Early striatal & extrastriatal cerebral grey matter excess within 3 weeks of anti-psychotic treatment in schizophrenia

Abstract

Background: We sought to determine whether brain volumetric differences are present in the early weeks of neuroleptic treatment in patients presenting in their first-episode of schizophrenia who had never previously been exposed to antipsychotic medication. Methods: We used a comprehensive computational morphometry analysis of the brain. 38 individuals with first-episode psychosis were balanced for age, sex, handedness, ethnicity, height, education in years, paternal socio-economic status and PANSS score. They were a consecutive series presenting to their local hospital for treatment. BAMM (Brain activation and morphological mapping)software was used to measure grey matter, white matter and CSF volumes. 12 were treated with neuroleptics (NT) and 26 were neuroleptic-naıve (NN). Groups did not differ in age, sex, socioeconomic class, handedness, ethnicity. In the NT group, significant clusters of volume excess in grey matter was detected bilaterally in the caudate, putamen, cingulate, cerebellum, and brainstem after around 18 days of neuroleptic treatment. Region-of-interest measurement of the caudate using T1 scans, 1.2mm, contiguous, 128 slices was done by a single operator blind to group membership. Results: Caudate volume significantly larger by 16% (on the left, p 0.012, 2 tailed) and 13% (on the right, p 0.028, 2 tailed) in the NT group. Conclusions: This is the first study to suggest that an increase (normalization) in striatal and extrastriatal grey matter volumes in Schizophrenia may occur as early as three weeks after neuroleptic treatment.