Abstract
Background: Insufficient treatment response to dopaminergic antipsychotics constitutes a major challenge in the treatment of patients with schizophrenia and seems to be related to persistently high levels of the neurotransmitter glutamate. Excess glutamate is neurotoxic and may cause the progressive loss of brain tissue and social functions seen in many patients.
Aim of PECANS II: To test if persistently high levels of glutamate and loss of brain tissue and social functions characterize a subgroup of patients with poor treatment response, while dopaminergic disturbances characterize another subgroup with good treatment response.
Materials and methods: PECANS II is a prospective follow-up study of 60 initial antipsychotic naïve patients with schizophrenia and 60 matched healthy controls. Brain levels of glutamate are measured with proton magnetic resonance imaging (1H-MRS), dopaminergic disturbances with positron emission tomography (PET) scanning, and loss of brain tissue with analysis of a structural MR-scanning revealing loss of cortical thickness and surface area. Neurochemical and structural disturbances are compared with treatment response and level of function as measured by various rating scales. All examinations are performed before and after 6 weeks’ treatment with a partial dopamine agonist (aripiprazole), and further after 6 months and 2 years. Patients are also examined with neuropsychological and psychophysiological test batteries as part of co-operating projects.
Results: Inclusion started 1 January 2014 and is ongoing until the end of 2016.
Conclusion: Identification of subgroups of patients with schizophrenia with distinct pathophysiological disturbances is clinically crucial, since brain levels of glutamate, loss of brain tissue, and dopaminergic disturbances may serve as markers for best-choice-of-treatment. Further, the results can pave the way for the development of new antipsychotic medication modulating glutamatergic disturbances and lead to better prevention strategies for the progressive loss of brain tissue and social functions in a treatment resistant subgroup of patients with schizophrenia.
The study is unique, due to the focus on glutamate and dopamine in antipsychotic naïve patients with schizophrenia.
Aim of PECANS II: To test if persistently high levels of glutamate and loss of brain tissue and social functions characterize a subgroup of patients with poor treatment response, while dopaminergic disturbances characterize another subgroup with good treatment response.
Materials and methods: PECANS II is a prospective follow-up study of 60 initial antipsychotic naïve patients with schizophrenia and 60 matched healthy controls. Brain levels of glutamate are measured with proton magnetic resonance imaging (1H-MRS), dopaminergic disturbances with positron emission tomography (PET) scanning, and loss of brain tissue with analysis of a structural MR-scanning revealing loss of cortical thickness and surface area. Neurochemical and structural disturbances are compared with treatment response and level of function as measured by various rating scales. All examinations are performed before and after 6 weeks’ treatment with a partial dopamine agonist (aripiprazole), and further after 6 months and 2 years. Patients are also examined with neuropsychological and psychophysiological test batteries as part of co-operating projects.
Results: Inclusion started 1 January 2014 and is ongoing until the end of 2016.
Conclusion: Identification of subgroups of patients with schizophrenia with distinct pathophysiological disturbances is clinically crucial, since brain levels of glutamate, loss of brain tissue, and dopaminergic disturbances may serve as markers for best-choice-of-treatment. Further, the results can pave the way for the development of new antipsychotic medication modulating glutamatergic disturbances and lead to better prevention strategies for the progressive loss of brain tissue and social functions in a treatment resistant subgroup of patients with schizophrenia.
The study is unique, due to the focus on glutamate and dopamine in antipsychotic naïve patients with schizophrenia.
| Original language | English |
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| Publication date | 8 Oct 2014 |
| Number of pages | 1 |
| Publication status | Published - 8 Oct 2014 |
| Event | Forskningsdag 2014, Glostrup Hospital - Glostrup, Denmark Duration: 8 Oct 2014 → 8 Oct 2014 |
Conference
| Conference | Forskningsdag 2014, Glostrup Hospital |
|---|---|
| Country/Territory | Denmark |
| City | Glostrup |
| Period | 08/10/2014 → 08/10/2014 |