvement in depression scores, greater improvement in functionality and greater improvement in verbal learning but less improvement in reasoning and problem solving (left caudate) and composite cognitive score (right caudate). CONCLUSIONS: The increased caudate volumes prior to treatment are contrary to previous reports in never-treated patients with first-episode schizophrenia, and together with our failure to demonstrate volume changes related to acute treatment, call into question previous proposals that enlarged caudate volume is a consequence of antipsychotic treatment.
RCT Entities:
BACKGROUND: Studies of pre-and post-treatment striatal volume in schizophrenia have reported conflicting results. MATERIALS AND METHODS: We assessed dorsal striatal (caudate and putamen) volumes bilaterally in 22 never-treated, non-substance-abusing patients with first-episode schizophrenia or schizophreniform disorder and 23 healthy controls matched for age, sex and educational status. Patients received either risperidone or flupenthixol long acting injection and were compared by structural MRI with controls at weeks 0, 4 and 13. T1-weighted data on a 3T MRI scanner were obtained and images were reconstructed using FreeSurfer. Treatment outcome was assessed by changes in psychopathology, insight, functionality, cognitive performance and motor symptoms. RESULTS: Caudate, but not putamen volumes was significantly larger in patients bilaterally at baseline (P=0.01). Linear mixed effects repeated measures found no significant group × time interactions for any of the regions. Caudate volume was not significantly associated with improvements in psychotic symptoms. Also, the findings of a regression model were inconsistent insofar as larger caudate volume was associated with less improvement in depression scores, greater improvement in functionality and greater improvement in verbal learning but less improvement in reasoning and problem solving (left caudate) and composite cognitive score (right caudate). CONCLUSIONS: The increased caudate volumes prior to treatment are contrary to previous reports in never-treated patients with first-episode schizophrenia, and together with our failure to demonstrate volume changes related to acute treatment, call into question previous proposals that enlarged caudate volume is a consequence of antipsychotic treatment.
Authors: Max de Leeuw; Marc M Bohlken; René Cw Mandl; Manon Hj Hillegers; René S Kahn; Matthijs Vink Journal: Neuropsychopharmacology Date: 2016-07-21 Impact factor: 7.853
Authors: Lawrence H Yang; Bernalyn Ruiz; Amar D Mandavia; Margaux M Grivel; Liang Y Wong; Michael R Phillips; Matcheri S Keshavan; Huijun Li; Jeffrey A Lieberman; Ezra Susser; Larry J Seidman; William S Stone Journal: Schizophr Res Date: 2020-04-05 Impact factor: 4.939