Schizophrenia
Conditions
Keywords
schizo-affective disorder, utra-resistance, clozapine, biomarker, fMRI
Brief summary
To objectify UR biomarkers, we propose a longitudinal follow-up of resistant patients with schizophrenia, starting before the onset of clozapine and including a multimodal brain imaging assessment (T1 and T2 weighted sequences, DTI, ASL-Perfusion, fMRI- Rest) associated with clinical and biological monitoring. In order to correct the MRI signal of clozapine hemodynamic effects, we will develop a new MRI methodology based on the concomitant collection of physiological parameters (blood pressure, electrocardiogram and respiration).
Detailed description
The identification of biomarkers of ultra-resistance (UR) to treatment in schizophrenia would allow earlier, better adapted and more effective personalized management of these patients, which would improve their functional prognosis. An early decrease in functional connectivity (FC) between some rest networks has recently been proposed as an UR biomarker by McNabb et al. Nevertheless, clozapine has, among its side effects, a direct cardiac action that profoundly modifies patient's hemodynamics. However, functional brain imaging techniques are based on BOLD effect which is dependent on these hemodynamic parameters. It is therefore not possible to say whether these differences in FC are inherent to the pathology or whether they are related to clozapine instauration which causes hemodynamic changes that may disturb BOLD signal. To objectify UR biomarkers, investigators propose a longitudinal follow-up of resistant patients, starting before clozapine instauration and including a multimodal brain imaging assessment (T1 and T2 weighted sequences, DTI, ASL-Perfusion, fMRI- Rest) associated with clinical and biological monitoring. In order to correct the MRI signal of clozapine hemodynamic effects, investigators will develop a new MRI methodology based on the concomitant collection of physiological parameters (blood pressure, electrocardiogram and respiration).
Interventions
OTHERfMRI
3 fMRI (TO, Month 2 and Month 6) 3 BDNF samples (TO, Month 2 and Month 6)
Sponsors
University Hospital, Caen
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* schizophrenia or schizoaffective disorder (DSM 5) * drug resistance * written patient approval * social security number in France * curator or tutor approval if needed
Exclusion criteria
* pregnancy * other research participation * neurological evolution disorder * no MRI contraindication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| functional resonance imaging: resting-state | baseline, Month 2 and Month 6 | Functional connectivity comparison between baseline, month 2 and month 6 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| BDNF samples | baseline, Month 2 and Month 6 | BDNF concentration comparison between baseline, month 2 and month 6 |
| functional resonance imaging: ASL | baseline, Month 2 and Month 6 | Cerebral perfusion comparison between baseline, month 2 and month 6 |
| anatomical resonance imaging: DTI | baseline, Month 2 and Month 6 | Anatomical connectivity comparison between baseline, month 2 and month 6 |
| anatomical resonance imaging: T1 | baseline, Month 2 and Month 6 | White and gray matter volumetric comparison between baseline, month 2 and month 6 |
Countries
France
Contacts
Primary ContactAnaïs Vandevelde, MD
Backup ContactOlivier Etard, MD
Outcome results
None listed