The microvascular alterations in frontal cortex during treatment with antipsychotics: a post-mortem study

Area of Science:

• Neuroscience
• Psychiatry
• Vascular Biology

Background:

• Schizophrenia is a severe psychiatric disorder with biological underpinnings in the brain.
• Dopamine balance in the frontal cortex is crucial for schizophrenia outcomes.
• Alterations in frontal cortex dopamine mechanisms can impact the vascular system and cause secondary neuronal damage.

Purpose of the Study:

• To investigate alterations in neuronal architecture and microvascular integrity in the frontal cortex of schizophrenia patients treated with D2-blocking antipsychotics.

Main Methods:

• Post-mortem examination of frontal cortex sections from three schizophrenia patients treated with antipsychotics for at least 24 months.
• Classical histopathological protocols were employed for slide preparation.

Main Results:

• Significant neural loss was observed, stemming from severe microvessel damage.
• Microvascular alterations included diameter reduction, collagen and hyaline deposits, edema, pinocytosis, and vacuolization.

Conclusions:

• Potent D2-antagonist antipsychotics can compromise the neurovascular unit and small vessels in the frontal cortex.
• This compromise affects blood flow and metabolism, leading to structural microvascular changes and increased apoptosis.
• Vascular support is essential for the dopaminergic system's integrity in the frontal cortex; dysfunction exacerbates neuronal loss and clinical symptoms.