Pharmacopsychiatry 2001; 34(6): 251-253
DOI: 10.1055/s-2001-18037
Short Communication
© Georg Thieme Verlag Stuttgart · New York

Favorable Effect on Neuronal Viability in the Anterior Cingulate Gyrus due to Long-Term Treatment with Atypical Antipsychotics:
An MRSI Study

D. F. Braus, G. Ende, W. Weber-Fahr, T. Demirakca, F. A. Henn
  • NMR-Research, Central Institute of Mental Health, Mannheim, Germany
Further Information

Publication History

Publication Date:
26 October 2001 (online)

In the present study, we evaluated 23 chronic schizophrenic patients under stable clinical conditions to determine the association between neuronal viability, as measured by in vivo 1H magnetic resonance spectroscopic imaging (MRSI), and antipsychotic drug effects in the anterior cingulate cortex. Careful screening of the medication history showed that 11 of these patients had been treated with traditional neuroleptics only, while the others had switched to atypical antipsychotics due to non-response to traditional drugs. The group of patients receiving typical neuroleptic medication showed a mean NAA that was lower than in the group of patients receiving atypical antipsychotic drugs. Removing the duration of illness effect indicated a significant correlation between the NAA signal in the anterior cingulate gyrus and time on atypical drugs in patients under long-term atypical antipsychotic treatment. In contrast, patients with traditional medication revealed progressive decrease in the NAA level. These results suggest a favorable effect on neuronal viability in the anterior cingulate gyrus due to long-term treatment with atypical antipsychotics.

References

  • 1 Bertolino A, Callicott J H, Nawroz S, Mattay V S, Duyn J H, Tedeschi G, Frank J A, Weinberger D R. Reproducibility of proton magnetic resonance spectroscopic imaging in patients with schizophrenia.  Neuropsychopharmacology. 1998;  18 1-9
  • 2 De Stefano N, Matthews P M, Arnold D L. Reversible decreases in N-acetylaspartate after acute brain injury.  Magn Reson Med. 1995;  34 721-727
  • 3 Deicken R F, Zhou L, Schuff N, Weiner M W. Proton magnetic resonance spectroscopy of the anterior cingulate region in schizophrenia.  Schizophr Res. 1997;  27 65-71
  • 4 DeLisi L E, Tew W, Xie S, Hoff A L, Sakuma M, Kushner M, Lee G, Shedlack K, Smith A M, Grimson R. A prospective follow-up study of brain morphology and cognition in first-episode schizophrenic patients: preliminary findings.  Biol Psychiatry. 1995;  38 349-60
  • 5 Ende G, Braus D F, Walter S, Weber-Fahr W, Soher B, Maudsley A A, Henn F A. Effects of age, medication, and illness duration on the N-acetyl aspartate signal of the anterior cingulate region in schizophrenia.  Schizophr Res. 2000;  41 389-95
  • 6 Green M F. Schizophrenia from a neurocognitive perspective. Boston; London; Toronto; Sydney; Singapore: Allyn and Bacon 1998: 190
  • 7 Green M F, Marshall B D, Jr., Wirshing W C, Ames D, Marder S R, McGurk S, Kern R S, Mintz J. Does risperidone improve verbal working memory in treatment-resistant schizophrenia?.  Am J Psychiatry. 1997;  154 799-804
  • 8 Honey G D, Bullmore E T, Soni W, Varatheesan M, Williams S C, Sharma T. Differences in frontal cortical activation by a working memory task after substitution of risperidone for typical antipsychotic drugs in patients with schizophrenia.  Proc Natl Acad Sci USA. 1999;  96 13432-13437
  • 9 Jentsch J D, Redmond D E, Jr., Elsworth J D, Taylor J R, Youngren K D, Roth R H. Enduring cognitive deficits and cortical dopamine dysfunction in monkeys after long-term administration of phencyclidine.  Science. 1997;  277 953-955
  • 10 Lee M A, Thompson P A, Meltzer H Y. Effects of clozapine on cognitive function in schizophrenia.  J Clin Psychiatry. 1994;  55 (Suppl B) 82-87
  • 11 Madsen A L, Keidling N, Karle A, Esbjerg S, Hemmingsen R. Neuroleptics in progressive structural brain abnormalities in psychiatric illness.  Lancet. 1998;  352 784-5
  • 12 Maudsley A A, Matson G B, Hugg J W, Weiner M W. Reduced phase encoding in spectroscopic imaging.  Magn Reson Med. 1994;  31 645-651
  • 13 Meltzer H Y, Lee M A, Ranjan R. Recent advances in the pharmacotherapy of schizophrenia.  Acta Psychiatr Scand Suppl. 1994;  384 95-101
  • 14 Meltzer H Y, Thompson P A, Lee M A, Ranjan R. Neuropsychologic deficits in schizophrenia: relation to social function and effect of antipsychotic drug treatment.  Neuropsychopharmacology. 1996;  14 27-33
  • 15 Michaelis T, Merboldt K D, Bruhn H, Hanicke W, Frahm J. Absolute concentrations of metabolites in the adult human brain in vivo: quantification of localized proton MR spectra.  Radiology. 1993;  187 219-227
  • 16 Robertson G S, Fibiger H C. Neuroleptics increase c-fos expression in the forebrain: contrasting effects of haloperidol and clozapine.  Neuroscience. 1992;  46 315-28
  • 17 Robertson G S, Matsumura H, Fibiger H C. Induction patterns of Fos-like immunoreactivity in the forebrain as predictors of atypical antipsychotic activity.  J Pharmacol Exp Ther. 1994;  271 1058-1066
  • 18 Soher B J, Young K, Govindaraju V, Maudsley A A. Automated spectral analysis III: application to in vivo proton MR spectroscopy and spectroscopic imaging.  Magn Reson Med. 1998;  40 822-831
  • 19 Woods B T. Is schizophrenia a progressive neurodevelopmental disorder? Toward a unitary pathogenetic mechanism.  Am J Psychiatry. 1998;  155 1661-1670

Priv.-Doz. Dr. Dieter F. Braus

NMR Research in Psychiatry
Central Institute of Mental Health

P.O. Box 12 21 20

68072 Mannheim

Germany

Phone: (+49) (621) 170 36 72

Fax: (+49) (621) 170 36 73

Email: dfbraus@as200.zi-mannheim.de

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