Roiz-Santiañez Roberto, Suarez-Pinilla Paula, Crespo-Facorro Benedicto
Unidad Investigación Psiquiatría, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Avda. Valdecilla s/n, 39008, Santander, Spain.
Curr Neuropharmacol. 2015;13(4):422-34. doi: 10.2174/1570159x13666150429002536.
The findings about the progressive brain changes in schizophrenia are controversial, and the potential confounding effect of antipsychotics on brain structure is still under debate. The goal of the current article was to review the existing longitudinal neuroimaging studies addressing the impact of antipsychotic drug treatment on brain changes in schizophrenia. A comprehensive search of PubMed was performed using combinations of key terms distributed into four blocks: "MRI", "longitudinal", "schizophrenia" and "antipsychotic". Studies were considered to be eligible for the review if they were original articles. Studies that examined only changes in brain density were excluded. A total of 41 MRI studies were identified and reviewed. Longitudinal MRI studies did not provide a consistent notion of the effects of antipsychotic treatment on the pattern of brain changes over time in schizophrenia. Overall, most of the included articles did not find a linear relationship between the degree of exposure and progressive brain changes. Further short- and longterm studies are warranted to a better understanding of the influence of antipsychotics in brain structural changes in schizophrenia and also to verify whether first and second generation antipsychotics may differentially affect brain morphometry.
关于精神分裂症患者脑部渐进性变化的研究结果存在争议，抗精神病药物对脑结构的潜在混杂效应仍在讨论之中。本文的目的是回顾现有的纵向神经影像学研究，探讨抗精神病药物治疗对精神分裂症患者脑部变化的影响。使用分布在四个板块的关键词组合在PubMed上进行了全面检索：“MRI”、“纵向”、“精神分裂症”和“抗精神病药物”。如果研究为原创文章，则被认为符合纳入综述的条件。仅研究脑密度变化的研究被排除。共识别并综述了41项MRI研究。纵向MRI研究并未就抗精神病药物治疗对精神分裂症患者脑部变化模式随时间的影响提供一致的观点。总体而言，大多数纳入文章并未发现暴露程度与脑部渐进性变化之间存在线性关系。有必要开展进一步的短期和长期研究，以更好地了解抗精神病药物对精神分裂症患者脑结构变化的影响，并验证第一代和第二代抗精神病药物是否可能对脑形态测量产生不同影响。
