Neuroimaging biomarkers to predict treatment response in schizophrenia: the end of 30 years of solitude?
Studies that have used structural magnetic resonance imaging (MRI) suggest that individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, and in the white matter tracts that connect them. Furthermore, these studies suggest that brain alterations may be particularly prominent, already at illness onset, in those individuals more likely to have poorer outcomes (eg, higher number of hospital admissions, and poorer symptom remission, level of functioning, and response to the first treatment with antipsychotic drugs). The fact that, even when present, these brain alterations are subtle and distributed in nature, has limited, until now, the utility of MRI in the clinical management of these disorders. More recently, MRI approaches, such as machine learning, have suggested that these neuroanatomical biomarkers can be used for direct clinical benefits. For example, using support vector machine, MRI data obtained at illness onset have been used to predict, with significant accuracy, whether a specific individual is likely to experience a remission of symptoms later on in the course of the illness. Taken together, this evidence suggests that validated, strong neuroanatomical markers could be used not only to inform tailored intervention strategies in a single individual, but also to allow patient stratification in clinical trials for new treatments.
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK; National Institute for Health Research, Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK.
Paola
P
Dazzan
D014150:Antipsychotic Agents / Q000627:therapeutic use; D001185:Artificial Intelligence; D015415:Biomarkers / Q000032:analysis*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D012559:Schizophrenia / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology*; D060388:Support Vector Machine
D014150:Antipsychotic Agents; D015415:Biomarkers
first-episode schizophrenia; magnetic resonance imaging; psychosis