Department of Psychiatry, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong.
Psychopharmacology (Berl). 2009 Oct;206(3):437-46. doi: 10.1007/s00213-009-1619-z. Epub 2009 Jul 30.
Anti-psychotic treatment appears to be associated with striatal volume increase, but how early this change occurs is still unknown.
A single prospective cohort of 20 anti-psychotic-naïve patients, newly diagnosed with schizophrenia, underwent magnetic resonance imaging brain scan at baseline. This was repeated following up to 8 weeks of anti-psychotic treatment. Ten patients had repeat scan within only 3 weeks. The choice of anti-psychotic medication was naturalistic, i.e., clinician-led. Well-matched healthy individuals were also scanned to control for non-specific changes over a 3-week period.
After 3 weeks of anti-psychotic treatment, significant grey matter volume increase in the right caudate, superior and inferior frontal gyrus, precentral gyrus, and left inferior parietal lobule was noted. However, after 8 weeks of anti-psychotic treatment, volume increase in the right thalamus and bilateral cerebellum was observed. Significant grey matter reduction was detected in the left medial frontal gyrus at both 3- and 8-week intervals.
Early increase in striatal volume change occurs as early as 3 weeks after anti-psychotic treatment, whilst thalamic volume increase is apparent later, by 8 weeks of treatment. We speculate that drug-mediated neuroplasticity may provide a biomarker for clinical recovery.
抗精神病药物治疗似乎与纹状体体积增加有关，但这种变化发生的时间尚不清楚。
一项前瞻性队列研究纳入了 20 名新诊断为精神分裂症且未经抗精神病药物治疗的患者，在基线时进行了磁共振成像脑扫描。在接受抗精神病药物治疗 8 周后，再次进行了扫描。10 名患者在仅 3 周内进行了重复扫描。抗精神病药物的选择是自然的，即由临床医生主导。为了控制 3 周内非特异性变化，还对匹配良好的健康个体进行了扫描。
在接受抗精神病药物治疗 3 周后，右侧尾状核、额上回和额下回、中央前回和左侧顶下小叶的灰质体积显著增加。然而，在接受抗精神病药物治疗 8 周后，右侧丘脑和双侧小脑的体积增加。在 3 周和 8 周时，左侧额内侧回的灰质体积均显著减少。
抗精神病药物治疗后 3 周即可出现纹状体体积的早期增加，而丘脑体积的增加则在 8 周后才出现。我们推测，药物介导的神经可塑性可能为临床康复提供生物标志物。
