RT Journal Article SR Electronic T1 Investigating structural subdivisions of the anterior cingulate cortex in schizophrenia, with implications for treatment resistance and glutamatergic levels JF Journal of Psychiatry and Neuroscience JO JPN FD Canadian Medical Association SP E1 OP E10 DO 10.1503/jpn.210113 VO 47 IS 1 A1 Ryo Ochi A1 Eric Plitman A1 Raihaan Patel A1 Ryosuke Tarumi A1 Yusuke Iwata A1 Sakiko Tsugawa A1 Julia Kim A1 Shiori Honda A1 Yoshihiro Noda A1 Hiroyuki Uchida A1 Gabriel A. Devenyi A1 Masaru Mimura A1 Ariel Graff-Guerrero A1 M. Mallar Chakravarty A1 Shinichiro Nakajima YR 2022 UL http://jpn.ca/content/47/1/E1.abstract AB Background: Abnormalities in the anterior cingulate cortex (ACC) are thought to play an important role in the pathophysiology of schizophrenia. Given regional variations in ACC structure, the present study aimed to examine ACC structural subdivisions and their relationships to treatment resistance and glutamatergic levels in schizophrenia.Methods: This study included 100 patients with schizophrenia and 52 healthy controls from 2 cohorts. We applied non-negative matrix factorization to identify accurate and stable spatial components of ACC structure. Between groups, we compared ACC structural indices in each spatial component based on treatment resistance or response and tested relationships with ACC glutamate + glutamine levels.Results: We detected reductions in cortical thickness and increases in mean diffusivity in the spatial components on the surface of the cingulate sulcus, especially in patients with treatment-resistant and clozapine-resistant schizophrenia. Notably, mean diffusivity in these components was higher in patients who did not respond to clozapine compared to those who did. Furthermore, these ACC structural alterations were related to elevated ACC glutamate + glutamine levels but not related to symptomatology or antipsychotic dose.Limitations: Sample sizes, cross-sectional findings and mixed antipsychotic status were limitations of this study.Conclusion: This study identified reproducible abnormalities in ACC structures in patients with treatment-resistant and clozapine-resistant schizophrenia. Given that these spatial components play a role in inhibitory control, the present study strengthens the notion that glutamate-related disinhibition is a common biological feature of treatment resistance in schizophrenia.