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Article: A systematic review of neuroimaging studies of clozapine-resistant schizophrenia

TitleA systematic review of neuroimaging studies of clozapine-resistant schizophrenia
Authors
Issue Date26-Sep-2023
PublisherNature Publishing Group UK
Citation
Schizophrenia, 2023, v. 9, n. 1 How to Cite?
AbstractThis 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.
Persistent Identifierhttp://hdl.handle.net/10722/341650
ISSN
2023 Impact Factor: 3.0
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorPang, TSW-
dc.contributor.authorChun, JSW-
dc.contributor.authorWong, TY-
dc.contributor.authorChu, ST-
dc.contributor.authorMa, CF-
dc.contributor.authorHoner, WG-
dc.contributor.authorChan, SKW-
dc.date.accessioned2024-03-20T06:58:01Z-
dc.date.available2024-03-20T06:58:01Z-
dc.date.issued2023-09-26-
dc.identifier.citationSchizophrenia, 2023, v. 9, n. 1-
dc.identifier.issn2754-6993-
dc.identifier.urihttp://hdl.handle.net/10722/341650-
dc.description.abstractThis 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.-
dc.languageeng-
dc.publisherNature Publishing Group UK-
dc.relation.ispartofSchizophrenia-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleA systematic review of neuroimaging studies of clozapine-resistant schizophrenia-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1038/s41537-023-00392-7-
dc.identifier.scopuseid_2-s2.0-85172222294-
dc.identifier.volume9-
dc.identifier.issue1-
dc.identifier.eissn2754-6993-
dc.identifier.isiWOS:001195216800001-

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