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Neuroprotection after a first episode of mania: a randomized controlled maintenance trial comparing the effects of lithium and quetiapine on grey and white matter volume

Berk, M., Dandash, O., Daglas, R., Cotton, S.M., Allott, K., Fornito, A., Suo, C., Klauser, P., Liberg, B., Henry, L., Macneil, C., Hasty, M., McGorry, P., Pantelis, C. and Yücel, M. 2017, Neuroprotection after a first episode of mania: a randomized controlled maintenance trial comparing the effects of lithium and quetiapine on grey and white matter volume, Translational psychiatry, vol. 7, pp. 1-7, doi: 10.1038/tp.2016.281.

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Title Neuroprotection after a first episode of mania: a randomized controlled maintenance trial comparing the effects of lithium and quetiapine on grey and white matter volume
Author(s) Berk, M.ORCID iD for Berk, M. orcid.org/0000-0002-5554-6946
Dandash, O.
Daglas, R.
Cotton, S.M.
Allott, K.
Fornito, A.
Suo, C.
Klauser, P.
Liberg, B.
Henry, L.
Macneil, C.
Hasty, M.
McGorry, P.
Pantelis, C.
Yücel, M.
Journal name Translational psychiatry
Volume number 7
Article ID e1011
Start page 1
End page 7
Total pages 7
Publisher Nature Publishing Group
Place of publication London, Eng.
Publication date 2017-01-24
ISSN 2158-3188
Summary Lithium and quetiapine are effective treatments for bipolar disorder, but their potential neuroprotective effects in humans remain unclear. A single blinded equivalence randomized controlled maintenance trial was conducted in a prospective cohort of first-episode mania (FEM) patients (n=26) to longitudinally compare the putative protective effects of lithium and quetapine on grey and white matter volume. A healthy control sample was also collected (n=20). Using structural MRI scans, voxel-wise grey and white matter volumes at baseline and changes over time in response to treatment were investigated. Patients were assessed at three time points (baseline, 3 and 12-month follow-up), whereas healthy controls were assessed at two time points (baseline and 12-month follow-up). Patients were randomized to lithium (serum level 0.6 mmol l(-1), n=20) or quetiapine (flexibly dosed up to 800 mg per day, n=19) monotherapy. At baseline, compared with healthy control subjects, patients with FEM showed reduced grey matter in the orbitofrontal cortex, anterior cingulate, inferior frontal gyrus and cerebellum. In addition, patients had reduced internal capsule white matter volume bilaterally (t1,66>3.20, P<0.01). Longitudinally, there was a significant treatment × time effect only in the white matter of the left internal capsule (F2,112=8.54, P<0.01). Post hoc testing showed that, compared with baseline, lithium was more effective than quetiapine in slowing the progression of white matter volume reduction after 12 months (t1,24=3.76, P<0.01). Our data support the role of lithium but not quetiapine therapy in limiting white matter reduction early in the illness course after FEM.
Language eng
DOI 10.1038/tp.2016.281
Field of Research 110319 Psychiatry (incl Psychotherapy)
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30091206

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.