Abstract
BackgroundThe corpus callosum (CC) deficits have been well documented in chronic schizophrenia. However, the long-term impacts of antipsychotic monotherapies on callosal anatomy remain unclear. This cross-sectional study sought to explore micro- and macro-structural characteristics of the CC in never-treated patients and those with long-term mono-antipsychotic treatment.MethodsThe study included 23 clozapine-treated schizophrenia patients (CT-SCZ), 19 risperidone-treated schizophrenia patients (RT-SCZ), 23 never-treated schizophrenia patients (NT-SCZ), and 35 healthy controls (HCs). High resolution structural images and diffusion tensor imaging (DTI) data for each participant were obtained via a 3.0 T MR scanner. FreeSurfer was used to examine the volumes and fractional anisotropy (FA) values of the CC for each participant.ResultsThere were significant deficits in the total and sub-regional CC volume and white matter integrity in NT-SCZ in comparison with healthy subjects. Compared with NT-SCZ, both CT-SCZ and RT-SCZ showed significantly increased FA values in the anterior CC region, while only RT-SCZ showed significantly increased volume in the mid-anterior CC region. Moreover, the volume of the mid-anterior CC region was significantly smaller in CT-SCZ compared to HCs. No correlations of clinical symptoms with callosal metrics were observed in schizophrenia patients.ConclusionsOur findings provide insight into micro- and macro-structural characteristics of the CC in chronic schizophrenia patients with or without antipsychotics. These results suggest that the pathology itself is responsible for cerebral abnormalities in schizophrenia and that chronic exposure to antipsychotics may have an impact on white matter structure of schizophrenia patients, especially in those with risperidone treatment.
Highlights
The corpus callosum (CC) deficits have been well documented in chronic schizophrenia
Positive and Negative Symptom Scale (PANSS) total and subscale scores in never-treated schizophrenia patients (NT-SCZ) were significantly higher than treated patients (P < 0.001) and there was no significant difference in PANSS scores between risperidone-treated schizophrenia patients (RT-SCZ) and clozapine-treated schizophrenia patients (CT-SCZ)
Pairwise comparison analyses revealed that NT-SCZ had significantly reduced CC volume compared to healthy controls (HCs) (P = 0.004, P < 0.05 corrected with false discovery rate (FDR)) (Table 2), while the other groups did not significantly differ from each other
Summary
The corpus callosum (CC) deficits have been well documented in chronic schizophrenia. Patients with poor outcome after treatment had more pronounced reduction in CC size compared to good-outcome patients and HCs [6] Neither of these studies included long-term drug-naive patients as a comparison group, complicating the interpretation of the findings as whether they reflect effects of neuropathology or medication remains unclear. Prior studies have demonstrated that the choice of antipsychotics may display different impacts on white matter structure in schizophrenia in terms of their different pharmacological mechanisms [7, 8] Clozapine and risperidone, both of which are atypical antipsychotic medications, have been widely prescribed in clinical practice, but their pharmacological mechanisms are not exactly the same. Few studies have explored the effects of long-term monotherapy with clozapine or risperidone on callosal structure in chronic schizophrenia
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