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European Archives of Psychiatry and Clinical Neuroscience

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Open Access 01-12-2019 | Original Paper

Reduced activity and connectivity of left amygdala in patients with schizophrenia treated with clozapine or olanzapine

Authors: Daniela Mier, Frederike Schirmbeck, Gabriela Stoessel, Christine Esslinger, Franziska Rausch, Susanne Englisch, Sarah Eisenacher, Lieuwe de Haan, Andreas Meyer-Lindenberg, Peter Kirsch, Mathias Zink

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 8/2019

Abstract

Obsessive–compulsive symptoms (OCS) in patients with schizophrenia are a common co-occurring condition, often associated with additional impairments. A subgroup of these patients develops OCS during treatment with second-generation antipsychotics (SGAs), most importantly clozapine and olanzapine. So far, little is known about possible neural mechanism of these SGAs, which seem to aggravate or induce OCS. To investigate the role of SGA treatment on neural activation and connectivity during emotional processing, patients were stratified according to their monotherapy into two groups (group I: clozapine or olanzapine, n = 20; group II: amisulpride or aripiprazole, n = 20). We used an fMRI approach, applying an implicit emotion recognition task. Group comparisons showed significantly higher frequency and severity of comorbid OCS in group I than group II. Task specific activation was attenuated in group I in the left amygdala. Furthermore, functional connectivity from left amygdala to right ventral striatum was reduced in group I. Reduced amygdala activation was associated with OCS severity. Recent literature suggests an involvement of an amygdala–cortico–striatal network in the pathogenesis of obsessive–compulsive disorder. The observed differential activation and connectivity pattern of the amygdala might thus indicate a neural mechanism for the development of SGA-associated OCS in patients with schizophrenia. Further neurobiological research and interventional studies are needed for causal inferences.

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Title: Reduced activity and connectivity of left amygdala in patients with schizophrenia treated with clozapine or olanzapine
Authors: Daniela Mier
Frederike Schirmbeck
Gabriela Stoessel
Christine Esslinger
Franziska Rausch
Susanne Englisch
Sarah Eisenacher
Lieuwe de Haan
Andreas Meyer-Lindenberg
Peter Kirsch
Mathias Zink
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 8/2019
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-018-0965-4

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Reduced activity and connectivity of left amygdala in patients with schizophrenia treated with clozapine or olanzapine

Abstract

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Abstract

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