An MRI study of basal ganglia volumes in first-episode schizophrenia patients treated with risperidone.
OBJECTIVE
The basal ganglia may contribute to extrapyramidal movement disorders, affective disturbances, and cognitive deficits in schizophrenia. Basal ganglia volumes are putatively affected by antipsychotic medications. The purpose of this study was to determine the long-term effects of risperidone treatment in a cohort of first-episode patients with schizophrenia.


METHODS
The subjects were 30 patients with first-episode schizophrenia, 12 patients chronically treated with typical antipsychotics, and 23 healthy comparison subjects. They were scanned by magnetic resonance imaging at baseline. The first-episode patients received 1 year of continuous risperidone treatment, after which they and the comparison subjects were rescanned. Caudate, putamen, and globus pallidus volumes were determined from coronal images.


RESULTS
The baseline caudate, putamen, and globus pallidus volumes were significantly larger in the chronically treated patients than in the untreated first-episode subjects and comparison subjects. These volumes did not differ between the first-episode patients and healthy comparison subjects. Basal ganglia volumes were unchanged after 1 year of exposure to risperidone in the first-episode subjects. Extrapyramidal movement disorders were present in the majority of chronically treated patients and more than one-third of the never-medicated first-episode patients at baseline.


CONCLUSIONS
This group of first-episode patients did not exhibit abnormalities of basal ganglia volumes, nor were basal ganglia volumes affected by exposure to risperidone. Movement disorders were observed in both first-episode and chronically treated patients, suggesting effects of both illness and medications.
Molecular Psychiatry and Therapeutics Laboratory, Department of Psychiatry, Dalhousie University, Queen Elizabeth-II Health Sciences Centre, Halifax, Nova Scotia, Canada.
D J
DJ
Lang
L C
LC
Kopala
R A
RA
Vandorpe
Q
Q
Rui
G N
GN
Smith
V M
VM
Goghari
W G
WG
Honer
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001479:Basal Ganglia / Q000033:anatomy & histology* / Q000187:drug effects; D001480:Basal Ganglia Diseases / Q000139:chemically induced; D002421:Caudate Nucleus / Q000033:anatomy & histology / Q000187:drug effects; D005260:Female; D005917:Globus Pallidus / Q000033:anatomy & histology / Q000187:drug effects; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D011699:Putamen / Q000033:anatomy & histology / Q000187:drug effects; D018967:Risperidone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy*
D014150:Antipsychotic Agents; D018967:Risperidone