Antipsychotic drug effects on motor activation measured by functional magnetic resonance imaging in schizophrenic patients

Brain function and laterality in schizophrenia were investigated by means o f a simple motor task with a self-generated left-hand sequential finger opp osition (SFO) using a whole-brain high-speed (100 ms per slice) functional imaging technique. Neuroleptic-naive, acutely ill schizophrenic patients we re compared to schizophrenic patients under stable neuroleptic medication a nd matched controls. The goal was to evaluate both the motor function in fi rst-episode patients and possible effects of different neuroleptic treatmen ts on functional MRI results. Forty patients satisfying ICD 10 criteria (F2 0.x) for schizophrenia and sex- and age-matched healthy volunteers particip ated in this study. All subjects underwent fMRI examinations on a conventio nal 1.5 T MR unit. The primary sensorimotor cortex and the high-order suppl ementary motor area (SMA) were evaluated. There was a close similarity in t he activation of the primary and high-order (SMA) sensorimotor areas betwee n first-episode schizophrenic patients and controls. In contrast, a signifi cant reduction in the overall blood oxygen level dependent (BOLD) response was seen in sensorimotor cortices (contra- and ipsilateral) in schizophreni c patients under stable medication with typical neuroleptics. This effect w as not present in patients treated with atypical antipsychotics. Both antip sychotic treatments, however, led to a significant reduction in activation of the SMA region compared to controls and neuroleptic-naive subjects. Thus , the present study provides no evidence for the localized involvement of t he primary motor cortex or the SMA as a relatively stable vulnerability mar ker in schizophrenia. There is, however, strong evidence that neuroleptics themselves influence fMRI activation patterns and that there are major diff erences between typical neuroleptics and atypical antipsychotics. (C) 1999 Elsevier Science B.V. All rights reserved.