期刊
PSYCHOLOGICAL MEDICINE
卷 45, 期 3, 页码 515-527出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291714001652
关键词
Antipsychotics; cortical thickness; first-episode psychosis; first-generation; second-generation
资金
- National Health and Medical Research Council (NHMRC) of Australia [970598, 981112]
- NHMRC Program [566529]
- NHMRC Clinical Career Developmental Award [359223]
- NHMRC Senior Principal Research Fellowship [628386]
- National Alliance for Research on Schizophrenia and Depression (NARSAD) Distinguished Investigator Awards from the Brain and Behavior Research Foundation (USA)
- Ian Potter Foundation, Melbourne
- Woods Family Trust, Melbourne
- Victorian Health Promotion Foundation, Melbourne
- Undergraduate Research Opportunities program (Melbourne University)
- Victorian Life Sciences Computation Initiative
Background. Whether there are differential effects of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) on the brain is currently debated. Although some studies report that FGAs reduce grey matter more than SGAs, others do not, and research to date is limited by a focus on schizophrenia spectrum disorders. To address this limitation, this study investigated the effects of medication in patients being treated for first-episode schizophrenia or affective psychoses. Method. Cortical thickness was compared between 52 first-episode psychosis patients separated into diagnostic (i.e. schizophrenia or affective psychosis) and medication (i.e. FGA and SGA) subgroups. Patients in each group were also compared to age-and sex-matched healthy controls (n=28). A whole-brain cortical thickness interaction analysis of medication and diagnosis was then performed. Correlations between cortical thickness with antipsychotic dose and psychotic symptoms were examined. Results. The effects of medication and diagnosis did not interact, suggesting independent effects. Compared with controls, diagnostic differences were found in frontal, parietal and temporal regions. Decreased thickness in FGA-treated versus SGA-treated groups was found in a large frontoparietal region (p<0.001, corrected). Comparisons with healthy controls revealed decreased cortical thickness in the FGA group whereas the SGA group showed increases in addition to decreases. In FGA-treated patients cortical thinning was associated with higher negative symptoms whereas increased cortical thickness in the SGA-treated group was associated with lower positive symptoms. Conclusions. Our results suggest that FGA and SGA treatments have divergent effects on cortical thickness during the first episode of psychosis that are independent from changes due to illness.
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