Long‐term antipsychotic use and brain changes in schizophrenia – a systematic review and meta‐analysis

Objective The association between long‐term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta‐analysis on long‐term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 y...

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Published in	Human psychopharmacology Vol. 32; no. 2; pp. e2574 - n/a
Main Authors	Huhtaniska, Sanna, Jääskeläinen, Erika, Hirvonen, Noora, Remes, Jukka, Murray, Graham K., Veijola, Juha, Isohanni, Matti, Miettunen, Jouko
Format	Journal Article
Language	English
Published	England Wiley Subscription Services, Inc 01.03.2017
Subjects	adverse effect aetiology Antipsychotic Agents - adverse effects Antipsychotic Agents - therapeutic use Antipsychotics Basal ganglia brain Brain - drug effects Brain - pathology Dose-Response Relationship, Drug follow‐up Humans Magnetic Resonance Imaging Mental disorders Meta-analysis MRI Parietal lobe psychotic disorders Psychotropic drugs Schizophrenia Schizophrenia - drug therapy Schizophrenia - pathology Studies Systematic review aetiology follow-up adverse effect brain psychotic disorders MRI
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ISSN	0885-6222 1099-1077 1099-1077
DOI	10.1002/hup.2574

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Abstract	Objective The association between long‐term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta‐analysis on long‐term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 years of follow‐up between MRI scans. Design Studies were systematically collected using 4 databases, and we also contacted authors for unpublished data. We calculated correlations between antipsychotic dose and/or type and brain volumetric changes and used random effect meta‐analysis to study correlations by brain area. Results Thirty‐one publications from 16 samples fulfilled our inclusion criteria. In meta‐analysis, higher antipsychotic exposure associated statistically significantly with parietal lobe decrease (studies, n = 4; r = −.14, p = .013) and with basal ganglia increase (n = 4; r = .10, p = .044). Most of the reported correlations in the original studies were statistically nonsignificant. There were no clear differences between typical and atypical exposure and brain volume change. The studies were often small and highly heterogeneous in their methods and seldom focused on antipsychotic medication and brain changes as the main subject. Conclusions Antipsychotic medication may associate with brain structure changes. More long‐term follow‐up studies taking into account illness severity measures are needed to make definitive conclusions.
AbstractList	The association between long-term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta-analysis on long-term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 years of follow-up between MRI scans. Studies were systematically collected using 4 databases, and we also contacted authors for unpublished data. We calculated correlations between antipsychotic dose and/or type and brain volumetric changes and used random effect meta-analysis to study correlations by brain area. Thirty-one publications from 16 samples fulfilled our inclusion criteria. In meta-analysis, higher antipsychotic exposure associated statistically significantly with parietal lobe decrease (studies, n = 4; r = -.14, p = .013) and with basal ganglia increase (n = 4; r = .10, p = .044). Most of the reported correlations in the original studies were statistically nonsignificant. There were no clear differences between typical and atypical exposure and brain volume change. The studies were often small and highly heterogeneous in their methods and seldom focused on antipsychotic medication and brain changes as the main subject. Antipsychotic medication may associate with brain structure changes. More long-term follow-up studies taking into account illness severity measures are needed to make definitive conclusions. Objective The association between long-term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta-analysis on long-term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 years of follow-up between MRI scans. Design Studies were systematically collected using 4 databases, and we also contacted authors for unpublished data. We calculated correlations between antipsychotic dose and/or type and brain volumetric changes and used random effect meta-analysis to study correlations by brain area. Results Thirty-one publications from 16 samples fulfilled our inclusion criteria. In meta-analysis, higher antipsychotic exposure associated statistically significantly with parietal lobe decrease (studies, n = 4; r = -.14, p = .013) and with basal ganglia increase (n = 4; r = .10, p = .044). Most of the reported correlations in the original studies were statistically nonsignificant. There were no clear differences between typical and atypical exposure and brain volume change. The studies were often small and highly heterogeneous in their methods and seldom focused on antipsychotic medication and brain changes as the main subject. Conclusions Antipsychotic medication may associate with brain structure changes. More long-term follow-up studies taking into account illness severity measures are needed to make definitive conclusions. Objective The association between long‐term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta‐analysis on long‐term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 years of follow‐up between MRI scans. Design Studies were systematically collected using 4 databases, and we also contacted authors for unpublished data. We calculated correlations between antipsychotic dose and/or type and brain volumetric changes and used random effect meta‐analysis to study correlations by brain area. Results Thirty‐one publications from 16 samples fulfilled our inclusion criteria. In meta‐analysis, higher antipsychotic exposure associated statistically significantly with parietal lobe decrease (studies, n = 4; r = −.14, p = .013) and with basal ganglia increase (n = 4; r = .10, p = .044). Most of the reported correlations in the original studies were statistically nonsignificant. There were no clear differences between typical and atypical exposure and brain volume change. The studies were often small and highly heterogeneous in their methods and seldom focused on antipsychotic medication and brain changes as the main subject. Conclusions Antipsychotic medication may associate with brain structure changes. More long‐term follow‐up studies taking into account illness severity measures are needed to make definitive conclusions. The association between long-term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta-analysis on long-term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 years of follow-up between MRI scans.OBJECTIVEThe association between long-term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta-analysis on long-term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 years of follow-up between MRI scans.Studies were systematically collected using 4 databases, and we also contacted authors for unpublished data. We calculated correlations between antipsychotic dose and/or type and brain volumetric changes and used random effect meta-analysis to study correlations by brain area.DESIGNStudies were systematically collected using 4 databases, and we also contacted authors for unpublished data. We calculated correlations between antipsychotic dose and/or type and brain volumetric changes and used random effect meta-analysis to study correlations by brain area.Thirty-one publications from 16 samples fulfilled our inclusion criteria. In meta-analysis, higher antipsychotic exposure associated statistically significantly with parietal lobe decrease (studies, n = 4; r = -.14, p = .013) and with basal ganglia increase (n = 4; r = .10, p = .044). Most of the reported correlations in the original studies were statistically nonsignificant. There were no clear differences between typical and atypical exposure and brain volume change. The studies were often small and highly heterogeneous in their methods and seldom focused on antipsychotic medication and brain changes as the main subject.RESULTSThirty-one publications from 16 samples fulfilled our inclusion criteria. In meta-analysis, higher antipsychotic exposure associated statistically significantly with parietal lobe decrease (studies, n = 4; r = -.14, p = .013) and with basal ganglia increase (n = 4; r = .10, p = .044). Most of the reported correlations in the original studies were statistically nonsignificant. There were no clear differences between typical and atypical exposure and brain volume change. The studies were often small and highly heterogeneous in their methods and seldom focused on antipsychotic medication and brain changes as the main subject.Antipsychotic medication may associate with brain structure changes. More long-term follow-up studies taking into account illness severity measures are needed to make definitive conclusions.CONCLUSIONSAntipsychotic medication may associate with brain structure changes. More long-term follow-up studies taking into account illness severity measures are needed to make definitive conclusions.
Author	Hirvonen, Noora Murray, Graham K. Miettunen, Jouko Isohanni, Matti Huhtaniska, Sanna Jääskeläinen, Erika Remes, Jukka Veijola, Juha
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BackLink	https://www.ncbi.nlm.nih.gov/pubmed/28370309$$D View this record in MEDLINE/PubMed
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Snippet	Objective The association between long‐term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a... The association between long-term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic... Objective The association between long-term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a...
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SubjectTerms	adverse effect aetiology Antipsychotic Agents - adverse effects Antipsychotic Agents - therapeutic use Antipsychotics Basal ganglia brain Brain - drug effects Brain - pathology Dose-Response Relationship, Drug follow‐up Humans Magnetic Resonance Imaging Mental disorders Meta-analysis MRI Parietal lobe psychotic disorders Psychotropic drugs Schizophrenia Schizophrenia - drug therapy Schizophrenia - pathology Studies Systematic review
Title	Long‐term antipsychotic use and brain changes in schizophrenia – a systematic review and meta‐analysis
URI	https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fhup.2574 https://www.ncbi.nlm.nih.gov/pubmed/28370309 https://www.proquest.com/docview/1881875328 https://www.proquest.com/docview/1925333374 https://www.proquest.com/docview/1884170260 https://www.proquest.com/docview/1888969896
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