Posted by Phillipa on August 16, 2013, at 20:18:41
No real idea what this means. Thought might be of interest for those who do understand. Phillipa
Medscape Medical News > PsychiatryBrain Imaging May Help Identify Antipsychotic Responders
Caroline Cassels
Aug 14, 2013
Researchers have identified a new neuroimaging marker that may help predict which patients with first-episode psychosis (FEP) will respond to treatment and which will not.Investigators at the King's College London's Institute of Psychiatry in the United Kingdom found a significant reduction in cortical gyrification across multiple brain regions in patients with FEP compared with healthy control individuals and FEP nonresponders. Nonresponders showed prominent hypogyria at bilateral insular, left frontal, and right temporal regions when compared with responders.
"Our study provides crucial evidence of a neuroimaging marker that, if validated, could be used early in psychosis to help identify those people less likely to respond to medications. It is possible that the alterations we observed are due to differences in the way the brain has developed early on in people who do not respond to medication compared to those who do," senior investigator Paola Dazzan, MD, MRCPsych, PhD, said in a release.
The study was published online August 14 in JAMA Psychiatry.
No Reliable Predictor
Currently, the investigators note, there is no reliable predictor of treatment response in FEP, yet early response to therapy is considered to be one of the strongest predictors of subsequent functional outcome in psychosis.
Among potential neuroimaging predictors of treatment response, the investigators note that cortical gyrification, the extent of folding of the cerebral cortex and a marker of how it has developed, "holds a distinct potential to investigate early neurodevelopmental disturbances that may contribute to the psychopathology of psychosis and that may characterize, already at illness onset, a subgroup of patients with particularly poor outcome."
Using magnetic resonance imaging, the investigators scanned the brains of 126 individuals 80 with FEP and 46 healthy control individuals at study outset. Patients with FEP were then treated and assessed 12 weeks later to determine treatment response to antipsychotic medications given in a naturalistic clinical setting.
Toward Personalized Treatment
The investigators found that patients with FEP showed a significant reduction in gyrification across multiple brain regions compared with healthy control individuals.
Information from Industry
They also found that individuals who did not respond to treatment had a significant reduction in gyrification across multiple brain regions, including the bilateral insular, left frontal, and right temporal regions, compared with responders. In addition, these effects were present for both affective and nonaffective psychosis.
"There have been few advances in developing novel antipsychotic drugs over the past 50 years, and we still face the same problems with a subgroup of people who do not respond to the drugs we currently use," said Dr. Dazzan.
"We could envisage using a marker like this one to identify people who are least likely to respond to existing medications and focus our efforts on developing new medication specifically adapted to this group. In the longer term, if we were able to identify poor responders at the outset, we may be able to formulate personalized treatment plans for that individual patient," she added.
Dr. Dazzan reports no relevant financial relationships. The disclosures of the remaining authors can be found in the original article.
JAMA Psychiatry. Published online August 14, 2013. Abstract
poster:Phillipa
thread:1049189
URL: http://www.dr-bob.org/babble/20130730/msgs/1049189.html