Schizophrenia Clinical Trial
Official title:
Research of Anatomo-functional Biomarkers in Schizophrenia
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).
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).
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