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Magnetic Resonance Imaging and Single Photon Emission Tomography in Treatment-Responsive and Treatment-Resistant Schizophrenia

Published online by Cambridge University Press:  02 January 2018

Stephen M. Lawrie*
Affiliation:
Edinburgh University Department of Psychiatry
Gordon T. Ingle
Affiliation:
Edinburgh University Department of Psychiatry
Celestine G. Santosh
Affiliation:
Magnetic Resonance Imaging Unit, Edinburgh University Department of Medical Radiology
Andrew C. Rogers
Affiliation:
Edinburgh University Department of Psychiatry
J. Ewen Rimmington
Affiliation:
Magnetic Resonance Imaging Unit, Edinburgh University Department of Medical Radiology
Kaliprasad P. Naidu
Affiliation:
Magnetic Resonance Imaging Unit, Edinburgh University Department of Medical Radiology
Jonathan J. K. Best
Affiliation:
Magnetic Resonance Imaging Unit, Edinburgh University Department of Medical Radiology
Ronan E. O'Carroll
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital
Guy M. Goodwin
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital
Klaus P. Ebmeier
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital
Eve C. Johnstone
Affiliation:
Edinburgh University Department of Psychiatry
*
Dr Stephen M. Lawrie, Edinburgh University Department of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF

Abstract

Background

Patients with schizophrenia differ from controls in several measures of brain structure and function, but it is uncertain how these relate to clinical features of the illness. We dichotomised patient groups by treatment response to test the hypothesis that treatment-resistant patients exhibit more marked biological abnormalities than treatment-responsive parients.

Method

Twenty treatment-responsive and 20 treatment-resistant patients with schizophrenia, matched for sex, age, and illness duration, were compared by magnetic resonance imaging, single photon emission tomography, and detailed neuropsychological assessment.

Results

Brain-imaging variables were not statistically related to treatment response, although poorly responsive patients had lower volumes of most brain structures. Several highly significant differences emerged between patient groups on neuropsychological testing. Episodic memory functioning distinguished patient groups even after we controlled for global cognitive impairment.

Conclusions

Cerebral structure and blood flow have a limited effect on treatment response in schizophrenia, but long-term episodic memory impairment is associated with, and may predict, poor prognosis.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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