Neuroanatomical profiles of treatment-resistance in patients with schizophrenia spectrum disorders.

TitleNeuroanatomical profiles of treatment-resistance in patients with schizophrenia spectrum disorders.
Publication TypeJournal Article
Year of Publication2019
AuthorsKim J, Plitman E, Iwata Y, Nakajima S, Mar W, Patel R, Chavez S, Chung JKu, Caravaggio F, Chakravarty MM, Remington G, Gerretsen P, Graff-Guerrero A
JournalProg Neuropsychopharmacol Biol Psychiatry
Date Published2019 Dec 13

Mounting evidence suggests neuroanatomical compromise in subcortical brain regions in patients with schizophrenia. However, only a few existing studies have examined the structural profiles of patients with treatment-resistant schizophrenia. The aim of this study was to compare differences in subcortical and hippocampal volumes between: (i) treatment-resistant patients who are non-responders to both first-line antipsychotics and clozapine (URS), (ii) treatment-resistant patients who are non-responders to first-line antipsychotics but are responders to clozapine (CLZ-Resp), (iii) responders to first-line antipsychotics (FL-Resp), and (iv) healthy controls (HC). T1-weighted images of 103 participants (27 URS, 29 CLZ-Resp, 21 FL-Resp, and 26 HCs) were obtained. Group differences in striatal, thalamic, globus pallidus, amygdala, and hippocampus volumes were examined. Subsequent analyses were performed for striatal and thalamic subdivisions. Multiple regression analyses were performed to examine the associations between subcortical and hippocampal volumes and demographic and clinical characteristics. The FL-Resp group showed increased striatal and globus pallidus volumes compared to the URS group. Compared to HCs, post-commissural putamen and globus pallidus volumes were larger in the FL-Resp group. The URS group showed reduced thalamic volume compared to the HC group. There were no subcortical or hippocampal volume differences between the URS and CLZ-Resp groups. Differences in structural volumes were not related to symptom severity. Our findings suggest different structural volume alterations in the subcortical regions between treatment-resistant schizophrenia and responders to first-line antipsychotics. Whether subcortical structure compromise is a distinct pathophysiological marker of treatment-resistant schizophrenia, or a result of antipsychotic exposure, remains to be explored.

Alternate JournalProg. Neuropsychopharmacol. Biol. Psychiatry
PubMed ID31843627