Abnormal white matter microstructure in drug-naive first episode schizophrenia patients before and after eight weeks of antipsychotic treatment

BackgroundIt remains unclear whether the topological deficits of the white matter network documented in cross-sectional studies of chronic schizophrenia patients are due to chronic illness or to other factors such as antipsychotic treatment effects. To answer this question, we evaluated the white matter network in medication-naive first-episode schizophrenia patients (FESP) before and after a course of treatment.MethodWe performed a longitudinal diffusion tensor imaging study in 42 drug-naive FESP at baseline and then after 8 weeks of risperidone monotherapy, and compared them with 38 healthy volunteers. Graph theory was utilized to calculate the topological characteristics of brain anatomical network. Patients’ clinical state was evaluated using the Positive and Negative Syndrome Scale (PANSS) before and after treatment.ResultsPretreatment, patients had relatively intact overall topological organizations, and deficient nodal topological properties primarily in prefrontal gyrus and limbic system components such as the bilateral anterior and posterior cingulate. Treatment with risperidone normalized topological parameters in the limbic system, and the enhancement positively correlated with the reduction in PANSS-positive symptoms. Prefrontal topological impairments persisted following treatment and negative symptoms did not improve.ConclusionsDuring the early phase of antipsychotic medication treatment there are region-specific alterations in white matter topological measures. Limbic white matter topological dysfunction improves with positive symptom reduction. Prefrontal deficits and negative symptoms are unresponsive to medication intervention, and prefrontal deficits are potential trait biomarkers and targets for negative symptom treatment development.

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Changes in the cytokine profile in first episode, drug-naïve patients with psychosis after short-term antipsychotic treatment

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.382 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S371-S371

Author(s):

P. Petrikis ◽

P. Voulgari ◽

V. Boumba ◽

D. Archimandriti ◽

P. Skapinakis ◽

...

Keyword(s):

Antipsychotic Medication ◽

Transforming Growth Factor ◽

Serum Levels ◽

Psychotic Symptoms ◽

First Episode ◽

Enzyme Linked Immunosorbent Assay ◽

Antipsychotic Treatment ◽

Before And After ◽

Drug Naïve ◽

Competing Interest

IntroductionAn increasing body of evidence suggests that antipsychotic medication can cause immunological changes that could be attributed to the amelioration of psychotic symptoms or the metabolic side effects of the drugs. So far, the results of the studies remain controversial.ObjectiveOur aim was to compare the levels of interleukin (IL) IL-2, IL-6 and transforming growth factor-β2 (TGF-β2) in drug-naïve, first-episode patients with psychosis before and after six weeks of antipsychotic medication.MethodsThirty-nine first episode patients with psychosis were enrolled in the study. Serum levels of IL-2, IL-6 and TGF-β2 were measured by enzyme linked immunosorbent assay (ELISA) before and six weeks after the initiation of antipsychotic medication. In addition, clinical psychopathology was assessed using Positive and Negative Syndrome Scale (PANSS) before and after treatment.ResultsSerum levels of IL-2 were significantly higher in the study group six weeks after the initiation of antipsychotic treatment (P < 0.001) while TGF-β2 levels were decreased (P < 0.001) and IL-6 levels were slightly reduced (P < 0.004).ConclusionThe changes in cytokine levels may be attributed to the action of antipsychotic medication and the remission of psychopathology. The reduction in TGF-β2 levels is observed in all patients and with all antipsychotic medications used. TGF-β2 may be a marker of clinical efficacy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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White-matter microstructure in previously drug-naive patients with schizophrenia after 6 weeks of treatment

Psychological Medicine ◽

10.1017/s0033291713000238 ◽

2013 ◽

Vol 43 (11) ◽

pp. 2301-2309 ◽

Cited By ~ 55

Author(s):

Q. Wang ◽

C. Cheung ◽

W. Deng ◽

M. Li ◽

C. Huang ◽

...

Keyword(s):

White Matter ◽

Early Phase ◽

Clinical Symptoms ◽

Diffusion Tensor ◽

Disease Process ◽

Anterior Cingulate ◽

First Episode ◽

Drug Naïve ◽

The Right ◽

First Episode Schizophrenia

BackgroundIt is not clear whether the progressive changes in brain microstructural deficits documented in previous longitudinal magnetic resonance imaging (MRI) studies might be due to the disease process or to other factors such as medication. It is important to explore the longitudinal alterations in white-matter (WM) microstructure in antipsychotic-naive patients with first-episode schizophrenia during the very early phase of treatment when relatively ‘free’ from chronicity.MethodThirty-five patients with first-episode schizophrenia and 22 healthy volunteers were recruited. High-resolution diffusion tensor imaging (DTI) was obtained from participants at baseline and after 6 weeks of treatment. A ‘difference map’ for each individual was calculated from the 6-week follow-up fractional anisotropy (FA) of DTI minus the baseline FA. Differences in Positive and Negative Syndrome Scale (PANSS) scores and Global Assessment of Functioning (GAF) scores between baseline and 6 weeks were also evaluated and expressed as a 6-week/baseline ratio.ResultsCompared to healthy controls, there was a significant decrease in absolute FA of WM around the bilateral anterior cingulate gyrus and the right anterior corona radiata of the frontal lobe in first-episode drug-naive patients with schizophrenia following 6 weeks of treatment. Clinical symptoms improved during this period but the change in FA did not correlate with the changes in clinical symptoms or the dose of antipsychotic medication.ConclusionsDuring the early phase of treatment, there is an acute reduction in WM FA that may be due to the effects of antipsychotic medications. However, it is not possible to entirely exclude the effects of underlying progression of illness.

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An fMRI study of visual attention and sensorimotor function before and after antipsychotic treatment in first-episode schizophrenia

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2008.06.003 ◽

2009 ◽

Vol 172 (1) ◽

pp. 16-23 ◽

Cited By ~ 38

Author(s):

Sarah K. Keedy ◽

Cherise Rosen ◽

Tin Khine ◽

Rajaprabhakaran Rajarethinam ◽

Philip G. Janicak ◽

...

Keyword(s):

Visual Attention ◽

First Episode ◽

Antipsychotic Treatment ◽

Sensorimotor Function ◽

Fmri Study ◽

Before And After ◽

First Episode Schizophrenia

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Corrigendum to “Cytokine alterations in first-episode schizophrenia patients before and after antipsychotic treatment” [Schizophr. Res. 154 (1–3) (2014) 23–29]

Schizophrenia Research ◽

10.1016/j.schres.2014.06.006 ◽

2014 ◽

Vol 157 (1-3) ◽

pp. 321

Author(s):

Lot de Witte ◽

Jakub Tomasik ◽

Emanuel Schwarz ◽

Paul C. Guest ◽

Hassan Rahmoune ◽

...

Keyword(s):

First Episode ◽

Antipsychotic Treatment ◽

Before And After ◽

First Episode Schizophrenia

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Improvement of cognitive flexibility and cingulate blood flow correlates after atypical antipsychotic treatment in drug-naive patients with first-episode schizophrenia

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2011.06.001 ◽

2011 ◽

Vol 194 (3) ◽

pp. 205-211 ◽

Cited By ~ 12

Author(s):

Bernardo M. Pardo ◽

Maite Garolera ◽

Mar Ariza ◽

Deborah Pareto ◽

Manel Salamero ◽

...

Keyword(s):

Blood Flow ◽

Atypical Antipsychotic ◽

Cognitive Flexibility ◽

First Episode ◽

Antipsychotic Treatment ◽

Drug Naïve ◽

First Episode Schizophrenia

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Cytokine alterations in first-episode schizophrenia patients before and after antipsychotic treatment

Schizophrenia Research ◽

10.1016/j.schres.2014.02.005 ◽

2014 ◽

Vol 154 (1-3) ◽

pp. 23-29 ◽

Cited By ~ 104

Author(s):

Lot de Witte ◽

Jakub Tomasik ◽

Emanuel Schwarz ◽

Paul C. Guest ◽

Hassan Rahmoune ◽

...

Keyword(s):

First Episode ◽

Antipsychotic Treatment ◽

Before And After ◽

First Episode Schizophrenia

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Unveiling the Metabolic Profile of First-Episode Drug-Naïve Schizophrenia Patients: Baseline Characteristics of a Longitudinal Study Among Han Chinese

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.702720 ◽

2021 ◽

Vol 12 ◽

Author(s):

Qi Zhang ◽

Hui He ◽

Xia Bai ◽

Liping Jiang ◽

Wei Chen ◽

...

Keyword(s):

Metabolic Profile ◽

First Episode ◽

Antipsychotic Treatment ◽

Medical Conditions ◽

Metabolic Disturbances ◽

Cognitive Assessments ◽

Laboratory Assessment ◽

History Of ◽

Drug Naïve ◽

First Episode Schizophrenia

Objective: Metabolic and other medical conditions are frequently comorbid with schizophrenia. As they might be the side-effects of antipsychotic treatment, studying first-episode drug-naïve schizophrenia (FDSZ) provides a unique opportunity to investigate a direct pathogenic link between metabolic changes and schizophrenia. Here, we presented the methods and baseline unique metabolic profile of FDSZ patients without medical comorbidities unveiling subthreshold indices of metabolic disturbances.Method: Drug-naïve individuals diagnosed with schizophrenia but without any previous medical conditions were invited to participate in the study. Participants were submitted to structured psychiatric and cognitive assessments, laboratory and neuroimaging tests. Subjects will be followed after antipsychotic treatment at 6, 24 and 48 weeks.Results: During an 8-month-period, out of 103 patients presenting with first episode psychosis, 67 subjects (43.3% men, 56.7% women) were enrolled in the study. They had a mean ± SD age of 32.1 ± 8.7 years, with a mean BMI of 21.1 kg/m2 and 11.3 ± 3.6 years of schooling. Less than 1/3 reported a family history of mental illness. Upon laboratory assessment, 10.4%, 7.5%, and 11.9% of patients were identified with hyperhomocysteinemia, hypertriglyceridemia and hyperprolactinemia, respectively, with percentages of women relatively higher than men except for hypertriglyceridemia.Conclusions: First episode schizophrenia patients, especially women, present subclinical metabolic abnormalities, independent of antipsychotic treatment.

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