title: Changes in brain regions associated with food-intake regulation, body mass and metabolic profiles during acute antipsychotic treatment in first-episode schizophrenia.
abstract: We investigated whether morphological brain changes occurred in brain regions associated with body-weight homeostasis during acute antipsychotic treatment, and if so, whether they were related to changes in body mass and metabolic profile. Twenty-two antipsychotic-naive patients with first-episode schizophrenia received either risperidone long acting injection or flupenthixol decanoate over 13 weeks and were compared by structural MRI with 23 matched healthy volunteers at weeks 0, 4 and 13. Images were reconstructed using freesurfer fully-automated whole brain segmentation. The ventral diencephalon and prefrontal cortex were selected to represent the homeostatic and hedonic food intake regulatory systems respectively. Body mass was measured at weeks 0, 7 and 13 and fasting glucose and lipid profiles at weeks 0 and 13. Linear mixed effect models indicated significant group(⁎)time interactions for the ventral diencephalon volumes bilaterally. Ventral diencephalon volume reduction was strongly correlated bilaterally with body mass increase and HDL-cholesterol reductions, and unilaterally with blood glucose elevation. There were no significant changes in prefrontal cortical thickness. These findings implicate the ventral diencephalon, of which the hypothalamus is the main component, in the acute adipogenic and dyslipidaemic effects of antipsychotic medication.
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, Cape Town, South Africa.
authors.forename: Robin
authors.initials: R
authors.lastname: Emsley
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, Cape Town, South Africa.
authors.forename: Laila
authors.initials: L
authors.lastname: Asmal
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, Cape Town, South Africa.
authors.forename: Bonginkosi
authors.initials: B
authors.lastname: Chiliza
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, Cape Town, South Africa.
authors.forename: Stefan
authors.initials: S
authors.lastname: du Plessis
authors.affiliation: Division of Neurology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Carr
authors.affiliation: Centre for Statistical Consultation, Stellenbosch University, South Africa.
authors.forename: Martin
authors.initials: M
authors.lastname: Kidd
authors.affiliation: Division of Psychiatric Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Malhotra
authors.affiliation: Department of Psychiatry, University Medical Centre Utrecht, The Netherlands.
authors.forename: Matthijs
authors.initials: M
authors.lastname: Vink
authors.affiliation: Department of Psychiatry, University Medical Centre Utrecht, The Netherlands.
authors.forename: Rene S
authors.initials: RS
authors.lastname: Kahn
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015992:Body Mass Index; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology*; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D004435:Eating / Q000187:drug effects* / Q000502:physiology*; D005260:Female; D005475:Flupenthixol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007273:Injections, Intramuscular; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018967:Risperidone / Q000008:administration & dosage / Q000009:adverse effects*; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology*; D013019:South Africa; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; C007761:flupenthixol decanoate; D005475:Flupenthixol; D018967:Risperidone