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Early striatal hypertrophy in first-episode psychosis within 3 weeks of initiating antipsychotic drug treatment

Published online by Cambridge University Press:  20 August 2008

S. E. Chua ,
Y. Deng ,
E. Y. H. Chen ,
C. W. Law ,
C. P. Y. Chiu ,
C. Cheung ,
J. C. H. Wong ,
N. Lienenkaëmper ,
V. Cheung  and
J. Suckling
...Show all authors
S. E. Chua
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China State Key Laboratory for Cognitive Science, The University of Hong Kong, S.A.R. China
Y. Deng
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China
E. Y. H. Chen
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China
C. W. Law
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China
C. P. Y. Chiu
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China
C. Cheung
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China
J. C. H. Wong
Affiliation:
Faculty of Medicine, University of Georgetown, Washington, DC, USA
N. Lienenkaëmper
Affiliation:
Department of Biomedical Sciences, The University of Utrecht, The Netherlands
V. Cheung
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China
J. Suckling
Affiliation:
Cambridge Brain Mapping Unit, Department of Psychiatry, University of Cambridge, UK
G. M. McAlonan*
Affiliation:
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, S.A.R. China State Key Laboratory for Cognitive Science, The University of Hong Kong, S.A.R. China
*
*Address for correspondence: Dr G. M. McAlonan, Department of Psychiatry, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, S.A.R. China. (Email: [email protected])
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Abstract

Background

We and others have reported that patients experiencing their first episode of psychosis already have significant structural brain abnormalities. Antipsychotics seem to reverse subcortical volume deficits after months of treatment. However, the early impact of medication on brain morphology is not known.

Method

Forty-eight individuals in their first episode of psychosis underwent magnetic resonance imaging (MRI) brain scanning. Twenty-six were antipsychotic naive and 22 were newly treated with antipsychotic medication for a median period of 3 weeks. In each group, 80% of subjects received a diagnosis of schizophrenia. The two groups were balanced for age, sex, handedness, ethnicity, height, years of education, paternal socio-economic status (SES) and Positive and Negative Syndrome Scale (PANSS) score. Group differences in whole-brain grey matter were compared voxel by voxel, using Brain Activation and Morphological Mapping (BAMM) software. We also conducted testing of group differences with region-of-interest (ROI) measurements of the caudate nucleus.

Results

Relative to the untreated group, those receiving antipsychotic medication for 3–4 weeks had significantly greater grey-matter volumes in the bilateral caudate and cingulate gyri, extending to the left medial frontal gyrus. ROI analysis confirmed that, in treated patients, the right and left caudate nuclei were significantly larger by 10% (p<0.039, two-tailed) and 9% (p<0.048, two-tailed) respectively.

Conclusions

Early striatal grey-matter enlargement may occur within the first 3–4 weeks of antipsychotic treatment. Possible reasons for putative striatal hypertrophy and its implications are discussed.

Keywords

Antipsychoticbrainfirst episodeMRIschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 5 , May 2009 , pp. 793 - 800
Copyright
Copyright © Cambridge University Press 2008

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