Antipsychotikaeffekt auf MR-Morphometrie und MR-Spektroskopie bei Schizophrenien

Zusammenfassung

Bildgebungsmethoden wie die MR-Morphometrie und die MR-Spektroskopie (MRS) werden seit längerem zur Untersuchung regionaler Hirnvolumen- bzw. -metabolismusveränderungen in der Schizophrenieforschung eingesetzt. Ein möglicher differenzieller Effekt von traditionellen Neuroleptika im Vergleich zu den atypischen Antipsychotika blieb dabei lange unberücksichtigt. In Übereinstimmung mit funktionellen Bildgebungsdaten zeigen nun neuere Daten, dass die so genannten atypischen Antipsychotika, verglichen mit traditionellen Neuroleptika, einen geringeren Einfluss auf die Basalganglienstruktur sowie einen eher günstigen Effekt auf die mit MRS gemessene neuronale Integrität zu haben scheinen. Das gilt ebenso für die Volumenveränderungen in fronto-temporalen Arealen sowie im anterioren Zingulum, welche mit kognitiven Funktionen korrelieren. Diese Befunde bedürfen jedoch vorsichtiger Interpretation, da die verbesserten Bildgebungsmöglichkeiten auch an zusätzliche methodologische Überlegungen geknüpft sind wie das Kontrollieren von Stör- und Moderatorvariablen, die exakte Designspezifikation, Strategien des Post-Processings, physiologische Variation des lebenden Gehirns, messbare Perfusionseffekte und Limitierungen durch die Hardware.

Summary

Recently there has been growing interest to employ neuroimaging tools such as MR morphometry and MR spectroscopy (MRS) to investigate regional brain volume change and metabolism associated with schizophrenia. The effect of different antipsychotic treatment on brain morphology and metabolism remains mostly unconsidered. More recently, in agreement with functional imaging data it could be shown that, compared to traditional neuroleptics, atypical drugs are less influencing basal ganglia structure and have a more favorable effect on neuronal viability in MRS and volume decrease fronto-temporal as well as in the anterior cingulated gyrus, correlating with cognitive function. These differential effects of antipsychotics need cautious interpretation since the improved imaging tools also give rise to additional methodological considerations such as control issues, specifications in experimental design, postprocessing strategies, physiological variation of the living brain, perfusion effects and hardware limitations.

Schlüsselwörter

MR-Morphometrie - MR-Spektroskopie - Schizophrenie - Antipsychotika

Keywords

MR morphometry - MR spectroscopy - schizophrenia - antipsychotics

• Literatur

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