Feng Ruiqi, Womer Fay Y, Edmiston E Kale, Chen Yifan, Wang Yinshan, Chang Miao, Yin Zhiyang, Wei Yange, Duan Jia, Ren Sihua, Li Chao, Liu Zhuang, Jiang Xiaowei, Wei Shengnan, Li Songbai, Zhang Xizhe, Zuo Xi-Nian, Tang Yanqing, Wang Fei
Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China.
Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.
Front Neurosci. 2020 Dec 10;14:579139. doi: 10.3389/fnins.2020.579139. eCollection 2020.
Previous studies of atypical antipsychotic effects on cortical structures in schizophrenia (SZ) and bipolar disorder (BD) have findings that vary between the short and long term. In particular, there has not been a study exploring the effects of atypical antipsychotics on age-related cortical structural changes in SZ and BD. This study aimed to determine whether mid- to long-term atypical antipsychotic treatment (mean duration = 20 months) is associated with cortical structural changes and whether age-related cortical structural changes are affected by atypical antipsychotics. Structural magnetic resonance imaging images were obtained from 445 participants consisting of 88 medicated patients (67 with SZ, 21 with BD), 84 unmedicated patients (50 with SZ, 34 with BD), and 273 healthy controls (HC). Surface-based analyses were employed to detect differences in thickness and area among the three groups. We examined the age-related effects of atypical antipsychotics after excluding the potential effects of illness duration. Significant differences in cortical thickness were observed in the frontal, temporal, parietal, and insular areas and the isthmus of the cingulate gyrus. The medicated group showed greater cortical thinning in these regions than the unmediated group and HC; furthermore, there were age-related differences in the effects of atypical antipsychotics, and these effects did not relate to illness duration. Moreover, cortical thinning was significantly correlated with lower symptom scores and Wisconsin Card Sorting Test (WCST) deficits in patients. After false discovery rate correction, cortical thinning in the right middle temporal gyrus in patients was significantly positively correlated with lower HAMD scores. The unmedicated group showed only greater frontotemporal thickness than the HC group. Mid- to long-term atypical antipsychotic use may adversely affect cortical thickness over the course of treatment and ageing and may also result in worsening cognitive function.
先前关于非典型抗精神病药物对精神分裂症（SZ）和双相情感障碍（BD）患者皮质结构影响的研究结果在短期和长期之间存在差异。特别是，尚未有研究探讨非典型抗精神病药物对SZ和BD患者与年龄相关的皮质结构变化的影响。本研究旨在确定中长期非典型抗精神病药物治疗（平均疗程 = 20个月）是否与皮质结构变化相关，以及与年龄相关的皮质结构变化是否受非典型抗精神病药物影响。对445名参与者进行了结构磁共振成像扫描，其中包括88名接受药物治疗的患者（67名SZ患者，21名BD患者）、84名未接受药物治疗的患者（50名SZ患者，34名BD患者）和273名健康对照者（HC）。采用基于表面的分析方法来检测三组之间厚度和面积的差异。在排除病程的潜在影响后，我们研究了非典型抗精神病药物与年龄相关的影响。在额叶、颞叶区、顶叶、岛叶以及扣带回峡部观察到皮质厚度存在显著差异。与未接受药物治疗的组和HC相比，接受药物治疗的组在这些区域的皮质变薄更为明显；此外，非典型抗精神病药物的影响存在与年龄相关的差异，且这些影响与病程无关。此外，患者的皮质变薄与较低的症状评分和威斯康星卡片分类测验（WCST）缺陷显著相关。经过错误发现率校正后，患者右侧颞中回的皮质变薄与较低的汉密尔顿抑郁量表（HAMD）评分显著正相关。未接受药物治疗的组仅比HC组的额颞叶厚度更大。中长期使用非典型抗精神病药物可能在治疗和衰老过程中对皮质厚度产生不利影响，还可能导致认知功能恶化。
