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Predicting treatment response from dopamine D2/3 receptor bnding potential? - A study in antipsychotic-naïve patients with schizophrenia

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Background and aim: One of the best validated findings in schizophrenia is the association between increased striatal dopaminergic transmission and positive psychotic symptoms. Numerous studies have likewise confirmed an association between blockade of striatal dopamine D2 receptors and the effect of antipsychotic compounds on the positive symptoms. Furthermore, blockade of striatal dopamine D2 receptors have in studies shown to associate negatively with subjective well-being.
Our main aim was to explore a possible predictive value of striatal dopamine D2/3 receptor binding potential (BPp) for treatment outcome in a cohort of antipsychotic-naïve first-episode schizophrenia patients. We further wanted to explore possible associations between the dopamine blockade and alterations of negative symptoms as well as functioning and subjective well-being.
Materials and methods: The Study was a longitudinal study of 29 antipsychotic-naïve patients with schizophrenia and 26 matched healthy controls, SPECT with [123l]-IBZM was used to examine the BPP of striatal dopamine D2/3 receptors. The participants were examined at baseline and after 6 weeks of treatment with a selective D2/3 receptor antagonist, amisulpride.
Results: We found a significant inverse correlation between the striatal BPp at baseline and improvement of positive symptoms (p=0.046; R squared = 0.152) after six weeks of treatment with amisulpride. There was no association between the blockade of the D2/3 receptors and improvement of positive symptoms. All patients had an increase of negative symptoms at follow-up, and there was an inverse correlation between the blockade and functioning (p=0.037; Spearman’s rho=-0.457).
Conclusion: Our results show an association between striatal BPp of dopamine D2/3 receptors in antipsychotic-naïve first-episode patients with schizophrenia and treatment response. Patients with a low BPp have a better treatment response than patients with a high BPp supporting that patients with a high BPp might have a different neurochemical profile. The results further suggested that the more the dopamine receptors were blocked the worse the functioning. Our findings contribute to the research of heterogeneous response in schizophrenia patients to antipsychotic treatment, and underline the importance of stratified medicine in schizophrenia.
Original languageEnglish
Publication date8 Oct 2014
Number of pages1
Publication statusPublished - 8 Oct 2014
EventForskningsdag 2014, Glostrup Hospital - Glostrup, Denmark
Duration: 8 Oct 20148 Oct 2014

Conference

ConferenceForskningsdag 2014, Glostrup Hospital
CountryDenmark
CityGlostrup
Period08/10/201408/10/2014

Event

Forskningsdag 2014, Glostrup Hospital

08/10/201408/10/2014

Glostrup, Denmark

Event: Conference

ID: 44628896