Distinguishing Between Treatment-Resistant and Non-Treatment-Resistant Schizophrenia Using Regional Homogeneity

Abstract

Background: Patients with treatment-resistant schizophrenia (TRS) and non-treatment-resistant schizophrenia (NTRS) respond to antipsychotic drugs differently. Previous studies demonstrated that patients with TRS or NTRS exhibited abnormal neural activity in different brain regions. Accordingly, in the present study, we tested the hypothesis that a regional homogeneity (ReHo) approach could be used to distinguish between patients with TRS and NTRS.Methods: A total of 17 patients with TRS, 17 patients with NTRS, and 29 healthy controls (HCs) matched in sex, age, and education levels were recruited to undergo resting-state functional magnetic resonance imaging (RS-fMRI). ReHo was used to process the data. ANCOVA followed by post-hoc t-tests, receiver operating characteristic curves (ROC), and correlation analyses were applied for the data analysis.Results: ANCOVA analysis revealed widespread differences in ReHo among the three groups in the occipital, frontal, temporal, and parietal lobes. ROC results indicated that the optimal sensitivity and specificity of the ReHo values in the left postcentral gyrus, left inferior frontal gyrus/triangular part, and right fusiform could differentiate TRS from NTRS, TRS from HCs, and NTRS from HCs were 94.12 and 82.35%, 100 and 86.21%, and 82.35 and 93.10%, respectively. No correlation was found between abnormal ReHo and clinical symptoms in patients with TRS or NTRS.Conclusions: TRS and NTRS shared most brain regions with abnormal neural activity. Abnormal ReHo values in certain brain regions might be applied to differentiate TRS from NTRS, TRS from HC, and NTRS from HC with high sensitivity and specificity.

Relationships between abnormal neural activities and cognitive impairments in patients with drug-naive first-episode schizophrenia

“…The abnormal regional spontaneous activities in the cuneus in the early stages of schizophrenia may cause higher-level cognitive impairments [51]. It was discovered that ReHo values decreased in right cuneus of patients with schizophrenia, which was partially consistent with previous findings [15,49]. We proposed that the disruption of the local synchronization of the spontaneous activities in these brain areas be related to the psychopathology of schizophrenia.…”

“…Regional homogeneity (ReHo) is a method employed in rs-fMRI and based on Kendall's coefficient of concordance to measure the temporal synchronization of the time series of each voxel and compare it with that of its adjacent neighbors [10]. Patients with SZ exhibit increased ReHo values in Dorsolateral Prefrontal Cortex (DLPFC) [11][12][13], medial prefrontal cortex [14], angular gyrus [15], precentral gyrus [16], and superior temporal gyrus [13] and decreased ReHo values in the superior temporal gyrus [13][14][15][16], occipital lobes [12,15,17], parietal lobule [14,16], precentral lobule [13,14], and postcentral gyrus [13,15,16]. A recent study showed positive correlations between attention function and mean ReHo values in the left middle frontal gyrus, right inferior/ middle temporal gyrus, angular gyrus, and inferior/superior parietal lobe in healthy control group, but no significant correlations were found in SZ group [18].…”

“…The reduced function of DLPFC plays a major role in pathophysiology of SZ and is associated with executive function deficits, response inhibition, and working memory errors [7,[19][20][21]. However, other brain areas, such as the superior temporal gyrus [13][14][15][16] and precentral lobule [14,16], have yielded inconsistent and controversial results, and the relationships between abnormal brain activities and cognitive impairments have not been well investigated.…”

Regional Homogeneity Brain Alterations in Schizophrenia: An Activation Likelihood Estimation Meta-Analysis

“…After initially removing the duplicates and browsing the title and summary, we found that 28 studies met the inclusion criteria, furthermore, after a detailed review of the full text, a total of 13 studies met the inclusion criteria. 8,9,11,12,[22][23][24][25][26][27][28][29][30] Figure 1 illustrates the identification and exclusion flow chart for the study. The included research reported ReHo differences in 511 schizophrenia (193 with FES and 318 with chronic schizophrenia), and compared with 452 HCs.…”

Enhanced Prefrontal Regional Homogeneity and Its Correlations With Cognitive Dysfunction/Psychopathology in Patients With First-Diagnosed and Drug-Naive Schizophrenia

“…Increased and decreased ReHo values represent abnormal neural activities (11). According to previous studies on subjects with a high risk of schizophrenia (12,13), first-episode adolescentonset drug-naïve schizophrenia (14,15), first-episode drug-naïve schizophrenia (16), chronic schizophrenia (17), and treatmentresistant schizophrenia (18), abnormal ReHo may be a good biomarker to distinguish patients with schizophrenia from healthy controls with increased or decreased ReHo values in different regions. However, previous results were inconsistent.…”