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Funktionelle Magnetresonanztomographie und Antipsychotika

Überblick und eigene Daten

Functional magnetic resonance imaging and antipsychotics

Overview and own data

  • Funktionelle Bildgebung in der Psychiatrie
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Zusammenfassung

Zunehmend wird die funktionelle Magnetresonanztomographie (fMRT) auch in der Evaluation psychopharmakologischer Substanzen eingesetzt. fMRT-Studien bei Gesunden und psychiatrischen Patienten konzentrierten sich auf die veränderte zerebrale Aktivität bei akuter Substanzapplikation und adaptive Effekte der Langzeitmedikation auf neuronale Netzwerke. In eigenen fMRT-Studien wurde longitudinal der Effekt von Olanzapin bzw. Amisulprid in neuroleptikanaiven und medikamentenfreien schizophrenen Patienten mit motorischen und visuo-akustischen Aufgaben untersucht. Dabei zeigte sich in Übereinstimmung mit Literaturbefunden, dass es im Gegensatz zu traditionellen Neuroleptika unter atypischen Antipsychotika nicht zu einer Aktivitätsabnahme im sensomotorischen Kortex kommt bzw. sich eine vorab vorliegende frontoparietale Aktivitätsminderung sowie neuropsychologische Testbefunde normalisieren. Dies stützt die Annahme, wonach atypische Antipsychotika zur Normalisierung frontoparietaler Dysfunktion bei Schizophrenie beitragen können. Eine große Zahl methodologischer Einschränkungen gilt es jedoch bei der Bewertung der bildgebenden Befunde zu beachten.

Abstract

Recently, there has been growing interest in using functional magnetic resonance imaging (fMRI) for the evaluation of psychopharmacological drugs. fMRI studies in healthy human volunteers and psychiatric patients focus on cerebral activity following acute drug administration (single challenge) and on adaptive effects on neural networks due to long-term medication. In our own fMRI studies, the effects of olanzapine or amisulpride in never treated or medication-free schizophrenic patients using robust motor, visual, and acoustic tasks was longitudinally examined. In agreement with previous reports in the literature it could be shown that, in contrast to traditional neuroleptics, atypical drugs do not decrease the activation of the sensorimotor cortex but rather normalize the reduced frontoparietal activation as well as the neuropsychological test results. This encourages the assumption that atypical antipsychotics seem to support the recovery or normalization of frontoparietal brain dysfunction in schizophrenia. However, with these new opportunities additional methodological considerations and limitations emerge.

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Danksagung

Dank gilt den Mitarbeiter(inne)n der Arbeitsgruppe NMR-Forschung in der Psychiatrie am Zentralinstitut für Seelische Gesundheit in Mannheim für ihre Mitarbeiten an der Datenakquisition und Auswertung eines Teils der hier vorgestellten Befunde.

Interessenkonflikt:

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: „Unrestricted research grants“ der Firmen Lilly Deutschland, Sanofi-Aventis Berlin, AstraZeneca Wedel und Pfizer, Karlsruhe.

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  1. NeuroImage Nord, Psychiatrie sowie Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf

    D. F. Braus & S. Brassen

  2. NeuroImage Nord, Psychiatrie sowie Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 , Hamburg

    D. F. Braus

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  1. D. F. Braus
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  2. S. Brassen
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Correspondence to D. F. Braus.

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Braus, D.F., Brassen, S. Funktionelle Magnetresonanztomographie und Antipsychotika. Radiologe 45, 178–185 (2005). https://doi.org/10.1007/s00117-004-1156-z

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  • DOI: https://doi.org/10.1007/s00117-004-1156-z

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