Structural brain changes associated with antipsychotic treatment in schizophrenia as revealed by voxel-based morphometric MRI: an activation likelihood estimation meta-analysis

BMC Psychiatry

Geraldo F Busatto¹  Stefan Borgwardt³  Eduardo Portela-Oliveira²  Ulysses S Torres¹ 

[1] Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Sao Paulo, Brazil;Department of Radiology, Hospital de Base, São José do Rio Preto Medical School, Sao Paulo, Brazil;Department of Psychosis Studies, Institute of Psychiatry, King’s College, London, UK

关键词: Neuroimaging;    Magnetic resonance imaging;    Voxel-based morphometry;    Antipsychotics;    Schizophrenia;   

Others  :  1123854
DOI  :  10.1186/1471-244X-13-342

 received in 2013-06-22, accepted in 2013-12-09,  发布年份 2013

【 摘 要 】

Background

The results of multiple studies on the association between antipsychotic use and structural brain changes in schizophrenia have been assessed only in qualitative literature reviews to date. We aimed to perform a meta-analysis of voxel-based morphometry (VBM) studies on this association to quantitatively synthesize the findings of these studies.

Methods

A systematic computerized literature search was carried out through MEDLINE/PubMed, EMBASE, ISI Web of Science, SCOPUS and PsycINFO databases aiming to identify all VBM studies addressing this question and meeting predetermined inclusion criteria. All studies reporting coordinates representing foci of structural brain changes associated with antipsychotic use were meta-analyzed by using the activation likelihood estimation technique, currently the most sophisticated and best-validated tool for voxel-wise meta-analysis of neuroimaging studies.

Results

Ten studies (five cross-sectional and five longitudinal) met the inclusion criteria and comprised a total of 548 individuals (298 patients on antipsychotic drugs and 250 controls). Depending on the methodologies of the selected studies, the control groups included healthy subjects, drug-free patients, or the same patients evaluated repeatedly in longitudinal comparisons (i.e., serving as their own controls). A total of 102 foci associated with structural alterations were retrieved. The meta-analysis revealed seven clusters of areas with consistent structural brain changes in patients on antipsychotics compared to controls. The seven clusters included four areas of relative volumetric decrease in the left lateral temporal cortex [Brodmann area (BA) 20], left inferior frontal gyrus (BA 44), superior frontal gyrus extending to the left middle frontal gyrus (BA 6), and right rectal gyrus (BA 11), and three areas of relative volumetric increase in the left dorsal anterior cingulate cortex (BA 24), left ventral anterior cingulate cortex (BA 24) and right putamen.

Conclusions

Our results identify the specific brain regions where possible associations between antipsychotic drug usage and structural brain changes in schizophrenia patients are more consistently reported. Additional longitudinal VBM studies including larger and more homogeneous samples of schizophrenia patients may be needed to further disentangle such alterations from those possibly linked to the intrinsic pathological progressive process in schizophrenia.

【 授权许可】

   
2013 Torres et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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Figure 3.

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