The following is a summary of “Neuromelanin-Sensitive MRI as Candidate Marker for Treatment Resistance in First-Episode Schizophrenia,” published in the March 2024 issue of Psychiatry by Pluijm et al.

The current lack of markers for treatment resistance in schizophrenia delays effective treatment. Neuromelanin-sensitive MRI (NM-MRI), a noninvasive measure of dopamine function, may hold promise as a marker for non-responders.

Researchers conducted a retrospective study investigating whether the NM-MRI signal is lower in non-responders compared to responders with schizophrenia.

They conducted NM-MRI scans on 79 individuals experiencing first-episode psychosis, along with 20 HCs matched for demographics. Treatment response evaluation occurred at a 6-month follow-up. In patients, the relationship between NM-MRI signal and treatment response was examined through an a priori voxel-wise analysis within the substantia nigra.

The results showed that of 62 patients, 15 were classified as non-responders and 47 as responders, with 17 excluded due to medication nonadherence or diagnosis changes. Voxel-wise analysis revealed 297 significant voxels in the ventral tier of the substantia nigra negatively associated with treatment response. Non-responders and healthy control subjects had lower NM-MRI signals than responders. The receiver operating characteristic curve analysis demonstrated that the NM-MRI signal distinguished non-responders, with areas under the curve ranging from 0.62 to 0.85. Over six months, the NM-MRI signal remained unchanged in patients.

Investigators concluded that NM-MRI signal differences between responders and non-responders strengthen the case for its potential use as a treatment resistance marker in schizophrenia.

Source: ajp.psychiatryonline.org/doi/10.1176/appi.ajp.20220780