AUTHOR=Chen Yifan , Womer Fay Y. , Feng Ruiqi , Zhang Xizhe , Zhang Yanbo , Duan Jia , Chang Miao , Yin Zhiyang , Jiang Xiaowei , Wei Shengnan , Wei Yange , Tang Yanqing , Wang Fei 

TITLE=A Real-World Observation of Antipsychotic Effects on Brain Volumes and Intrinsic Brain Activity in Schizophrenia

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 15 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2021.749316

DOI=10.3389/fnins.2021.749316

ISSN=1662-453X

ABSTRACT=Background: The confounding effects of antipsychotics led to the inconsistencies of neuroimaging findings have long been the barriers of understanding of the pathophysiology of schizophrenia (SZ). Although it’s widely accepted that antipsychotics can alleviate psychotic symptoms during the early most acute phase, the longer-term effects of antipsychotics on brain have been unclear. The aim of this study is to look at susceptibility of different imaging measures to longer-term medicated status through the real-world observation.
Methods: We compared grey matter volume (GMV) and Amplitude of Low Frequency Fluctuations (ALFF) in 89 medicated-schizophrenia (med-SZ), 81 unmedicated-schizophrenia (unmed-SZ) and 235 healthy controls (HC), and the differences were explored for relationships between imaging modalities and clinical variables. We also analyze age-related effects on GMV and ALFF values in the two patient groups (med-SZ, unmed-SZ)
Results: Med-SZ demonstrated less GMV in the prefrontal cortex, temporal lobe, cingulate gyri, left insula than unmed-SZ and HC (p < 0.05, FWE corrected). Additionally, GMV loss correlated with the psychiatric symptom relief in all SZ. However, ALFF values weren’t influenced by medicated status: all SZ showed increased ALFF in the anterior cerebrum, decreased ALFF in posterior visual cortices compared to HC (p < 0.05, FWE corrected). Age-related GMV effects were seen in all of the regions which showing group-level difference except fusiform gyrus. No significant correlation was found between ALFF values and psychiatric symptoms.
Conclusion: GMV loss appeared to be pronounced to longer-term antipsychotics, whereby imbalanced alterations in regional low-frequency fluctuations persisted unaffected by antipsychotic treatment. Our findings may help to understand the disease course of schizophrenia and identify potentially a reliable neuroimaging feature for diagnosis.