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A systematic review of neuroimaging studies of clozapine-resistant schizophrenia.
- Source :
-
Schizophrenia (Heidelberg, Germany) [Schizophrenia (Heidelb)] 2023 Sep 26; Vol. 9 (1), pp. 65. Date of Electronic Publication: 2023 Sep 26. - Publication Year :
- 2023
-
Abstract
- This systematic review aimed to review neuroimaging studies comparing clozapine-resistant schizophrenia patients with clozapine-responding patients, and with first-line antipsychotic responding (FLR) patients. A total of 19 studies including 6 longitudinal studies were identified. Imaging techniques comprised computerized tomography (CT, n = 3), structural magnetic resonance imaging (MRI, n = 7), magnetic resonance spectroscopy (MRS, n = 5), functional MRI (n = 1), single-photon emission computerized tomography (SPECT, n = 3) and diffusion tensor imaging (DTI, n = 1). The most consistent finding was hypo-frontality in the clozapine-resistant group compared with the clozapine-responding group with possible differences in frontal-striatal-basal ganglia circuitry as well as the GABA level between the two treatment-resistant groups. Additional statistically significant findings were reported when comparing clozapine-resistant patients with the FLR group, including lower cortical thickness and brain volume of multiple brain regions as well as lower Glx/Cr level in the dorsolateral prefrontal cortex. Both treatment-resistant groups were found to have extensive differences in neurobiological features in comparison with the FLR group. Overall results suggested treatment-resistant schizophrenia is likely to be a neurobiological distinct type of the illness. Clozapine-resistant and clozapine-responding schizophrenia are likely to have both shared and distinct neurobiological features. However, conclusions from existing studies are limited, and future multi-center collaborative studies are required with a consensus clinical definition of patient samples, multimodal imaging tools, and longitudinal study designs.<br /> (© 2023. The Author(s).)
Details
- Language :
- English
- ISSN :
- 2754-6993
- Volume :
- 9
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Schizophrenia (Heidelberg, Germany)
- Publication Type :
- Academic Journal
- Accession number :
- 37752161
- Full Text :
- https://doi.org/10.1038/s41537-023-00392-7