Brain scans could predict response to antipsychotic medication

Researchers from The University of Nottingham and King's College London have identified neuroimaging markers in the brain which could help predict whether people with psychosis respond to antipsychotic medications or not. In approximately half of young people experiencing their first episode of a psychosis (FEP), the symptoms do not improve considerably with the initial medication prescribed, increasing the risk of subsequent episodes and worse outcome. Identifying individuals at greatest risk of not responding to existing medications could help in the search for improved medications, and may eventually help clinicians personalise treatment plans. In a study published today in JAMA Psychiatry , researchers used structural Magnetic Resonance Imaging (MRI) to scan the brains of 126 individuals — 80 presenting with FEP, and 46 healthy controls. Participants had an MRI scan shortly after their FEP, and another assessment 12 weeks later, to establish whether symptoms had improved following the first treatment with antipsychotic medications The researchers examined a particular feature of the brain called "cortical gyrification" — the extent of folding of the cerebral cortex and a marker of how it has developed. They found that the individuals who did not respond to treatment already had a significant reduction in gyrification across multiple brain regions, compared to patients who did respond and to individuals without psychosis. This reduced gyrification was particularly present in brain areas considered important in psychosis, such as the temporal and frontal lobes.