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Citation

Lawrie SM, Ingle GT, Santosh CG, Rogers AC, Rimmington JE, Naidu KP, Best JJK, O'Carroll R, Goodwin GM, Ebmeier KP & Johnstone EC (1995) Magnetic resonance imaging and single photon emission tomography in treatment-responsive and treatment-resistant schizophrenia. British Journal of Psychiatry, 167 (2), pp. 202-210. https://doi.org/10.1192/bjp.167.2.202

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 patients. 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.

Journal
British Journal of Psychiatry: Volume 167, Issue 2