scholarly journals Antipsychotic Effects on Cortical Morphology in Schizophrenia and Bipolar Disorders

2020 ◽  
Vol 14 ◽  
Author(s):  
Ruiqi Feng ◽  
Fay Y. Womer ◽  
E. Kale Edmiston ◽  
Yifan Chen ◽  
Yinshan Wang ◽  
...  
Keyword(s):  
Atypical Antipsychotic ◽  
Cortical Thickness ◽  
Atypical Antipsychotics ◽  
Structural Changes ◽  
Middle Temporal Gyrus ◽  
Antipsychotic Treatment ◽  
Illness Duration ◽  
Cortical Thinning ◽  
Age Related

Background: Previous studies of atypical antipsychotic effects on cortical structures in schizophrenia (SZ) and bipolar disorder (BD) have findings that vary between the short and long term. In particular, there has not been a study exploring the effects of atypical antipsychotics on age-related cortical structural changes in SZ and BD. This study aimed to determine whether mid- to long-term atypical antipsychotic treatment (mean duration = 20 months) is associated with cortical structural changes and whether age-related cortical structural changes are affected by atypical antipsychotics.Methods: Structural magnetic resonance imaging images were obtained from 445 participants consisting of 88 medicated patients (67 with SZ, 21 with BD), 84 unmedicated patients (50 with SZ, 34 with BD), and 273 healthy controls (HC). Surface-based analyses were employed to detect differences in thickness and area among the three groups. We examined the age-related effects of atypical antipsychotics after excluding the potential effects of illness duration.Results: Significant differences in cortical thickness were observed in the frontal, temporal, parietal, and insular areas and the isthmus of the cingulate gyrus. The medicated group showed greater cortical thinning in these regions than the unmediated group and HC; furthermore, there were age-related differences in the effects of atypical antipsychotics, and these effects did not relate to illness duration. Moreover, cortical thinning was significantly correlated with lower symptom scores and Wisconsin Card Sorting Test (WCST) deficits in patients. After false discovery rate correction, cortical thinning in the right middle temporal gyrus in patients was significantly positively correlated with lower HAMD scores. The unmedicated group showed only greater frontotemporal thickness than the HC group.Conclusion: Mid- to long-term atypical antipsychotic use may adversely affect cortical thickness over the course of treatment and ageing and may also result in worsening cognitive function.

scholarly journals Contribution of Prolonged Ischemia and Donor Age to Chronic Renal Allograft Dysfunction

2000 ◽  
Vol 11 (7) ◽  
pp. 1317-1324
Author(s):  
STEFAN GÜNTHER TULLIUS ◽  
ANJA REUTZEL-SELKE ◽  
FRANK EGERMANN ◽  
MELINA NIEMINEN-KELHÄ ◽  
SVEN JONAS ◽  
...  
Keyword(s):  
Structural Changes ◽  
Renal Allograft ◽  
Donor Age ◽  
Fischer 344 ◽  
Graft Outcome ◽  
Age Related ◽  
The Impact ◽  
Functional Deterioration ◽  
Observation Period

Abstract. As a consequence of an advancing discrepancy between supply of suitable grafts and demand from potential recipients, less than optimal organs are increasingly being used. Although clinical studies demonstrate the involvement of various risk factors, including donor age and duration of ischemia on long-term graft outcome, their individual contribution and correlation has not been followed experimentally. After cold ischemic times of 5, 60, and 120 min, kidney allografts of 3-, 12-, and 18-mo-old Fischer 344 donors were transplanted into 3-mo-old Lewis rats. Age-related changes were examined in matched native uninephrectomized controls. Proteinuria and creatinine clearance were determined, and histologic and immunohistologic studies were assessed and quantified at the end of the observation period (20 wk). All grafts functioned satisfactorily with the exception of one graft each from 12- and 18-mo-old donors with prolonged ischemia (120 min). Functional deterioration and structural changes progressed in parallel to increasing donor age and prolonged ischemia. The impact of expanded ischemia was particularly detrimental in grafts from older donor animals. Donor age and duration of ischemia act in a synergistic manner in our model. Brief ischemic times seem of particular relevance when grafts from older donors are being used.

Abstract 1: Improvement of Sensory Function Following Rehabilitation in Chronic Stroke Is Associated With Increased Cortical Thickness

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Svetlana Pundik ◽  
Aleca Scoco ◽  
Margaret Skelly ◽  
Jessica McCabe ◽  
Janis J Daly
Keyword(s):  
Cortical Thickness ◽  
Structural Changes ◽  
Chronic Stroke ◽  
Sensory Function ◽  
Middle Temporal Gyrus ◽  
Complex Nature ◽  
Middle Temporal ◽  
Sensory Recovery ◽  
Cortical Regions ◽  
Sensory Acuity

Introduction: Loss of somatosensory function after stroke weakens the ability to adequately relate to our environment, thus significantly reduces quality of life. Neuroplastic processes of sensory recovery are poorly understood. The objective of this study was to identify cortical regions that undergo structural changes (measured by change in cortical thickness (CT)) during sensory recovery. The hypothesis was that for subjects who improve sensory acuity, CT change in regions of the bilateral sensory network correlates with change in sensory acuity. Methods: Chronic stroke survivors were treated with 12-weeks rehabilitation. Outcome measures were sensory acuity (monofilament), Fugl-Meyer upper limb coordination and CT (T1 Magnetic Resonance Imaging). CT change was calculated based on T1 images using Freesurfer longitudinal processing stream. General linear regression modeling identified cortical regions where change in CT was associated with change in sensory acuity after controlling for baseline sensory impairment and change in motor function. Cluster-wise correction for multiple comparisons was conducted using Monte-Carlo simulation at p<0.05. Results: Subjects, who improved in sensory acuity (n=18), were 55.8±13.7 year old; 10% female; 1.8±0.9 years after first ever stroke. Acuity improved from 43.9±14mm to 40.53±13mm (p=0.004). FM improved from 22.4±8 to 34.5±10 (p<0.0001). For the ipsilesional hemisphere, CT increase correlated with sensory improvement in lateral occipital gyrus (size=1543mm2; peak vertex coordinates in MNI space x=-10.9, y=-97, z=10.9, cluster wise p=0.0002) and in middle temporal gyrus (795mm2, x=-57.2, y=-56.5,z=0.9, p=0.002). For the contralesional hemisphere, increased CT was associated with improved monofilament acuity within supramarginal gyrus (930mm2 ; x=47.2, y=-43.0, z=43.2, p=0.0002) and middle temporal gyrus (974mm2; x=53.5, y=-59.6, z=-1.7; p= 0.0001). Conclusion: Rehabilitation produces modality-specific structural brain changes that can be measured by changes in cortical thickness. Improved sensation correlates with increased thickness in bilateral high-order association sensory cortices reflecting a complex nature of sensory rehabilitation.

Serotonin Syndrome in Elderly Patients Treated for Psychotic Depression with Atypical Antipsychotics and Antidepressants: Two Case Reports

CNS Spectrums ◽  
2007 ◽  
Vol 12 (8) ◽  
pp. 596-598 ◽  
Author(s):  
Izchak Kohen ◽  
Marc L. Gordon ◽  
Peter Manu
Keyword(s):  
Elderly Patients ◽  
Atypical Antipsychotic ◽  
Mental Status ◽  
Atypical Antipsychotics ◽  
Serotonin Syndrome ◽  
Case Reports ◽  
Antipsychotic Treatment ◽  
Psychotic Depression ◽  
Medical Inpatient ◽  
First Case

ABSTRACTWe report two cases of serotonin syndrome in elderly patients during treatment of psychotic depression with atypical antipsychotics and antidepressants. The first case is a 69-year-old man who was admitted for depression with psychosis and treated with trazodone, risperidone, and sertraline. Subsequently, he developed myoclonus, tremor, cogwheel rigidity, and diaphoresis. The second case is a 72-year-old female initially admitted to a medical inpatient unit for a change in mental status that presented as increased confusion, lethargy, slurred speech, and a fever of 101.5°. She had been on phenelzine and quetiapine. In both cases, all symptoms resolved within 24 hours of the psychotropics being stopped. In both cases, we believe that serotonin syndrome was produced by a combination of an antidepressant and an atypical antipsychotic. There have been several case reports of serotonin syndrome from similar combinations of antidepressant and atypical antipsychotic treatment. Clinicians treating elderly patients with a combination of serotonergic antidepressants and atypical antipsychotics for psychotic depression should be aware of the potential for serotonin syndrome.

The impact of weight gain associated with atypical antipsychotic use in schizophrenia

2004 ◽  
Vol 16 (3) ◽  
pp. 113-123 ◽  
Author(s):  
Pierre Chue ◽  
Raphael Cheung
Keyword(s):  
Weight Gain ◽  
Weight Management ◽  
Atypical Antipsychotic ◽  
Atypical Antipsychotics ◽  
Current Data ◽  
Antipsychotic Treatment ◽  
Metabolic Disturbances ◽  
Obesity And Diabetes ◽  
The Impact ◽  
Selection Of

Background:Atypical antipsychotics offer clear advantages in the management of schizophrenia, compared with conventional neuroleptics, but weight gain is a significant adverse effect with some of these agents.Objective:To review the literature on weight gain associated with atypical antipsychotic treatment in schizophrenia.Methods:Relevant sources were identified from Medline searches to February 2003 using combinations of keywords including ‘schizophrenia’, ‘antipsychotics’, ‘weight gain’, ‘adverse events’, ‘obesity’, and ‘diabetes’.Results:Most atypical antipsychotics induce some weight gain, but the magnitude of the effect varies markedly. The greatest increases are seen with clozapine and olanzapine: risperidone has a slight effect, comparable with that of conventional neuroleptics, while ziprasidone and aripiprazole appear from current data to have little effect. In addition, atypical antipsychotics have been associated with metabolic disturbances, particularly glucose dysregulation and dyslipidemia. These effects tend to be more marked with olanzapine and clozapine than with other agents. Weight gain associated with atypical antipsychotics imposes substantial morbidity, in addition to that associated with schizophrenia itself. Furthermore, weight gain can significantly impair patients' quality of life, and leads to non-adherence with treatment. Effective weight management should include the selection of an appropriate atypical antipsychotic and for effective weight management, as well both diet and exercise, formal weight management programs tailored to the needs of schizophrenic patients may be useful, and some patients may benefit from weight-reducing drugs.Conclusions:Weight gain associated with atypical antipsychotics is a common problem that requires effective management. The selection of an agent with a low risk of weight gain, such as risperidone or ziprasidone, is central to such management.

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