Rhonda El-Sheikh

1
Introduction

• Rhonda El-Sheikh
• Department of Psychiatry and Behavioral
  Neuroscience
• Brain Research And Imaging Neuroscience
• Background
• MS in Biomedical Engineering, Neurophysiology
  minor, May 2004
• Wayne State University
• BS in Computer Science, Telecommunications minor,
  December 2000
• Michigan State University

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Introduction

• Main Focus
• Magnetic Resonance Spectroscopy (MRS)
• Quantifying both 31P, and 1H MRS data
• Morphometrics
• Collecting volumetric data based on a
  region-of-interest (ROI) approach
• Using a Talairach-Brodmann atlas to refine ROI
  definitions of Brodmann areas in vivo

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Differential Effects of Antipsychotic Drugs on
Pituitary Volume

• Rhonda M. El-Sheikh1, Frank P. MacMaster1, Ameet
  R. Upadhyaya1, Jeffrey Nutche2, David R.
  Rosenberg1, Matcheri S. Keshavan1
• 1Psychiatry Behavioral Neurosciences, Wayne
  State University School of Medicine, Detroit, MI,
  2Western Psychiatric Institute Clinic,
  University of Pittsburgh Medical Center,
  Pittsburgh, PA
• 1st June, 2005

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Objective

• To examine the effect of antipsychotics on
  pituitary volume
• Antipsychotics are known to affect pituitary
  function leading to robust prolactin elevations
• Increased prolactin may be associated with
  structural alterations in pituitary volume

5
Methods

• Using structural magnetic resonance imaging (MRI)
  scans, pituitary volumes were measured in a
  series of five samples
• A. Before and after treatment samples
• PSY Treatment naïve first episode psychotic
  patients (primarily taking risperidone or
  olanzapine)
• OCD Obsessive compulsive disorder patients
• MDD Major depressive disorder patients
• ADHD Attention deficit hyperactivity disorder
  patients
• B. Unmedicated healthy controls

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Sample Information and Change in Pituitary Volume
Sample Age Range (years) Sex Medication Duration (weeks) Percent Change in Pituitary Volume
Psychosis 12-39 14M, 4F Antipsychotic 52 11
OCD 7-18 9M, 15F SSRI 12 1
MDD 10-19 4M, 10F SSRI 12 3
ADHD 6-11 12M Methylphenidate 8 1
Healthy Controls 12-33 7M, 5F None 52 1
Significant at p lt 0.05
7
Results

• Pituitary volume significantly increased in the
  PSY subjects after successful treatment, as
  opposed to healthy controls
• t17 2.44, p 0.026, 11 increase 1
  increase respectively
• Risperidone produced larger increases in
  pituitary volume as opposed to olanzapine
• 13 increase 3 increase respectively
• There was no effect of treatment noted in the
  OCD, MDD and ADHD groups, despite symptomatic
  improvement

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Conclusions

• Pituitary volume increases appear specific to
  antipsychotic treatments, especially prolactin
  elevating drugs (i.e. risperidone) in contrast to
  prolactin sparing drugs (i.e. olanzapine)
• Pituitary volumes may be a biomarker for
  treatment related neuroendocrine dysfunctions
• Future studies should combine neuroendocrine
  measures with pituitary volumetric measures