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Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia

AIM: Validating the vulnerabilities and pathologies underlying treatment‐resistant schizophrenia (TRS) is an important challenge in optimizing treatment. Gyrification and surface area (SA), reflecting neurodevelopmental features, have been linked to genetic vulnerability to schizophrenia. The aim of...

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Autores principales: Kitajima, Kazutoshi, Tamura, Shunsuke, Sasabayashi, Daiki, Nakajima, Shinichiro, Iwata, Yusuke, Ueno, Fumihiko, Takai, Yoshifumi, Takahashi, Junichi, Caravaggio, Fernando, Mar, Wanna, Torres‐Carmona, Edgardo, Noda, Yoshihiro, Gerretsen, Philip, de Luca, Vincenzo, Mimura, Masaru, Hirano, Shogo, Nakao, Tomohiro, Onitsuka, Toshiaki, Remington, Gary, Graff‐Guerrero, Ariel, Hirano, Yoji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092309/
https://www.ncbi.nlm.nih.gov/pubmed/36165228
http://dx.doi.org/10.1111/pcn.13482
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author Kitajima, Kazutoshi
Tamura, Shunsuke
Sasabayashi, Daiki
Nakajima, Shinichiro
Iwata, Yusuke
Ueno, Fumihiko
Takai, Yoshifumi
Takahashi, Junichi
Caravaggio, Fernando
Mar, Wanna
Torres‐Carmona, Edgardo
Noda, Yoshihiro
Gerretsen, Philip
de Luca, Vincenzo
Mimura, Masaru
Hirano, Shogo
Nakao, Tomohiro
Onitsuka, Toshiaki
Remington, Gary
Graff‐Guerrero, Ariel
Hirano, Yoji
author_facet Kitajima, Kazutoshi
Tamura, Shunsuke
Sasabayashi, Daiki
Nakajima, Shinichiro
Iwata, Yusuke
Ueno, Fumihiko
Takai, Yoshifumi
Takahashi, Junichi
Caravaggio, Fernando
Mar, Wanna
Torres‐Carmona, Edgardo
Noda, Yoshihiro
Gerretsen, Philip
de Luca, Vincenzo
Mimura, Masaru
Hirano, Shogo
Nakao, Tomohiro
Onitsuka, Toshiaki
Remington, Gary
Graff‐Guerrero, Ariel
Hirano, Yoji
author_sort Kitajima, Kazutoshi
collection PubMed
description AIM: Validating the vulnerabilities and pathologies underlying treatment‐resistant schizophrenia (TRS) is an important challenge in optimizing treatment. Gyrification and surface area (SA), reflecting neurodevelopmental features, have been linked to genetic vulnerability to schizophrenia. The aim of this study was to identify gyrification and SA abnormalities specific to TRS. METHODS: We analyzed 3T magnetic resonance imaging findings of 24 healthy controls (HCs), 20 responders to first‐line antipsychotics (FL‐Resp), and 41 patients with TRS, including 19 clozapine responders (CLZ‐Resp) and 22 FL‐ and clozapine‐resistant patients (patients with ultratreatment‐resistant schizophrenia [URS]). The local gyrification index (LGI) and associated SA were analyzed across groups. Diagnostic accuracy was verified by receiver operating characteristic curve analysis. RESULTS: Both CLZ‐Resp and URS had lower LGI values than HCs (P = 0.041, Hedges g [g (H)] = 0.75; P = 0.013, g (H) = 0.96) and FL‐Resp (P = 0.007, g (H) = 1.00; P = 0.002, g (H) = 1.31) in the left medial parietal cortex (Lt‐MPC). In addition, both CLZ‐Resp and URS had lower SA in the Lt‐MPC than FL‐Resp (P < 0.001, g (H) = 1.22; P < 0.001, g (H) = 1.75). LGI and SA were positively correlated in non‐TRS (FL‐Resp) (ρ = 0.64, P = 0.008) and TRS (CLZ‐Resp + URS) (ρ = 0.60, P < 0.001). The areas under the receiver operating characteristic curve for non‐TRS versus TRS with LGI and SA in the Lt‐MPC were 0.79 and 0.85, respectively. SA in the Lt‐MPC was inversely correlated with negative symptoms (ρ = −0.40, P = 0.018) and clozapine plasma levels (ρ = −0.35, P = 0.042) in TRS. CONCLUSION: LGI and SA in the Lt‐MPC, a functional hub in the default‐mode network, were abnormally reduced in TRS compared with non‐TRS. Thus, altered LGI and SA in the Lt‐MPC might be structural features associated with genetic vulnerability to TRS.
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spelling pubmed-100923092023-04-13 Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia Kitajima, Kazutoshi Tamura, Shunsuke Sasabayashi, Daiki Nakajima, Shinichiro Iwata, Yusuke Ueno, Fumihiko Takai, Yoshifumi Takahashi, Junichi Caravaggio, Fernando Mar, Wanna Torres‐Carmona, Edgardo Noda, Yoshihiro Gerretsen, Philip de Luca, Vincenzo Mimura, Masaru Hirano, Shogo Nakao, Tomohiro Onitsuka, Toshiaki Remington, Gary Graff‐Guerrero, Ariel Hirano, Yoji Psychiatry Clin Neurosci Regular Articles AIM: Validating the vulnerabilities and pathologies underlying treatment‐resistant schizophrenia (TRS) is an important challenge in optimizing treatment. Gyrification and surface area (SA), reflecting neurodevelopmental features, have been linked to genetic vulnerability to schizophrenia. The aim of this study was to identify gyrification and SA abnormalities specific to TRS. METHODS: We analyzed 3T magnetic resonance imaging findings of 24 healthy controls (HCs), 20 responders to first‐line antipsychotics (FL‐Resp), and 41 patients with TRS, including 19 clozapine responders (CLZ‐Resp) and 22 FL‐ and clozapine‐resistant patients (patients with ultratreatment‐resistant schizophrenia [URS]). The local gyrification index (LGI) and associated SA were analyzed across groups. Diagnostic accuracy was verified by receiver operating characteristic curve analysis. RESULTS: Both CLZ‐Resp and URS had lower LGI values than HCs (P = 0.041, Hedges g [g (H)] = 0.75; P = 0.013, g (H) = 0.96) and FL‐Resp (P = 0.007, g (H) = 1.00; P = 0.002, g (H) = 1.31) in the left medial parietal cortex (Lt‐MPC). In addition, both CLZ‐Resp and URS had lower SA in the Lt‐MPC than FL‐Resp (P < 0.001, g (H) = 1.22; P < 0.001, g (H) = 1.75). LGI and SA were positively correlated in non‐TRS (FL‐Resp) (ρ = 0.64, P = 0.008) and TRS (CLZ‐Resp + URS) (ρ = 0.60, P < 0.001). The areas under the receiver operating characteristic curve for non‐TRS versus TRS with LGI and SA in the Lt‐MPC were 0.79 and 0.85, respectively. SA in the Lt‐MPC was inversely correlated with negative symptoms (ρ = −0.40, P = 0.018) and clozapine plasma levels (ρ = −0.35, P = 0.042) in TRS. CONCLUSION: LGI and SA in the Lt‐MPC, a functional hub in the default‐mode network, were abnormally reduced in TRS compared with non‐TRS. Thus, altered LGI and SA in the Lt‐MPC might be structural features associated with genetic vulnerability to TRS. John Wiley & Sons Australia, Ltd 2022-10-27 2023-01 /pmc/articles/PMC10092309/ /pubmed/36165228 http://dx.doi.org/10.1111/pcn.13482 Text en © 2022 The Authors. Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Regular Articles
Kitajima, Kazutoshi
Tamura, Shunsuke
Sasabayashi, Daiki
Nakajima, Shinichiro
Iwata, Yusuke
Ueno, Fumihiko
Takai, Yoshifumi
Takahashi, Junichi
Caravaggio, Fernando
Mar, Wanna
Torres‐Carmona, Edgardo
Noda, Yoshihiro
Gerretsen, Philip
de Luca, Vincenzo
Mimura, Masaru
Hirano, Shogo
Nakao, Tomohiro
Onitsuka, Toshiaki
Remington, Gary
Graff‐Guerrero, Ariel
Hirano, Yoji
Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia
title Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia
title_full Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia
title_fullStr Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia
title_full_unstemmed Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia
title_short Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia
title_sort decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment‐resistant and ultratreatment‐resistant schizophrenia
topic Regular Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092309/
https://www.ncbi.nlm.nih.gov/pubmed/36165228
http://dx.doi.org/10.1111/pcn.13482
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