Progressive brain changes in schizophrenia related to antipsychotic treatment? A meta-analysis of longitudinal MRI studies
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CONTEXT: Antipsychotic treatment is the first-line treatment option for schizophrenia. Individual studies suggested they can significantly affect brain structure and account for progressive brain changes observed during the illness. OBJECTIVES: To quantitatively examine the effect of antipsychotics as compared to illness related factors on progressive brain changes in schizophrenia. DATA SOURCES: Electronic databases were searched until April 2012. All magnetic resonance imaging studies reporting progressive brain changes in schizophrenia subjects and antipsychotic exposure were retrieved. STUDY SELECTION: 30 longitudinal MRI studies with antipsychotic administration in schizophrenia patients met the inclusion criteria. DATA EXTRACTION: Brain volumes before and after antipsychotic exposure, duration of illness, severity of psychotic symptoms as well as demographic, clinical, and methodological variables were extracted from each publication, or obtained directly from its authors. DATA SYNTHESIS: The overall sample was of 1046 schizophrenia patients and 780 controls for a median duration of follow-up of 72.4 weeks. At baseline, patients showed significant whole brain volume reductions and enlarged lateral ventricle (LV) volumes compared to controls. No baseline volumetric abnormalities were detected in the gray matter volumes (GMV), white matter volumes, cerebrospinal fluid and caudate nucleus. Longitudinally, there were progressive GMV decreases and LV enlargements in patients but not in controls. The GMV decreases were inversely correlated with cumulative exposure to antipsychotic treatments, while no effects were observed for duration of illness or illness severity. CONCLUSIONS: Schizophrenia is characterized by progressive gray matter volume decreases and lateral ventricular volume increases. Some of these neuroanatomical alterations may be associated with antipsychotic treatment.
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Small anatomical differences have been found in the medial temporal and frontal lobes of individuals prior to psychosis.
“Similarly, small anatomical differences have been found in the medial temporal and frontal lobes of individuals prior to psychosis 53 ,”
From Developmental timing and critical windows for the treatment of psychiatric disorders (2016) · cites this paper as [53]
Progressive brain tissue loss in schizophrenia has been associated with genetic factors, disease-related factors, and antipsychotic medication intake.
“The (progressive) brain tissue loss has been associated with genetic factors and with disease-related factors 11,12 as well as effects of antipsychotic medication intake. 13”
From Physical exercise keeps the brain connected: biking increases white matter integrity in patients with schizophrenia and healthy controls. (2015) · cites this paper as [13]
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- Authors
- Fusar-Poli, P., Smieskova, R., Kempton, M. J., Ho, B. C., Andreasen, N. C., & Borgwardt, S.
- Affiliations
- University of Basel (CH)
- King's College London (GB)
- University of Iowa (US)
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 37
- Issue
- 8
- Pages
- 1680-1691
- ISSN
- 0149-7634 (ISSN-L)
- PMC
- PMC3964856
- OpenAlex
- W1970520385
- Cited by
- 512
- References
- 11
- Citations by year
- 2026: 26 · 2025: 25 · 2024: 25 · 2023: 27 · 2022: 34 · 2021: 44 · 2020: 45 · 2019: 40 · 2018: 49 · 2017: 51 · 2016: 59 · 2015: 49 · 2014: 33 · 2013: 5
- FWCI
- 6.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (acceptedVersion, cc-by-nc)
- PubMed Central (acceptedVersion, cc-by-nc)
- Funders
- Medical Research Council (MR/J008915/1)
- National Institute of Mental Health (R01MH031593, R01MH040856)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- schizophrenia, antipsychotic drugs, gray matter volume, lateral ventricle enlargement, brain atrophy, longitudinal MRI, disease duration, psychotic symptom severity, neuroanatomical changes
- MeSH terms
- Brain, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Schizophrenia, Antipsychotic Agents
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