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Cerebral cortical gray expansion associated with two second-generation antipsychotics
David L Garver1, Jennifer A Holcomb, James D Christensen
1Department of Psychiatry and Behavioral Science, University of Louisville School of Medicine, Louisville, Kentucky, USA. david.garver@insightbb.com
Biological Psychiatry
|July 5, 2005
Summary
Second-generation antipsychotics (SGAs) like risperidone and ziprasidone increased cortical gray matter in schizophrenia patients. First-generation antipsychotics (FGAs) did not show this effect, suggesting SGAs may improve cognition.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Second-generation antipsychotics (SGAs) offer advantages over first-generation antipsychotics (FGAs) in treating schizophrenia, including reduced side effects and potential cognitive benefits.
- SGAs are known for their 5-HT2a antagonism, a mechanism distinct from FGAs.
- This study investigates the differential impact of SGAs and FGAs on brain structure, specifically cortical gray matter volumes.
Purpose of the Study:
- To compare the effects of SGAs (risperidone, ziprasidone) and an FGA (haloperidol) on cerebral cortical gray matter volumes in patients with schizophrenia.
- To determine if observed changes in gray matter correlate with the known neurocognitive benefits of SGAs.
Main Methods:
- Volumetric analysis of cerebral cortical gray matter was performed on 19 schizophrenia patients.
- Patients were treated for 28 days with either SGAs (risperidone/ziprasidone, n=13) or an FGA (haloperidol, n=6).
- A control group (n=7) was assessed over a similar interval without antipsychotic treatment.
Main Results:
- Treatment with SGAs (risperidone, ziprasidone) resulted in a significant expansion of cerebral cortical gray matter (20.6 ± 11.4 cc, p < .0005).
- Patients treated with the FGA (haloperidol) showed no significant change in cortical gray volumes (p = .983).
- Control subjects also exhibited no change in cortical gray volumes (p = .932).
Conclusions:
- Early treatment with SGAs (ziprasidone, risperidone) is associated with an increase in cerebral cortical gray matter volume.
- This volumetric expansion was not observed with FGA (haloperidol) treatment.
- The observed cortical gray matter increase may underlie the enhanced neurocognitive functioning and improved quality of life associated with SGA therapy.