68% chance of identifying patients resistant to existing drugs
Posted on 03.24.2024 at 10.50pm Posted on 03.24.2024 at 10.50pm Modified on 03.24.2024 at 8.24pm Views 3
A new study suggests that the right treatment for schizophrenia patients can be found using a specific magnetic resonance imaging (MRI) that focuses on a brain pigment called neuromelanin. [사진=게티이미지뱅크]A new study suggests that the right treatment for schizophrenia patients can be found using a specific magnetic resonance imaging (MRI) that focuses on a brain pigment called neuromelanin. This is what the medical and health webzine “Health Day” recently reported based on an article by Dutch researchers published in the American Journal of Psychiatry.
This MRI, called “neuromelanin response MRI” (NM-MRI), was designed based on the fact that treatment-resistant schizophrenia patients have lower dopamine secretion. Dopamine is a substance (neurotransmitter) that transmits information between nerve cells. The greater the amount of dopamine secreted, the greater the pleasure and excitement perceived by the brain. Patients with schizophrenia often have excessive dopamine secretion, resulting in aggression and poor impulse control.
A pigment called neuromelanin is produced when dopamine is secreted from the substantia nigra of the midbrain. When dopamine secretion increases, neuromelanin accumulates in nerve cells. Therefore, among schizophrenic patients, those with high neuromelanin can receive general treatment, and those with low neuromelanin can start clozapine early, which is the last drug prescribed to resistant patients.
Researchers led by Marieke van der Flim, a postdoctoral researcher at the University of Amsterdam in the Netherlands, said NM-MRI could represent a “game changer” in the treatment of schizophrenia. This is because it has been shown that neuromelanin levels, which are the standard for dopamine function, can be an early biomarker of treatment resistance.
The researchers conducted NM-MRI scans on 79 patients aged 18 to 35 who first developed schizophrenia and 20 healthy control subjects. At 6 months, the relationship between NM-MRI signals and treatment response was examined, and patients who responded to overall treatment were divided into responders and those who did not respond were classified as nonresponders.
People who showed moderate or elevated symptoms in one of five areas, including delusions, hallucinations, postures and unusual thoughts, after two trials of antipsychotic drugs were classified as non-responders. Patients were considered non-responders if they did not respond to another antipsychotic medication or if they experienced serious side effects and were prescribed clozapine during the study period.
Seventeen patients were excluded, mainly due to non-adherence to medications or change in diagnosis. Of the remaining 62 patients, 47 were classified as responders and 17 as nonresponders. Of the 17 non-responders, 15 had significantly lower NM-MRI signals.
The researchers said they were able to predict which patients would respond to treatment with up to 68% accuracy based on the neuromelanin tests. Additional NM-MRI scans were performed on 28 responders and 9 non-responders, and the NM-MRI signals remained the same for 6 months.
The researchers said: “This study shows the potential of NM-MRI as a non-invasive biomarker for treatment resistance in early schizophrenia” and added: “Through an appropriate prediction model, treatment resistance in schizophrenia can be identified early and the delay in the effect can be significantly reduced.” “It is,” she said.
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