Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the AEsop first-onset psychosis study.
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Authors
Pariante, Carmine M
Dazzan, Paola
Danese, Andrea
Morgan, Kevin D
Brudaglio, Flora
Morgan, Craig
Fearon, Paul
Orr, Ken
Hutchinson, Gerard
Pantelis, Christos
Issue Date
2005-Oct
Type
Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Language
en
Keywords
Alternative Title
Abstract
Subjects at their first psychotic episode show an enlarged volume of the pituitary gland, but whether this is due to hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, or to stimulation of the prolactin-secreting cells by antipsychotic treatment, is unclear. We measured pituitary volume, using 1.5-mm, coronal, 1.5 T, high-resolution MRI images, in 78 patients at the first psychotic episode and 78 age- and gender-matched healthy controls. In all, 18 patients were antipsychotic-free (12 of these were antipsychotic-naïve), 26 were receiving atypical antipsychotics, and 33 were receiving typical antipsychotics. As hypothesized, patients had a larger pituitary volume than controls (+22%, p< 0.001). When divided by antipsychotic treatment, and compared to controls, the pituitary volume was 15% larger in antipsychotic-free patients (p=0.028), 17% larger in patients receiving atypicals (p=0.01), and 30% larger in patients receiving typicals (p<0.001). Patients receiving typicals not only had the largest pituitary volume compared to controls but also showed a trend for a larger pituitary volume compared to the other patients grouped together (+11%, p=0.08). When divided by diagnosis, and compared to controls, the pituitary volume was 24% larger in patients with schizophrenia/schizophreniform disorder (n=40, p<0.001), 19% larger in depressed patients (n=13, p=0.022), 16% larger in bipolar patients (n=16, p=0.037), and 12% larger in those with other psychoses (n=9, p=0.2). In conclusion, the first-episode of a psychotic disorder is associated with a larger pituitary independently of the presence of antipsychotic treatment, and this could be due to activation of the HPA axis. Typical antipsychotics exert an additional enlarging effect on pituitary volume, likely to be related to activation of prolactin-secreting cells. This activation of the hormonal stress response could participate to the important metabolic abnormalities observed in patients with psychosis.
Description
Citation
Pariante, C. M., Dazzan, P., Danese, A., Morgan, K. D., Brudaglio, F., Morgan, C., Fearon, P., Orr, K., Hutchinson, G., Pantelis, C., Velakoulis, D., Jones, P. B., Leff, J., & Murray, R. M. (2005). Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the AEsop first-onset psychosis study. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 30(10), 1923–1931. https://doi.org/10.1038/sj.npp.1300766
Publisher
License
Journal
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
Volume
30
Issue
10
PubMed ID
ISSN
0893-133X