Neuromelanin MRI as Biomarker for Treatment Resistance in First Episode Schizophrenia

Treatment resistance in schizophrenia (TRS) is a major clinical problem with 20-35% of psychotic patients showing non-response to standard antipsychotic treatment. Neuromelanin-sensitive MRI sequence (NM-MR), which indirectly measures dopamine synthesis in the substantia nigra (SN), has potential as biomarker for TRS, since TRS patients have lower dopamine synthesis than treatment responders with positron emission tomography imaging. NM-MRI indeed shows increased signal in schizophrenia patients, but has not yet been tested in TRS. The current study investigated if TRS patients show lower NM-MRI signal than responders.