[Clozapine: neuropsychological and neuroimaging studies]

The purpose of this work is to review the main investigations on the cognitive and cerebral effects of clozapine treatment in schizophrenic patients. We remark the differential effects in respect to other neuroleptics. Memory is the neuropsychological function more widely investigated. Clozapine produces visual memory impairment, but not the verbal memory deficit observed following the classical neuroleptic treatment. The effect of clozapine in the cortico-subcortical circuitry points to a differential effects on frontal lobe functions. It has been observed positive effects in controlled verbal fluency and also in visuoconstructive functions. However, in these studies retest effects are not controlled. There are several magnetic resonance imaging works that found a decrease of caudate nuclei volume, in contrast to the increase observed after treatment with classical neuroleptics. The differential effects on neuropsychological functions may be caused by the differential action of antipsychotics on the fronto-estriatal structures. In the future research it is necessary to perform studies including together neuropsychological and functional neuroimaging data in order to clarify the mechanisms responsible of positive and negative psychopharmacological effects.