Different effects of typical and atypical antipsychotics on grey matter in first episode psychosis: the ÆSOP Study

Dazzan, P., Morgan, K.D., Orr, K.G., Hutchinson, G., Chitnis, X., Suckling, J., Fearon, P., McGuire, P.K., Mallett, R.M., Jones, P.B., Leff, J. and Murray, R.M. 2005. Different effects of typical and atypical antipsychotics on grey matter in first episode psychosis: the ÆSOP Study. Neuropsychopharmacology. 30 (4), pp. 765-774. https://doi.org/10.1038/sj.npp.1300603

TitleDifferent effects of typical and atypical antipsychotics on grey matter in first episode psychosis: the ÆSOP Study
AuthorsDazzan, P., Morgan, K.D., Orr, K.G., Hutchinson, G., Chitnis, X., Suckling, J., Fearon, P., McGuire, P.K., Mallett, R.M., Jones, P.B., Leff, J. and Murray, R.M.
Abstract

Typical antipsychotic drugs act on the dopaminergic system, blocking the dopamine type 2 (D2) receptors. Atypical antipsychotics have lower affinity and occupancy for the dopaminergic receptors, and a high degree of occupancy of the serotoninergic receptors 5-HT2A. Whether these different pharmacological actions produce different effects on brain structure remains unclear. We explored the effects of different types of antipsychotic treatment on brain structure in an epidemiologically based, nonrandomized sample of patients at the first psychotic episode. Subjects were recruited as part of a large epidemiological study (ÆSOP: aetiology and ethnicity in schizophrenia and other psychoses). We evaluated 22 drug-free patients, 32 on treatment with typical antipsychotics and 30 with atypical antipsychotics. We used high-resolution MRI and voxel-based methods of image analysis. The MRI analysis suggested that both typical and atypical antipsychotics are associated with brain changes. However, typicals seem to affect more extensively the basal ganglia (enlargement of the putamen) and cortical areas (reductions of lobulus paracentralis, anterior cingulate gyrus, superior and medial frontal gyri, superior and middle temporal gyri, insula, and precuneus), while atypical antipsychotics seem particularly associated with enlargement of the thalami. These changes are likely to reflect the effect of antipsychotics on the brain, as there were no differences in duration of illness, total symptoms scores, and length of treatment among the groups. In conclusion, we would like to suggest that even after short-term treatment, typical and atypical antipsychotics may affect brain structure differently.

KeywordsSchizophrenia, psychosis, antipsychotics, MRI, basal ganglia, frontal lobe
JournalNeuropsychopharmacology
Journal citation30 (4), pp. 765-774
ISSN0893-133X
YearApr 2005
Digital Object Identifier (DOI)https://doi.org/10.1038/sj.npp.1300603
Publication dates
PublishedApr 2005

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Dean, K., Fearon, P., Morgan, K.D., Hutchinson, G., Orr, K.G., Chitnis, X., Suckling, J., Mallett, R.M., Leff, J., Jones, P.B., Murray, R.M. and Dazzan, P. 2006. Grey matter correlates of minor physical anomalies in the AESOP first-episode psychosis study. British Journal of Psychiatry. 189 (3), pp. 221-228. https://doi.org/10.1192/bjp.bp.105.016337

Insight in psychosis and neuropsychological function: meta-analysis
Aleman, A., Agrawal, N., Morgan, K.D. and David, A.S. 2006. Insight in psychosis and neuropsychological function: meta-analysis. British Journal of Psychiatry. 189 (3), pp. 204-212. https://doi.org/10.1192/bjp.189.3.204

The structural brain correlates of neurological soft signs in healthy individuals
Dazzan, P., Morgan, K.D., Chitnis, X., Suckling, J., Morgan, C., Fearon, P., McGuire, P.K., Jones, P.B., Leff, J. and Murray, R.M. 2006. The structural brain correlates of neurological soft signs in healthy individuals. Cerebral Cortex. 16 (8), pp. 1225-1231. https://doi.org/10.1093/cercor/bhj063

Insight and cognition
Morgan, K.D. 2006. Insight and cognition. in: Morgan, K.D., David, A.S., Murray, R.M. and Eberhard, J. (ed.) Cognition and schizophrenia: improving real life function Cambridge, UK Cambridge Medical Communication. pp. 37-43

Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the sop first-onset psychosis study
Pariante, C.M., Dazzan, P., Danese, A., Morgan, K.D., Brudaglio, F., Morgan, C., Fearon, P., Orr, K.G., Hutchinson, G., Pantelis, C., Velakoulis, D., Jones, P.B., Leff, J. and Murray, R.M. 2005. Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the sop first-onset psychosis study. Neuropsychopharmacology. 30 (10), pp. 1923-1931. https://doi.org/10.1038/sj.npp.1300766

Pathways to care and ethnicity. 2: source of referral and help-seeking: report from the AESOP study
Morgan, C., Mallett, R.M., Hutchinson, G., Bagalkote, H., Morgan, K.D., Fearon, P., Dazzan, P., Boydell, J., McKenzie, K., Harrison, G., Murray, R.M., Jones, P.B., Craig, T.K.J. and Leff, J. 2005. Pathways to care and ethnicity. 2: source of referral and help-seeking: report from the AESOP study. British Journal of Psychiatry. 186 (4), pp. 290-296.

Pathways to care and ethnicity. 1: sample characteristics and compulsory admission: report from the ÆSOP Study
Morgan, C., Mallett, R.M., Hutchinson, G., Bagalkote, H., Morgan, K.D., Fearon, P., Dazzan, P., Boydell, J., McKenzie, K., Harrison, G., Murray, R.M., Jones, P.B., Craig, T.K.J. and Leff, J. 2005. Pathways to care and ethnicity. 1: sample characteristics and compulsory admission: report from the ÆSOP Study. British Journal of Psychiatry. 186 (4), pp. 281-289.

Incidence of bipolar affective disorder in three UK cities: results from the ÆSOP Study
Lloyd, T., Kennedy, N., Fearon, P., Kirkbride, J.B., Mallett, R.M., Leff, J., Holloway, J., Harrison, G., Dazzan, P., Morgan, K.D., Murray, R.M. and Jones, P.B. 2005. Incidence of bipolar affective disorder in three UK cities: results from the ÆSOP Study. British Journal of Psychiatry. 186 (2), pp. 126-131.

A study of hippocampal shape anomaly in schizophrenia and in families multiply affected by schizophrenia or bipolar disorder
Connor, S.E.J., Ng, V., McDonald, C., Schulze, K., Morgan, K.D., Dazzan, P. and Murray, R.M. 2004. A study of hippocampal shape anomaly in schizophrenia and in families multiply affected by schizophrenia or bipolar disorder. Neuroradiology. 46 (7), pp. 523-534. https://doi.org/10.1007/s00234-004-1224-0

Neuropsychological studies of insight in psychosis
Morgan, K.D. and David, A.S. 2004. Neuropsychological studies of insight in psychosis. in: Amador, X.S. and David, A.S. (ed.) Insight and psychosis: awareness of illness in schizophrenia and related disorders. 2nd edition Oxford, UK Oxford University Press.

Perception of psychosis in patients
Morgan, K.D. 2004. Perception of psychosis in patients. Epidemiologia e Psichiatria Sociale. 13 (4), pp. 222-226.

Normal cerebral asymmetry in familial and non-familial schizophrenic probands and their unaffected relatives
Chapple, B., Grech, A., Sham, P., Toulopoulou, T., Walshe, M., Schulze, K., Morgan, K.D., Murray, R.M. and McDonald, C. 2004. Normal cerebral asymmetry in familial and non-familial schizophrenic probands and their unaffected relatives. Schizophrenia Research. 67 (1), pp. 33-40. https://doi.org/10.1016/S0920-9964(03)00095-1

The structural brain correlates of neurological soft signs in ÆSOP first-episode psychoses study
Dazzan, P., Morgan, K.D., Orr, K.G., Hutchinson, G., Chitnis, X., Suckling, J., Fearon, P., Salvo, J., McGuire, P.K., Mallett, R.M., Jones, P.B., Leff, J. and Murray, R.M. 2003. The structural brain correlates of neurological soft signs in ÆSOP first-episode psychoses study. Brain. 127 (1), pp. 143-153. https://doi.org/10.1093/brain/awh015

A functional magnetic resonance imaging study of overt letter verbal fluency using a clustered acquisition sequence: greater anterior cingulate activation with increased task demand
Fu, C.H.Y., Morgan, K.D., Suckling, J., Williams, S.C.R., Andrew, C., Vythelingum, G.N. and McGuire, P.K. 2002. A functional magnetic resonance imaging study of overt letter verbal fluency using a clustered acquisition sequence: greater anterior cingulate activation with increased task demand. NeuroImage. 17 (2), pp. 871-879. https://doi.org/10.1016/S1053-8119(02)91189-4

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