Title |
Progressive Brain Atrophy and Cortical Thinning in Schizophrenia after Commencing Clozapine Treatment
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Published in |
Neuropsychopharmacology, April 2015
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DOI | 10.1038/npp.2015.90 |
Pubmed ID | |
Authors |
Mohamed Ahmed, Dara M Cannon, Cathy Scanlon, Laurena Holleran, Heike Schmidt, John McFarland, Camilla Langan, Peter McCarthy, Gareth J Barker, Brian Hallahan, Colm McDonald |
Abstract |
Despite evidence that clozapine may be neuroprotective, there are few longitudinal MRI studies that have specifically explored an association between commencement of clozapine treatment for schizophrenia and changes in regional brain volume or cortical thickness. Thirty-three patients with treatment resistant schizophrenia and 31 healthy controls (HC) matched for age and gender underwent structural MRI brain scans at baseline and 6-9 months after commencing clozapine. MRI images were analysed using SIENA (Structural Image Evaluation, using Normalisation, of Atrophy) and FreeSurfer to investigate changes over time in brain volume and cortical thickness respectively. Significantly greater reductions in volume were detected in the right and left medial prefrontal cortex and in the periventricular area in the patient group regardless of treatment response. Widespread further cortical thinning was observed in patients compared to healthy controls. The majority of patients improved symptomatically and functionally over the study period, and patients who improved were more likely to have less cortical thinning of the left medial frontal cortex and the right middle temporal cortex. These findings demonstrate on-going reductions in brain volume and progressive cortical thinning in patients with schizophrenia who are switched to clozapine treatment. It is possible that this grey matter loss reflects a progressive disease process irrespective of medication use or that it is contributed to by switching to clozapine treatment. The clinical improvement of most patients indicates that antipsychotic related grey matter volume loss may not necessarily be harmful or reflect neurotoxicity.Neuropsychopharmacology accepted article preview online, 01 April 2015. doi:10.1038/npp.2015.90. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Unknown | 4 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 4 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Japan | 1 | 1% |
United Kingdom | 1 | 1% |
Chile | 1 | 1% |
Italy | 1 | 1% |
Unknown | 93 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 16 | 16% |
Researcher | 13 | 13% |
Student > Master | 12 | 12% |
Student > Bachelor | 11 | 11% |
Student > Doctoral Student | 6 | 6% |
Other | 22 | 23% |
Unknown | 17 | 18% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 19 | 20% |
Neuroscience | 15 | 15% |
Psychology | 12 | 12% |
Nursing and Health Professions | 7 | 7% |
Biochemistry, Genetics and Molecular Biology | 6 | 6% |
Other | 16 | 16% |
Unknown | 22 | 23% |