Corson P W, Nopoulos P, Miller D D, Arndt S, Andreasen N C
Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242, USA.
Am J Psychiatry. 1999 Aug;156(8):1200-4. doi: 10.1176/ajp.156.8.1200.
For many years, it has been assumed that medications affect brain chemistry and physiology but not structure. Recent reports suggest that neuroleptic medication changes basal ganglia volume. To explore this possibility, the authors assessed for basal ganglia volume change in individuals who had their basal ganglia structures delineated and measured on magnetic resonance scans at the beginning and end of a 2-year period and who received neuroleptic medication during this time.
The basal ganglia volumes of 23 male patients with schizophrenia spectrum disorders were measured from manual traces delineating the caudate and lenticular nucleus on magnetic resonance images at admission and 2 years later. Patients' neuroleptic exposure was calculated over the 2 years by using a dose-year formula.
During the 2-year period, mean basal ganglia volume of patients receiving predominantly typical neuroleptics increased, while the opposite was observed for patients receiving mostly atypical neuroleptics. Correlation analysis for the entire group showed a positive relationship between the 2-year exposure to typical neuroleptic medication and change in basal ganglia volume and the reverse for exposure to atypical neuroleptics.
In this group, basal ganglia volume increased following exposure to typical neuroleptics and decreased following exposure to atypical neuroleptics.
多年来，人们一直认为药物会影响大脑的化学和生理机能，但不会影响其结构。最近的报告表明，抗精神病药物会改变基底神经节的体积。为了探究这种可能性，作者评估了在两年期间开始和结束时通过磁共振扫描对基底神经节结构进行描绘和测量，且在此期间接受抗精神病药物治疗的个体的基底神经节体积变化。
对23名患有精神分裂症谱系障碍的男性患者，在入院时和两年后通过在磁共振图像上手动描绘尾状核和豆状核来测量其基底神经节体积。使用剂量-年公式计算患者在两年期间的抗精神病药物暴露量。
在这两年期间，主要接受典型抗精神病药物治疗的患者的基底神经节平均体积增加，而主要接受非典型抗精神病药物治疗的患者则观察到相反的情况。对整个组的相关分析表明，两年内典型抗精神病药物暴露量与基底神经节体积变化呈正相关，而非典型抗精神病药物暴露量则相反。
在该组中，暴露于典型抗精神病药物后基底神经节体积增加，而暴露于非典型抗精神病药物后基底神经节体积减小。
