Scherk Harald, Falkai Peter
Department of Psychiatry and Psychotherapy, Saarland University Hospital, Homburg, Germany.
Curr Opin Psychiatry. 2006 Mar;19(2):145-50. doi: 10.1097/01.yco.0000214339.06507.d8.
This review highlights the recent findings of different effects of typical and atypical antipsychotics on brain structure.
Studies examining the effect of treatment with typical antipsychotics on brain structure revealed a significant increase in basal ganglia volumes and decreased grey matter volume in different cortical regions. These volume changes were detectable even after a 12-week treatment. In contrast to these results, treatment with atypical antipsychotics does not seem to change basal ganglia volumes in neuroleptic-naïve patients. Moreover, switching from typical to atypical antipsychotic treatment reduces the increased basal ganglia volume to normal values compared with healthy controls. Only the volumes of thalamus and cortical grey matter increased after atypical antipsychotic treatment.
Currently, there is growing evidence that atypical antipsychotics might ameliorate structural changes caused by the disease process underlying schizophrenia and effects of typical antipsychotics. Further studies have to investigate the mechanism leading to these varying effects on brain structure.
本综述重点介绍了典型和非典型抗精神病药物对脑结构不同影响的近期研究结果。
研究典型抗精神病药物治疗对脑结构影响的研究发现，基底节体积显著增加，不同皮质区域灰质体积减少。即使经过12周治疗，这些体积变化仍可检测到。与这些结果相反，在未使用过抗精神病药物的患者中，非典型抗精神病药物治疗似乎不会改变基底节体积。此外，与健康对照相比，从典型抗精神病药物治疗转换为非典型抗精神病药物治疗可将增加的基底节体积降至正常水平。非典型抗精神病药物治疗后仅丘脑和皮质灰质体积增加。
目前，越来越多的证据表明，非典型抗精神病药物可能改善精神分裂症潜在疾病过程和典型抗精神病药物作用所引起的结构变化。进一步的研究必须调查导致对脑结构产生这些不同影响的机制。
