UMMS Affiliation

Department of Psychiatry; Implementation Science and Practice Advances Research Center

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Mental and Social Health | Mental Disorders | Nervous System | Psychiatry | Psychiatry and Psychology | Therapeutics


BACKGROUND: Antipsychotic medications are the common treatment for schizophrenia. However, reliable biomarkers that can predict individual treatment response are still lacking. The present study aimed to examine whether baseline putamen activity can predict individual treatment response in schizophrenia.

METHODS: Two independent samples of patients with drug-naive, first-episode schizophrenia (32 patients in sample 1 and 44 in sample 2) and matched healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) at baseline. Patients were treated with olanzapine for 8 weeks; symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS) at baseline and week 8. Fractional amplitude of low frequency fluctuation (fALFF) and pattern classification techniques were used to analyze the data.

FINDINGS: Univariate analysis shows an elevated pre-treatment fALFF in the left ventromedial putamen in both patient samples compared to healthy controls (p's < 0.001). The support vector regression (SVR) analysis suggests a positive relationship between baseline pre-treatment fALFF in the left ventromedial putamen and improvement in positive symptom at week 8 in each patient group using a cross-validated method (r=0.452, p=.002; r=0.511, p=.003, respectively).

INTERPRETATION: Our study suggests that elevated pre-treatment mean fALFF in the left ventromedial putamen may predict individual therapeutic response to olanzapine treatment in drug-naive, first-episode patients with schizophrenia. Future studies are needed to confirm whether this finding is generalizable to patients with schizophrenia treated with other antipsychotic medications.

FUND: The National Key RandD Program of China and the National Natural Science Foundation of China.


Fractional amplitude of low frequency fluctuation, Olanzapine, Pattern classification, Schizophrenia

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© 2019 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://

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EBioMedicine. 2019 Aug;46:248-255. doi: 10.1016/j.ebiom.2019.07.022. Epub 2019 Jul 12. Link to article on publisher's site

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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