Stability of emotional dysfunctions? A long-term fMRI study in first-episode schizophrenia.
OBJECTIVE
Patients with schizophrenia are characterized by emotional symptoms such as flattened affect which are accompanied by cerebral dysfunctions. This study aimed at determining changes of mood-related neural correlates under standardized pharmacological therapy in first-episode schizophrenia.


METHODS
Using fMRI in a longitudinal approach, 10 first-episode schizophrenia patients (6 males) and 10 healthy subjects (same education, gender and age) were investigated during sad and happy mood induction using facial expressions. Reassessments were carried out following 6 months of standardized antipsychotic treatment. Data analysis focussed on therapy-related changes in cerebral activation and on stable, therapy-independent group differences.


RESULTS
According to self ratings, mood induction was successful in both groups and did not reveal time-dependent changes. Patients revealed stable hypoactivations in core brain regions of emotional processing like the anterior cingulate cortex, orbitofrontal and temporal areas as well as the hippocampus. Therapy-related signal increases in pre- and postcentral, inferior temporal and frontal areas were restricted to sadness.


CONCLUSIONS
Stable dysfunctions which are unaffected by therapy and symptom improvement were found in cortico-limbic regions crucially involved in emotion processing. They presumably reflect patients' difficulties in emotion regulation and emotional memory processes. However, therapy-related activation changes were also observed and demonstrate efficacy of antipsychotic therapy on improving emotion functionality. They may represent an increased usage of autobiographic emotional memories and an improved strategy to experience an emotion by mirroring someone else's emotions.
Reske
Martina
M
Department of Psychiatry and Psychotherapy, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany. mreske@ukaachen.de
Kellermann
Thilo
T
Habel
Ute
U
Jon Shah
N
N
Backes
Volker
V
von Wilmsdorff
Martina
M
Stöcker
Tony
T
Gaebel
Wolfgang
W
Schneider
Frank
F
D000328:Adult; D000339:Affect / Q000187:drug effects / Q000502:physiology*; D000342:Affective Symptoms / Q000188:drug therapy / Q000503:physiopathology*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000187:drug effects / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000187:drug effects / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000187:drug effects / Q000503:physiopathology; D006220:Haloperidol / Q000627:therapeutic use*; D006624:Hippocampus / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008032:Limbic System / Q000187:drug effects / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology*; D013702:Temporal Lobe / Q000187:drug effects / Q000503:physiopathology
D014150:Antipsychotic Agents; D006220:Haloperidol; D018967:Risperidone