First and second generation antipsychotics and morphological and neurochemical brain changes in schizophrenia. Review of magnetic resonance imaging and proton spectroscopy findings

The author reviews literature on the topic of the morphological and neurochemical changes in the brain in schizophrenia which is connected with the influence of the antipsychotics, both I and II generation. The most replicated findings in schizophrenia are: an increase of basal ganglia volume and decrease of grey matter in different regions (after typical neuroleptics). These phenomena are not stated after atypical neuroleptics. If, especially in the first period of the disease the progression of the morphological changes in the brain in schizophrenia,, can be observed, the atypical neuroleptics could limit that process and classical neuroleptics - rather not. The atypics may also act neuroprotectively on the brain tissue. This action can also be observed in the results of proton magnetic resonance spectroscopy. The increase of N-acetylaspartate (NAA) levels in different brain regions was observed after treatment with atypical medication. NAA is recognised as the marker of neurons viability and function. The author discusses the possible mechanisms of neuroleptic action on the brain in schizophrenia and future research directions.