McCormick Laurie, Decker Lawrence, Nopoulos Peg, Ho Beng-Choon, Andreasen Nancy
The University of Iowa, Carver College of Medicine, Department of Psychiatry, W278 GH, University of Iowa Hospitals and Clinics, Mental Health Clinical Research Center, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Schizophr Res. 2005 Dec 1;80(1):73-84. doi: 10.1016/j.schres.2005.06.022. Epub 2005 Sep 15.
We have previously found typical neuroleptic exposure to be correlated with an increase in anterior cingulate volume over time in patients with schizophrenia. However, the effect of atypical neuroleptics on anterior cingulate volume and the clinical significance of these changes are not known. To determine if atypicals differ from typicals in their effect on anterior cingulate volume change over time and to assess the clinical significance of such changes, subjects with schizophrenia were compared to normal controls over time. Anterior cingulate volume was delineated with manual traces on magnetic resonance images of the brain in 31 neuroleptic-naïve subjects and 18 normal controls at admission and 2-3 years later. Neuroleptic exposure for each subject was calculated using a dose-year formula. Increased typical neuroleptics exposure over time was correlated to increased anterior cingulate volume over time (r = 0.92, p < 0.001), while increased atypical neuroleptics exposure was correlated to decreased anterior cingulate volume (r = -0.57, p < 0.006). Increased anterior cingulate volume was correlated to greater psychotic symptom improvement (r = 0.78, p < 0.010). Anterior cingulate volume changes over time are correlated differently with atypical versus typical neuroleptic exposure over time. The increase in anterior cingulate volume with typicals is correlated to improved psychotic symptoms over time.
我们之前发现，在精神分裂症患者中，长期使用典型抗精神病药物与前扣带回体积增加有关。然而，非典型抗精神病药物对前扣带回体积的影响以及这些变化的临床意义尚不清楚。为了确定非典型抗精神病药物与典型抗精神病药物在对前扣带回体积随时间变化的影响上是否存在差异，并评估这些变化的临床意义，我们对精神分裂症患者和正常对照者进行了长期比较。在31名未使用过抗精神病药物的受试者和18名正常对照者入院时及2 - 3年后，通过手动勾勒脑磁共振图像上的前扣带回体积。使用剂量 - 年公式计算每个受试者的抗精神病药物暴露量。随着时间推移，典型抗精神病药物暴露量增加与前扣带回体积增加相关（r = 0.92，p < 0.001），而非典型抗精神病药物暴露量增加与前扣带回体积减少相关（r = -0.57，p < 0.006）。前扣带回体积增加与精神病症状改善程度更大相关（r = 0.78，p < 0.010）。前扣带回体积随时间的变化与非典型和典型抗精神病药物随时间的暴露情况存在不同的相关性。典型抗精神病药物使前扣带回体积增加与随时间精神病症状改善相关。
