Parkinsonism and basal ganglia volumes in first-episode psychosis

Introduction Parkinsonian motor signs are the most frequent of the genuine motor abnormalities present in drug-naive patients with schizophrenia, and are also present in patients with a first-episode of psychosis (FEP). Objective To study whether there are differences in basal ganglia volumes depending on the presence of Parkinsonism in FEP. Methods Forty-six patients with a FEP were included in the study. Twenty-three controls were included to normalise patients’ brain volume data. Parkinsonism was assessed with the UKU scale. Brain volumes were obtained with MRI (1.5 Tesla Siemens Avanto). Reconstruction and volumetric segmentation was made with the Freesurfer© software ( http://surfer.nmr.mgh.harvard.edu/ ). Patients were divided into two groups, considering the presence/absence of Parkinsonism (UKU total score cutoff point = 4). Patients have been treated with antipsychotics a mean of less than 2 months. There were not significant differences in the total exposure to antipsychotics between both groups. ANCOVAS were performed including gender as covariate. Results Patients with Parkinsonism showed a trend towards significance to exhibit reduced volumes in the left caudate and right putamen ( Fig. 1 ). Conclusions FEP patients who exhibit Parkinsonian signs tend to show reduced left caudate and right putamen volumes in the early phases of psychotic illness, after correcting by gender.