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Beneficial effect of atypical antipsychotics on prefrontal brain function in acute psychotic disorders

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Abstract

Disturbance of prefrontal brain functions is assumed to be responsible for prominent psychopathological symptoms in psychotic disorders. Treatment with atypical, in contrast to typical antipsychotics is considered as a possible strategy for an improvement of prefrontal brain function. In the present study, response control as a specific prefrontal brain function was assessed by means of the Nogo–anteriorization (NGA) derived from the event–related potentials elicited during a Go–NoGo task in a consecutive sample of 39 patients suffering from acute psychotic disorders (brief psychotic disorders, 298.8, n = 34 and schizoaffective disorders, 295.70,n = 5; cycloid psychoses according to the Leonhard classification). A highly significant positive correlation between the amount of antipsychotic medication in terms of chlorpromazine equivalents per day and the NGA as a measure of prefrontal response control was only found in the subgroup of patients treated exclusively or predominantly with atypical antipsychotics but not for those treated with typical antipsychotics. These results are in line with the notion that atypical antipsychotics may exert a beneficial effect on prefrontal brain function.

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References

  1. Abbruzzese M, Ferri S, Scarone S (1997) The selective breakdown of frontal functions in patients with obsessive-compulsive disorder and in patients with schizophrenia: A double dissociation experimental finding. Neuropsychologia 35:907–912

    Article  PubMed  Google Scholar 

  2. Andreasen NC, Rezai K, Alliger R, Swayze VW 2nd, Flaum M, Kirchner P, Cohen G, O’Leary DS (1992) Hypofrontality in neuroleptic-naive patients and in patients with chronic schizophrenia. Assessment with xenon 133 single-photon emission computed tomography and the Tower of London. Arch Gen Psychiatry 49:943–958

    PubMed  Google Scholar 

  3. Bartlett EJ, Brodie JD, Simkowitz P, Dewey SL, Rusinek H,Wolf AP, Fowler JS, Volkow ND, Smith G, Wolkin A (1994) Effects of haloperidol challenge on regional cerebral glucose utilization in normal human subjects. Am J Psychiatry 151:681–686

    PubMed  Google Scholar 

  4. Berman I, Viegner B, Merson A, Allan E, Pappas D, Green AI (1997) Differential relationships between positive and negative symptoms and neuropsychological deficits in schizophrenia. Schizophr Res 25:1–10

    Article  PubMed  Google Scholar 

  5. Bilder RM, Goldman RS, Volavka J, Czobor P, Hoptman M, Sheitman B, Lindenmayer JP, Citrome L, McEvoy J, Kunz M, Chakos M, Cooper TB, Horowitz TL, Lieberman JA (2002) Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. Am J Psychiatry 159:1018–1028

    Article  PubMed  Google Scholar 

  6. Braus DF, Ende G, Weber-Fahr W, Demirakca T, Henn FA (2001) Favorable effect on neuronal viability in the anterior cingulate gyrus due to long-term treatment with atypical antipsychotics: an MRSI study. Pharmacopsychiatry 34:251–253

    PubMed  Google Scholar 

  7. Braus DF, Ende G, Weber-Fahr W, Demirakca T, Tost H, Henn FA (2002) Functioning and neuronal viability of the anterior cingulate neurons following antipsychotic treatment: MR-spectroscopic imaging in chronic schizophrenia. Eur Neuropsychopharmacol 12:145–152

    Article  PubMed  Google Scholar 

  8. Canadian Cognition and Outcome Study Group (1998) Neuropsychological changes in early phase schizophrenia over twelve months of treatment with olanzapine, risperidone, or haloperidol. Schizophr Res 29:152–153

    Google Scholar 

  9. Carter CS, Mintun M, Nichols T, Cohen JD (1997) Anterior cingulate gyrus dysfunction and selective attention deficits in schizophrenia: [15O]H2O PET study during single-trial Stroop task performance. Am J Psychiatry 154:1670–1675

    PubMed  Google Scholar 

  10. Cuesta MJ, Peralta V, Zarzuela A (2001) Effects of olanzapine and other antipsychotics on cognitive function in chronic schizophrenia: a longitudinal study. Schizophr Res 48:17–28

    Article  PubMed  Google Scholar 

  11. Desco M, Gispert JD, Reig S, Sanz J, Pascau J, Sarramea F, Benito C, Santos A, Palomo T, Molina V (2003) Cerebral metabolic patterns in chronic and recent-onset schizophrenia. Psychiatry Res 122:125–135

    PubMed  Google Scholar 

  12. Ehlis AC, Zielasek J, Herrmann MJ, Ringel T, Jacob C, Wagener A, Fallgatter AJ (2004) Evidence for unaltered brain electrical topography during prefrontal response control in cycloid psychoses. Int J Psychophysiol (in press)

  13. Ende G, Braus DF, Walter S, Weber-Fahr W, Soher B, Maudsley AA, Henn FA (2000) Effects of age, medication, and illness duration on the N-acetyl aspartate signal of the anterior cingulate region in schizophrenia. Schizophr Res 41:389–395

    Article  PubMed  Google Scholar 

  14. Fallgatter AJ, Bartsch AJ, Herrmann MJ (2002) Electrophysiological measurements of anterior cingulate function. J Neural Transm 109:977–988

    PubMed  Google Scholar 

  15. Fallgatter AJ, Bartsch AJ, Zielasek J, Herrmann MJ (2003) Brainelectrical dysfunction of the anterior cingulate in schizophrenic patients. Psychiatry Research: Neuroimaging 124:37–48

    Article  Google Scholar 

  16. Fallgatter AJ, Brandeis D, Strik WK (1997) A robust assessment of the NoGo-Anteriorisation of P300 microstates in a cued Continuous Performance Test. Brain Topogr 9:295–302

    Article  PubMed  Google Scholar 

  17. Fallgatter AJ, Eisenack SS, Neuhauser B, Aranda D, Scheuerpflug P, Herrmann MJ (2000) Stability of late event-related potentials: topographical descriptors of motor control compared with the P300 amplitude. Brain Topogr 12:255–261

    Article  PubMed  Google Scholar 

  18. Fallgatter AJ, Müller TJ (2001) Electrophysiological signs of reduced prefrontal response control in schizophrenic patients. Psychiatry Res: Neuroimaging 107:19–28

    Article  Google Scholar 

  19. Fallgatter AJ, Strik WK (1999) The NoGo-anteriorisation as a neurophysiological standard-index for cognitive response control. Int J Psychophysiol 32:115–120

    Article  Google Scholar 

  20. Gallhofer B, Bauer U, Lis S, Krieger S, Gruppe H (1996) Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs. Eur Neuropsychopharmacol 6(Suppl 2):S13–S20

    Article  PubMed  Google Scholar 

  21. Gorynia I, Campman V, Uebelhack R (2003) Intermanual coordination in relation to different clinical subgroups in righthanded patients with schizophrenic and other psychotic disorders. Eur Arch Psychiatry Clin Neurosci 253:53–59

    Article  PubMed  Google Scholar 

  22. Green MF, Marshall BD Jr, Wirshing WC, Ames D, Marder SR, McGurk S, Kern RS, Mintz J (1997) Does Risperidone improve verbal working memory in treatment-resistant schizophrenia? Am J Psychiatry 154:799–804

    PubMed  Google Scholar 

  23. Hazlett EA, Buchsbaum MS, Jeu LA, Nenadic I, Fleischman MB, Shihabuddin L, Haznedar MM, Harvey PD (2000) Hypofrontality in unmedicated schizophrenia patients studied with PET during performance of a serial verbal learning task. Schizophr Res 43:33–46

    Article  PubMed  Google Scholar 

  24. Higashima M, Kawasaki Y, Urata K, Sakai N, Nagasawa T, Koshino Y, Sumiya H, Tonami N, Tsuji S, Matsuda H (2000) Regional cerebral blood flow in male schizophrenic patients performing an auditory discrimination task. Schizophr Res 42:29–39

    Article  PubMed  Google Scholar 

  25. Honey GD, Bullmore ET, Soni W, Varatheesan M, Williams SC, Sharma T (1999) Differences in frontal cortical activation by a working memory task after substitution of risperidone for typical antipsychotic drugs in patients with schizophrenia. Proc Natl Acad Sci USA 96:13432–13437

    PubMed  Google Scholar 

  26. Ichikawa J, Dai J, O’Laughlin IA, Fowler WL, Meltzer HY (2002) Atypical, but not typical, antipsychotic drugs increase cortical acetylcholine release without an effect in the nucleus accumbens or striatum. Neuropsychopharmacology 26:325–339

    Article  PubMed  Google Scholar 

  27. Ichikawa J, Meltzer HY (1999) Relationship between dopaminergic and serotonergic neuronal activity in the frontal cortex and the action of typical and atypical antipsychotic drugs. Eur Arch Psychiatry Clin Neurosci 249(Suppl 4):90–98

    PubMed  Google Scholar 

  28. Ingvar DH, Franzen G (1974) Abnormalities of cerebral blood flow distribution in patients with chronic schizophrenia. Acta Psychiatr Scand 50:425–462

    PubMed  Google Scholar 

  29. Jabs BE, Pfuhlmann B, Bartsch AJ, Cetkovich-Bakmas MG, Stöber G (2002) Cycloid psychoses – from clinical concepts to biological foundations. J Neural Transm 109:907–919

    Article  PubMed  Google Scholar 

  30. Jaeger M, Hintermayr M, Bottlender R, Strauss A, Möller, H-J (2003) Course and outcome of first-admitted patients with acute and transient psychotic disorders (ICD-10:F23). Eur Arch Psychiatry Clin Neurosci 253:209–215

    PubMed  Google Scholar 

  31. Jasper H (1958) Report of committee on methods of clinical exam in EEG. Electroencephalogr Clin Neurophysiol 10:370–375

    Article  Google Scholar 

  32. Lahti AC, Holcomb HH, Weiler MA, Medoff DR, Frey KN, Hardin M, Tamminga CA (2004) Clozapine but not Haloperidol re-establishes normal task-activated rCBF patterns in schizophrenia within the anterior cingulate cortex. Neuropsychoparmacology 29:171–178

    Article  Google Scholar 

  33. Laux G, Dietmaier O, König W (2000) Pharmakopsychiatrie.Urban and Fischer, 3rd ed, Munich, p 237

  34. Lee MA, Thompson PA, Meltzer HY (1994) Effects of clozapine on cognitive function in schizophrenia. J Clin Psychiatry 55 (Suppl B):82–87

    PubMed  Google Scholar 

  35. Lehmann D (1987) Principles of spatial analysis. In: Gevins A, Remond A (eds) Methods of Analysis of Brain Electrical and Magnetic Signals. Handbook of Electroencephalography and Clinical Neurophysiology. Elsevier; 2nd ed, Amsterdam, pp 309–354

  36. Lehmann D, Faber PL,Achermann P, Jeanmonod D, Gianotti LR, Pizzagalli D (2001) Brain sources of EEG gamma frequency during volitionally medication-induced, altered states of consciousness, and experience of the self. Psychiatry Res 108:111–121

    PubMed  Google Scholar 

  37. Lehmann D, Skrandies W (1980) Reference-free identification of components of checkerboard-evoked multichannel potential fields. Electroencephalogr Clin Neurophysiol 48:609–621

    Article  PubMed  Google Scholar 

  38. Leonhard K (1999) The cycloid psychosis. In: Beckmann H (ed) Classification of endogenous psychoses and their differentiated etiology. Springer, 2nd ed, Vienna, New York, pp 61–75

  39. Li XM, Perry KW, Wong DT, Bymaster FP (1998) Olanzapine increases in vivo dopamine and norepinephrine release in rat prefrontal cortex,nucleus accumbens and striatum. Psychopharmacology (Berl) 136:153–161

    Article  PubMed  Google Scholar 

  40. Lidow MS, Williams GV, Goldman-Rakic PS (1998) The cerebral cortex: a case for a common site of action of antipsychotics. Trends Pharmacol Sci 19:136–140

    Article  PubMed  Google Scholar 

  41. Madsen AL, Keiding N, Karle A, Esbjerg S, Hemmingsen R (1998) Neuroleptics in progressive structural brain abnormalities in psychiatric illness. Lancet 352:784–785

    Article  PubMed  Google Scholar 

  42. Miller DD, Andreasen NC, O’Leary DS, Watkins GL, Boles Ponto LL, Hichwa RD (2001) Comparison of the Effects of Risperidone and Haloperidol on Regional Cerebral Blood Flow in Schizophrenia. Biol Psychiatry 49:704–715

    Article  PubMed  Google Scholar 

  43. Mulert C, Gallinat J, Pascual-Marqui R, Dorn H, Frick K, Schlattmann P, Mientus S, Herrmann WM, Winterer G (2001) Reduced event-related current density in the anterior cingulate cortex in schizophrenia. Neuroimage 13:589–600

    Article  PubMed  Google Scholar 

  44. Mulert C, Jäger L, Schmitt R, Bussfeld P, Pogarell O, Möller H-J, Juckel G, Hegerl U (2004) Integration of fMRI and simultaneous EEG: towards a comprehensive understanding of localization and time-course of brain activity in target detection. NeuroImage 22:83–94

    Article  PubMed  Google Scholar 

  45. Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113

    Article  PubMed  Google Scholar 

  46. Pascual-Marqui R (1999) Review of methods for solving the EEG inverse problem. Int J Bioelectromagnetism 1:75–86

    Google Scholar 

  47. Pascual-Marqui RD, Lehmann D, Koenig T, Kochi K, Merlo MC, Hell D, Koukkou M (1999) Low resolution brain electromagnetic tomography (LORETA) functional imaging in acute, neuroleptic-naive, first-episode, productive schizophrenia. Psychiatry Res 90:169–179

    PubMed  Google Scholar 

  48. Pascual-Marqui RD, Michel CM, Lehmann D (1994) Low resolution electromagnetic tomography, a new method for localizing electrical activity in the brain. Int J Psychophysiol 18:49–65

    Article  PubMed  Google Scholar 

  49. Pehek EA, Yamamoto BK (1994) Differential effects of locally administered clozapine and haloperidol on dopamine efflux in the rat prefrontal cortex and caudate-putamen. J Neurochem 63: 2118–2124

    PubMed  Google Scholar 

  50. Purdon SE, Malla A, Labelle A, Lit W (2001) Neuropsychological change in patients with schizophrenia after treatment with quetiapine or haloperidol. J Psychiatry Neurosci 26:137–149

    PubMed  Google Scholar 

  51. Riley EM, McGovern D, Mockler D, Doku VCK, OCeallaigh S, Fannon DG, Tennakoon L, Santamaria M, Soni W, Morris RG, Sharma T (2000) Neuropsychological functioning in firstepisode psychosis – evidence of specific deficits. Schizophr Res 43:47–55

    Article  PubMed  Google Scholar 

  52. Rosvold HE, Mirsky A, Sarason I, Bransome ED Jr, Beck LH (1956) A continuous performance test of brain damage. J Consult Psychol 20:343–350

    PubMed  Google Scholar 

  53. Stip E, Lussier I (1996) Effect of risperidone on cognition in patients with schizophrenia. Can J Psychiatry 41(Suppl 8):35–40

    Google Scholar 

  54. Strik WK, Fallgatter AJ, Stoeber G, Franzek E, Beckmann H (1996) Specific P300 features in patients with cycloid psychosis. Acta Psychiatr Scand 94:471–476

    PubMed  Google Scholar 

  55. Strik WK, Fallgatter AJ, Brandeis D, Pascual-Marqui R (1998) Three dimensional tomography of event-related potentials during response inhibition: evidence for phasic frontal lobe activation. Electroencephalogr Clin Neurophysiol 108:406–413

    Article  PubMed  Google Scholar 

  56. Vaiva G, Cottencin O, Llorca PM, Devos P, Dupont S, Mazas O, Rascle C, Thomas P, Steinling M, Goudemand M (2002) Regional cerebral blood flow in deficit/nondeficit types of schizophrenia according to SDS criteria. Prog Neuropsychopharmacol Biol Psychiatry 26:481–485

    Article  PubMed  Google Scholar 

  57. Velligan DI, Newcomer J, Pultz J, Csernansky J, Hoff AL, Mahurin R, Miller AL (2002) Does cognitive function improve with quetiapine in comparison to haloperidol? Schizophr Res 53:239–248

    Article  PubMed  Google Scholar 

  58. Vitacco D, Brandeis D, Pascual-Marqui R, Martin E (2002) Correspondence of event-related potential tomography and functional magnetic resonance imaging during language processing. Human Brain Mapping 17:4–12

    Article  PubMed  Google Scholar 

  59. Volz HP, Gaser C, Häger F, Rzanny R, Pönisch J, Mentzel HJ, Kaiser WA, Sauer H (1999) Decreased frontal activation in schizophrenics during stimulation with the Continuous Performance Test – a functional magnetic resonance imaging study. Eur Psychiatry 14:17–24

    Article  PubMed  Google Scholar 

  60. Winterer G, Mulert C, Mientus S, Gallinat J, Schlattmann P, Dorn H, Herrmann WM (2001) P300 and LORETA: comparison of normal subjects and schizophrenic patients. Brain Topogr 13: 299–313

    Article  PubMed  Google Scholar 

  61. Yücel M, Pantelis C, Stuart GW, Wood SJ, Maruff P, Velakoulis D, Pipingas A, Crowe SF, Tochon-Danguy HJ, Egan GF (2002) Anterior Cingulate Activation During Stroop Task Performance: A PET to MRI Coregistration Study of Individual Patients With Schizophrenia. Am J Psychiatry 159:251–254

    Article  PubMed  Google Scholar 

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Ehlis, AC., Zielasek, J., Herrmann, M.J. et al. Beneficial effect of atypical antipsychotics on prefrontal brain function in acute psychotic disorders. Eur Arch Psychiatry Clin Neurosci 255, 299–307 (2005). https://doi.org/10.1007/s00406-005-0562-1

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