MRI May Predict Which Patients Will Develop Treatment-Resistant Schizophrenia

A neuromelanin-sensitive MRI (NM-MRI) may successfully predict which patients with first-episode psychosis will eventually develop treatment-resistant schizophrenia, according to astudy published today inAJP in Advance. Neuromelanin is a brain pigment that is a by-product of dopamine metabolism and therefore can be a visual indicator of healthy dopamine functioning.“[T]here is an urgent need for markers to identify treatment nonresponders in schizophrenia at an early stage and facilitate timely initiation of clozapine, the only antipsychotic with proven efficacy in nonresponders,” wrote Marieke van der Pluijm, Ph.D., of the University of Amsterdam and coll eagues. Patients with treatment-resistant schizophrenia do not show increased dopamine function, unlike patients who respond to treatment, van der Pluijm and colleagues continued. This suggests that neuromelanin levels—a proxy of dopamine function—may be an early marker for treatment resistance.The researchers recruited 62 patients aged 18 to 35 years with first-episode psychosis whose primary diagnosis was on the schizophrenia spectrum. They also recruited 20 healthy controls. All participants were assessed at baseline with an NM-MRI scan, a clinical interview, and an IQ test. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS). Patients received antipsychotic treatment from their psychiatrists throughout the study.Treatment response was assessed with a clinical interview at six mon...
Source: Psychiatr News - Category: Psychiatry Tags: American Journal of Psychiatry biomarker dopamine MRI neuromelanin responders schizophrenia treatment resistance University of Amsterdam Source Type: research