Elsevier

Biological Psychiatry

Volume 29, Issue 9, 1 May 1991, Pages 865-877
Biological Psychiatry

Prefrontal sulcal prominence is inversely related to response to clozapine in schizophrenia

https://doi.org/10.1016/0006-3223(91)90053-OGet rights and content

Abstract

The object of this study was to determine if brain computed tomography (CT) scan measures are related to treatment response to clozapine, an atypical antipsychotic drug that is effective in some therapy-resistant schizophrenic patients. Thirty-four therapy-resistant patients were evaluated with the Brief Psychiatric Rating Scale (BPRS) before and after 6 weeks of treatment with clozapine. The patients were classified into Nonresponders, Moderate Responders, and Good Responders based on the percent change in BPRS. Comparison of these groups on prefrontal sulcal prominence (PSP) indicated a statistically significant linear trend, with nonresponders having the highest, moderate responders an intermediate degree, and good responders the least PSP. There were no linear trends for the ventricular-brain ratio (VBR), and no quadratic trends for either brain measure. A similar linear trend relating PSP to four of five BPRS subscales, including both positive and negative symptoms, was observed. The relationship between PSP and treatment response was also assessed with multiple linear regression, and PSP significantly contributed to prediction of BPRS at 6 weeks. The results are discussed with regards to the hypothesis that the effect of clozapine on psychopathology depends on prefrontal cortical function.

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      We are not aware of any studies examining structural changes following CLZ treatment in TRS, although several investigations have reported on baseline structural predictors of CLZ response. Friedman et al. (1991) found that CLZ response was positively related to a smaller prefrontal sulcal prominence at baseline, reflecting prefrontal atrophy, in those with TRS (Friedman et al., 1991). Konicki et al. (2001) reported that CLZ responders with TRS had less prefrontal sulcal widening at baseline than nonresponders (Konicki et al., 2001).

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