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Does antipsychotic medication affect white matter in schizophrenia and bipolar disorder? a review of diffusion tensor imaging literature

Published online by Cambridge University Press:  16 April 2020

M. Kyriakopoulos ,
L. Samartzis ,
D. Dima ,
D. Hayes ,
R. Corrigall ,
G. Barker ,
C.U. Correll  and
S. Frangou
M. Kyriakopoulos
Affiliation:
Section of Neurobiology of Psychosis, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
L. Samartzis
Affiliation:
Section of Neurobiology of Psychosis, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK Department of Psychiatry, Nicosia Mental Health Services, Nicosia, Cyprus, UK
D. Dima
Affiliation:
Section of Neurobiology of Psychosis, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
D. Hayes
Affiliation:
Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
R. Corrigall
Affiliation:
Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
G. Barker
Affiliation:
Centre of Neuroimaging Sciences, Institute of Psychiatry, King's College London, London, UK
C.U. Correll
Affiliation:
Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, New York, NY, USA
S. Frangou
Affiliation:
Section of Neurobiology of Psychosis, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK

Abstract

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Introduction

White matter (WM) abnormalities are considered integral to the pathophysiology of Schizophrenia (SZ) and Bipolar Disorder (BD), but there is ongoing uncertainty about the contribution of medication to these findings.

Objectives

Diffusion Tensor Imaging (DTI) is a neuroimaging technique that provides quantitative indices of the structural and orientational characteristics of WM. These indices include mean diffusivity (MD), which is a directionally averaged measure of the apparent diffusion coefficient, and fractional anisotropy (FA), which summarizes the orientational dependence of diffusivity. We wanted to determine if these indices are affected by antipsychotic medication.

Aims

Our aim was to examine the available literature in order to differentiate antipsychotic effects from disorder-specific WM abnormalities on DTI measures.

Methods

We conducted a systematic qualitative review of the DTI literature in Bipolar Disorder (BD) and Schizophrenia (SZ), between 1998 and 2010 and included only studies where the relationship between DTI measures and antipsychotic medication was explicitly examined and reported.

Results

We identified 40 studies in SZ and 8 in BD. All studies were cross-sectional and involved relatively small patient samples. 32 studies (80%) did not find any relationship between antipsychotic medication (dose, cumulative exposure) and FA or MD.

Conclusions

Current evidence does not indicate a major impact of antipsychotic treatment on DTI indices of WM integrity. However, the lack of longitudinal, within-subject designs is a major gap in the current literature.

Type
P03-111
Information
European Psychiatry , Volume 26 , Issue S2: Abstracts of the 19th European Congress of Psychiatry , March 2011 , pp. 1280
Copyright
Copyright © European Psychiatric Association 2011
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