title: Disease and drug effects on internally-generated and externally-elicited responses in first episode schizophrenia and psychotic bipolar disorder.
abstract: Neurocognitive deficits are associated with most psychotic disorders, but may differ across diagnosis and by treatment status. This ambiguity is partly addressed in longitudinal pre/post treatment studies with first episode patients. Antipsychotic-naïve first-episode schizophrenia patients have shown intact performance on a predictive saccade task that assesses simple motor learning, spatial abilities, and response planning. After antipsychotic treatment, however, schizophrenia patients performing this task show a selective impairment in the accuracy of anticipatory responses, generated from learned internal representations of the task stimulus. This finding is in line with other observations of antipsychotic medication effects on frontostriatal systems, particularly dorsolateral prefrontal cortex. We sought to replicate this provocative finding with an independent sample of antipsychotic-naïve first-episode schizophrenia patients and extend it by including a group of patients with first episode bipolar disorder with psychosis (BDP). Matched healthy controls were also studied in parallel. Schizophrenia patients demonstrated intact performance pretreatment followed by impairment post-treatment for accuracy of anticipatory responses, and worse accuracy was associated with higher antipsychotic dose. BDP patients displayed saccade accuracy deficits before and after treatment and had no correlation of performance and antipsychotic dose. The findings suggest different neural alterations early in the course of each psychotic disorder, and different vulnerabilities to antipsychotic treatment effects between schizophrenia and BDP.
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, 5841 S. Maryland Ave., MC3077, University of Chicago, IL 60637, United States. Electronic address: skeedy@uchicago.edu.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Keedy
authors.affiliation: Department of Pharmacy Practice, University of Illinois at Chicago, IL, United States. Electronic address: jbishop@uic.edu.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Bishop
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, IL, United States. Electronic address: pweiden@psych.uic.edu.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Weiden
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States. Electronic address: John.Sweeney@utsouthwestern.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Sweeney
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, IL, United States. Electronic address: crosen@psych.uic.edu.
authors.forename: Cherise
authors.initials: C
authors.lastname: Rosen
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, IL, United States. Electronic address: rmarvin@psych.uic.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Marvin
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States. Electronic address: james.reilly@northwestern.edu.
authors.forename: James L
authors.initials: JL
authors.lastname: Reilly
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D007858:Learning / Q000187:drug effects; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000187:drug effects*; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D012438:Saccades / Q000187:drug effects; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D013028:Space Perception / Q000187:drug effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Dorsolateral prefrontal cortex; Psychosis; Risperidone; Saccades; Striatum
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