Department of Psychosis Studies, Institute of Psychiatry, King's College London, United Kingdom.
Neurosci Biobehav Rev. 2013 Sep;37(8):1680-91. doi: 10.1016/j.neubiorev.2013.06.001. Epub 2013 Jun 14.
Antipsychotic treatment is the first-line treatment option for schizophrenia. Individual studies suggested they can significantly affect brain structure and account for progressive brain changes observed during the illness.
To quantitatively examine the effect of antipsychotics as compared to illness related factors on progressive brain changes in schizophrenia.
Electronic databases were searched until April 2012. All magnetic resonance imaging studies reporting progressive brain changes in schizophrenia subjects and antipsychotic exposure were retrieved.
30 longitudinal MRI studies with antipsychotic administration in schizophrenia patients met the inclusion criteria.
Brain volumes before and after antipsychotic exposure, duration of illness, severity of psychotic symptoms as well as demographic, clinical, and methodological variables were extracted from each publication, or obtained directly from its authors.
The overall sample was of 1046 schizophrenia patients and 780 controls for a median duration of follow-up of 72.4 weeks. At baseline, patients showed significant whole brain volume reductions and enlarged lateral ventricle (LV) volumes compared to controls. No baseline volumetric abnormalities were detected in the gray matter volumes (GMV), white matter volumes, cerebrospinal fluid and caudate nucleus. Longitudinally, there were progressive GMV decreases and LV enlargements in patients but not in controls. The GMV decreases were inversely correlated with cumulative exposure to antipsychotic treatments, while no effects were observed for duration of illness or illness severity.
Schizophrenia is characterized by progressive gray matter volume decreases and lateral ventricular volume increases. Some of these neuroanatomical alterations may be associated with antipsychotic treatment.
抗精神病药物治疗是精神分裂症的一线治疗选择。个别研究表明，它们可以显著影响大脑结构，并解释在疾病过程中观察到的进行性脑变化。
定量研究抗精神病药物与与疾病相关的因素对精神分裂症进行性脑变化的影响。
电子数据库搜索至 2012 年 4 月。检索了所有报告精神分裂症患者抗精神病药物暴露和进行性脑变化的磁共振成像研究。
30 项具有抗精神病药物治疗的精神分裂症患者纵向 MRI 研究符合纳入标准。
从每个出版物中提取或直接从其作者处获得抗精神病药物暴露前后的脑容量、疾病持续时间、精神病症状严重程度以及人口统计学、临床和方法学变量。
共有 1046 例精神分裂症患者和 780 例对照的总体样本，中位随访时间为 72.4 周。在基线时，与对照组相比，患者表现出明显的全脑体积减少和侧脑室（LV）体积增大。未检测到灰质体积（GMV）、白质体积、脑脊液和尾状核的基线容积异常。纵向研究中，患者出现进行性 GMV 减少和 LV 增大，但对照组没有。GMV 减少与抗精神病药物治疗的累积暴露量呈负相关，而与疾病持续时间或疾病严重程度无关。
精神分裂症的特征是进行性灰质体积减少和侧脑室体积增大。这些神经解剖学改变的一些可能与抗精神病药物治疗有关。
