title: Impact of antipsychotic treatment on attention and motor learning systems in first-episode schizophrenia.
abstract: BACKGROUND
  Antipsychotic medications have established clinical benefit, but there are few neuroimaging studies before and after initiating antipsychotic medication to assess drug influence on brain circuitry. Attention and motor learning tasks are promising approaches for examining treatment-related changes in frontostriatal systems.
  
  
  METHODS
  Twenty-one unmedicated first-episode schizophrenia patients (14 antipsychotic-naïve) participated in functional imaging studies while performing visual attention (prosaccades) and motor learning tasks (predictive saccades). Posttreatment testing was completed in 14 patients after 4-6 weeks of antipsychotic treatment. Matched healthy controls were studied in parallel.
  
  
  RESULTS
  Pretreatment, patients had reduced activation in the dorsal neocortical visual attention network. Activation deficits were significantly reduced posttreatment. Higher medication dose was associated with greater caudate activation at follow-up. For the motor learning task, patients' dorsolateral prefrontal cortex (DLPFC) was unimpaired prior to treatment but showed significantly reduced activation after treatment.
  
  
  CONCLUSIONS
  Impairments in dorsal cortical attention networks are present in untreated first-episode schizophrenia patients. These impairments are reduced after antipsychotic treatment, suggesting a beneficial effect on neural systems for attention. Treatment-emergent decreases in DLPFC activation observed for the motor learning task are consistent with other clinical and preclinical evidence suggesting that antipsychotics can have adverse effects on prefrontal function.
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL; skeedy@uchicago.edu.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Keedy
authors.affiliation: Department of Psychiatry, Northwestern University, Chicago, IL;
authors.forename: James L
authors.initials: JL
authors.lastname: Reilly
authors.affiliation: Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL;
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Bishop
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, Chicago, IL;
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Weiden
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: John A
authors.initials: JA
authors.lastname: Sweeney
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000494:pharmacology*; D001288:Attention / Q000187:drug effects* / Q000502:physiology; D002421:Caudate Nucleus / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007858:Learning / Q000187:drug effects* / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity / Q000187:drug effects* / Q000502:physiology; D017397:Prefrontal Cortex / Q000187:drug effects* / Q000503:physiopathology; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D014796:Visual Perception / Q000187:drug effects / Q000502:physiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: caudate; cognition; dorsolateral prefrontal cortex; fMRI; risperidone; saccades