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Increased orbitofrontal cortex activation associated with "pro-obsessive" antipsychotic treatment in patients with schizophrenia

Increased orbitofrontal cortex activation associated with "pro-obsessive" antipsychotic treatment in patients with schizophrenia

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SCHIRMBECK, Frederike, Daniela MIER, Christine ESSLINGER, Franziska RAUSCH, Susanne ENGLISCH, Sarah EIFLER, Andreas MEYER-LINDENBERG, Peter KIRSCH, Mathias ZINK, 2015. Increased orbitofrontal cortex activation associated with "pro-obsessive" antipsychotic treatment in patients with schizophrenia. In: Journal of Psychiatry & Neuroscience. 40(2), pp. 89-99. ISSN 1180-4882. eISSN 1488-2434. Available under: doi: 10.1503/jpn.140021

@article{Schirmbeck2015-03-01Incre-45675, title={Increased orbitofrontal cortex activation associated with "pro-obsessive" antipsychotic treatment in patients with schizophrenia}, year={2015}, doi={10.1503/jpn.140021}, number={2}, volume={40}, issn={1180-4882}, journal={Journal of Psychiatry & Neuroscience}, pages={89--99}, author={Schirmbeck, Frederike and Mier, Daniela and Esslinger, Christine and Rausch, Franziska and Englisch, Susanne and Eifler, Sarah and Meyer-Lindenberg, Andreas and Kirsch, Peter and Zink, Mathias} }

Esslinger, Christine Meyer-Lindenberg, Andreas Eifler, Sarah terms-of-use Schirmbeck, Frederike 2019-04-17T13:22:26Z Rausch, Franziska Kirsch, Peter 2019-04-17T13:22:26Z Esslinger, Christine 2015-03-01 Eifler, Sarah eng Rausch, Franziska Increased orbitofrontal cortex activation associated with "pro-obsessive" antipsychotic treatment in patients with schizophrenia Kirsch, Peter Englisch, Susanne Mier, Daniela Englisch, Susanne Meyer-Lindenberg, Andreas Mier, Daniela Schirmbeck, Frederike Background: Patients with schizophrenia have an approximately 10-fold higher risk for obsessive–compulsive symptoms (OCS) than the general population. A large subgroup seems to experience OCS as a consequence of second-generation antipsychotic agents (SGA), such as clozapine. So far little is known about underlying neural mechanisms.<br /><br />Methods: To investigate the role of SGA treatment on neural processing related to OCS in patients with schizophrenia, we stratified patients according to their monotherapy into 2 groups (group I: clozapine or olanzapine; group II: amisulpride or aripiprazole). We used an fMRI approach, applying a go/no-go task assessing inhibitory control and an n-back task measuring working memory.<br /><br />Results: We enrolled 21 patients in group I and 19 patients in group II. Groups did not differ regarding age, sex, education or severity of psychotic symptoms. Frequency and severity of OCS were significantly higher in group I and were associated with pronounced deficits in specific cognitive abilities. Whereas brain activation patterns did not differ during working memory, group I showed significantly increased activation in the orbitofrontal cortex (OFC) during response inhibition. Alterations in OFC activation were associated with the severity of obsessions and mediated the association between SGA treatment and co-occurring OCS on a trend level.<br /><br />Limitations: The main limitation of this study is its cross-sectional design.<br /><br />Conclusion: To our knowledge, this is the first imaging study conducted to elucidate SGA effects on neural systems related to OCS. We propose that alterations in brain functioning reflect a pathogenic mechanism in the development of SGA-induced OCS in patients with schizophrenia. Longitudinal studies and randomized interventions are needed to prove the suggested causal interrelations. Zink, Mathias Zink, Mathias

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