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BioMed Research International
Volume 2014, Article ID 325052, 9 pages
Clinical Study

Patients with Poor Response to Antipsychotics Have a More Severe Pattern of Frontal Atrophy: A Voxel-Based Morphometry Study of Treatment Resistance in Schizophrenia

1Biostructure and Bioimaging Institute, National Research Council, Via T. De Amicis 95, 80145 Naples, Italy
2Section of Psychiatry, Department of Neuroscience and Reproductive and Odontostomatological Sciences, University “Federico II”, 80131 Naples, Italy
3IDC Hermitage Capodimonte Spa, 80145 Naples, Italy
4Department of Advanced Biomedical Sciences, University “Federico II”, 80131 Naples, Italy
5Department of Neuroscience, Reproductive and Odontostomatological Sciences, University “Federico II”, 80131 Naples, Italy

Received 13 February 2014; Revised 20 June 2014; Accepted 11 July 2014; Published 23 July 2014

Academic Editor: Annalena Venneri

Copyright © 2014 Mario Quarantelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Approximately 30% of schizophrenia patients do not respond adequately to the therapy. Previous MRI studies have suggested that drug treatment resistance is associated with brain morphological abnormalities, although region-of-interest analysis of MR studies from nonresponder and responder patients failed to demonstrate a statistically significant difference between these two schizophrenia subgroups. We have used a voxel-based analysis of segmented MR studies to assess structural cerebral differences in 20 nonresponder and 15 responder patients and 16 age-matched normal volunteers. Differences between the three groups emerged bilaterally mainly at the level of the superior and middle frontal gyri, primarily due to reduced grey matter volumes in nonresponders, as compared to both normal volunteers and responder patients. Post hoc direct comparison between the two schizophrenia subgroups demonstrated significantly reduced grey matter volumes in middle frontal gyrus bilaterally, in the dorsolateral aspects of left superior frontal gyrus extending into postcentral gyrus and in the right medial temporal cortex. Our results extend and integrate previous findings suggesting a more severe atrophy in nonresponder schizophrenia patients, compared to responder patients, mainly at the level of the superior and middle frontal gyri. Longitudinal studies in drug-naïve patients are needed to assess the role of these associations.