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Differential effect of quetiapine and lithium on functional connectivity of the striatum in first episode mania

Dandash, Orwa, Yücel, Murat, Daglas, Rothanthi, Pantelis, Christos, McGorry, Patrick, Berk, Michael and Fornito, Alex 2018, Differential effect of quetiapine and lithium on functional connectivity of the striatum in first episode mania, Translational psychiatry, vol. 8, no. 1, pp. 1-9, doi: 10.1038/s41398-018-0108-8.

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Title Differential effect of quetiapine and lithium on functional connectivity of the striatum in first episode mania
Author(s) Dandash, Orwa
Yücel, Murat
Daglas, Rothanthi
Pantelis, Christos
McGorry, Patrick
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Fornito, Alex
Journal name Translational psychiatry
Volume number 8
Issue number 1
Article ID 59
Start page 1
End page 9
Total pages 9
Publisher Nature Publishing
Place of publication London, Eng.
Publication date 2018-03-06
ISSN 2158-3188
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Psychiatry
PSYCHOTIC BIPOLAR PROBANDS
MEDIAL PREFRONTAL CORTEX
PLACEBO-CONTROLLED TRIAL
RESTING STATE FMRI
BASAL-GANGLIA
DOUBLE-BLIND
SPONTANEOUS FLUCTUATIONS
1ST-DEGREE RELATIVES
MOOD DISORDERS
BRAIN ACTIVITY
Summary Mood disturbances seen in first-episode mania (FEM) are linked to disturbed functional connectivity of the striatum. Lithium and quetiapine are effective treatments for mania but their neurobiological effects remain largely unknown. We conducted a single-blinded randomized controlled maintenance trial in 61 FEM patients and 30 healthy controls. Patients were stabilized for a minimum of 2 weeks on lithium plus quetiapine then randomly assigned to either lithium (serum level 0.6 mmol/L) or quetiapine (dosed up to 800 mg/day) treatment for 12 months. Resting-state fMRI was acquired at baseline, 3 months (patient only) and 12 months. The effects of treatment group, time and their interaction, on striatal functional connectivity were assessed using voxel-wise general linear modelling. At baseline, FEM patients showed reduced connectivity in the dorsal (p = 0.05) and caudal (p = 0.008) cortico-striatal systems when compared to healthy controls at baseline. FEM patients also showed increased connectivity in a circuit linking the ventral striatum with the medial orbitofrontal cortex, cerebellum and thalamus (p = 0.02). Longitudinally, we found a significant interaction between time and treatment group, such that lithium was more rapid, compared to quetiapine, in normalizing abnormally increased functional connectivity, as assessed at 3-month and 12-month follow-ups. The results suggest that FEM is associated with reduced connectivity in dorsal and caudal corticostriatal systems, as well as increased functional connectivity of ventral striatal systems. Lithium appears to act more rapidly than quetiapine in normalizing hyperconnectivity of the ventral striatum with the cerebellum.
Language eng
DOI 10.1038/s41398-018-0108-8
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 ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30108881

Document type: Journal Article
Collections: School of Medicine
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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.