Study finds no structural difference between brains of treatment-responsive and treatment-resistant schizophrenia patients
Nearly one-third patients with schizophrenia do not respond to first-line anti-psychotics. This warrants an early diagnosis of this treatment-resistant subset so that drugs like clozapine can be used at an early stage before the psychiatric condition worsens in such patients. Diffusion tensor imaging (DTI) which can pick up anomalies in white matter connections at an early stage can test the hypothesis that whether the brains of patients with treatment resistant schizophrenia (TRS) are structurally different from those sensitive to usual drugs. In a recently published study in Indian Journal of Psychiatry by Aggarwal et al.have demonstarted a lack of significant difference in DTI findings between patients with TRS and non-TRS, thus countering the categorical hypothesis for TRS.
Schizophrenia is arguably the most puzzling of psychiatric syndromes and one of the most debilitating psychiatric disorders. Patients with TRS are found to be highly symptomatic, require extensive periods of hospitalization.
Clinicians and investigators have attempted to predict nonresponse to treatment as early as possible, with an aim to possibly start clozapine before the treatment resistance evolves. Prediction has been made previously through neuroimaging, using CT and MRI (mainly) which highlights the structural or functional changes in brain, possibly contributing to etiopathogenesis of treatment resistance in schizophrenia.
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