title: Subcortical modulation of attentional control by second-generation antipsychotics in first-episode psychosis.
abstract: Psychotic disorders are characterized by significant deficits in attentional control, but the neurobiological mechanisms underlying these deficits early in the course of illness prior to extensive pharmacotherapy are not well understood. Moreover, little is known regarding the symptom and brain changes associated with amelioration of attentional impairments through antipsychotic pharmacotherapy. In this study 14 male patients experiencing a first-episode of psychosis with minimal prior antipsychotic treatment completed an attentional control task while undergoing functional magnetic resonance imaging at the onset of treatment with a second generation antipsychotic (risperidone or aripiprazole) in a double blind randomized clinical trial and then again following approximately 12 weeks of treatment. In addition, 14 age-, and performance-matched healthy male volunteers who were not treated completed the same task at a baseline timepoint and then again following 12 weeks. Patients showed significantly greater activation than healthy volunteers in the right globus pallidus, left thalamus, and right thalamus at the time of the baseline scan. Among patients there was a significant reduction in right globus pallidus blood-oxygen level dependent (BOLD) response following antipsychotic treatment that correlated significantly with improvement in response accuracy and reductions in thought disturbance. No changes in globus pallidus activation were observed in healthy volunteers over this time period. These preliminary findings suggest that improvement in attentional control and concomitant reductions in thought disturbance in first-episode psychosis may be associated with reductions in subcortical activity following administration of second-generation antipsychotics early in the course of illness. These findings have implications for understanding how changes in basal ganglia activity may be linked to improvements in attentional control through antipsychotics.
authors.affiliation: Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, 352 Rebel Drive, University, MS 38766, USA. Electronic address: tikuta@olemiss.edu.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Ikuta
authors.affiliation: Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA; Hofstra North Shore - LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA.
authors.forename: Delbert G
authors.initials: DG
authors.lastname: Robinson
authors.affiliation: Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA; Hofstra North Shore - LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Gallego
authors.affiliation: Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA.
authors.forename: Bart D
authors.initials: BD
authors.lastname: Peters
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Gruner
authors.affiliation: Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA; Hofstra North Shore - LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Kane
authors.affiliation: Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA; Hofstra North Shore - LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA.
authors.forename: Majnu
authors.initials: M
authors.lastname: John
authors.affiliation: New York College of Osteopathic Medicine of the New York Institute of Technology, Old Westbury, NY, USA.
authors.forename: Serge
authors.initials: S
authors.lastname: Sevy
authors.affiliation: Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA; Hofstra North Shore - LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Malhotra
authors.affiliation: Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY, USA; Hofstra North Shore - LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Szeszko
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects*; D001479:Basal Ganglia / Q000187:drug effects; D001921:Brain / Q000033:anatomy & histology / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D005917:Globus Pallidus / Q000033:anatomy & histology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced / Q000188:drug therapy; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy*; D018967:Risperidone / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D018967:Risperidone
keywords: Attentional control; Basal ganglia; First episode psychosis; Functional magnetic resonance imaging; Schizophrenia; Second generation antipsychotics