Evidence map›Paper›PMID 26948188›Full record

SynthesisThe lancet. Psychiatry2016

Brain-imaging studies of treatment-resistant schizophrenia: a systematic review.

Elias Mouchlianitis, Robert McCutcheon, Oliver D Howes

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The lancet. Psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 10 pooled it
12.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 10 syntheses or guidelines pooled it, 140 citations in OpenAlex.

  1. Pooled it
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  4. Guideline
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  6. Heterogeneity and efficacy of antipsychotic treatment for schizophrenia with or without treatment resistance: a meta-analysis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2020
    Pooled it
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  8. Guidelines for the Pharmacotherapy of Schizophrenia in Adults.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2017
    Pooled it
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  11. An etiological approach to psychosis: potential benefits for treatment, research and prevention.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Elias MouchlianitisDepartment of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.
Robert McCutcheonDepartment of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK; Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Institute of Clinical Science, Imperial College London, London, UK. Electronic address: robert.mccutcheon@kcl.ac.uk.
Oliver D HowesDepartment of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK; Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Institute of Clinical Science, Imperial College London, London, UK.
Imperial College London · GBKing's College London · GB

Funding

Medical Research Council G0700995Medical Research Council MC_U120097115Wellcome Trust 094849Wellcome Trust 200102
6 · The paper itself

Abstract

Around 30% of patients with schizophrenia show an inadequate response to antipsychotics-ie, treatment resistance. Neuroimaging studies can help to uncover the underlying neurobiological reasons for such resistance and identify these patients earlier. Additionally, studies examining the effect of clozapine on the brain can help to identify aspects of clozapine that make it uniquely effective in patients with treatment resistance. We did a systematic search of PubMed between Jan 1, 1980, and April 13, 2015, to identify all neuroimaging studies that examined treatment-resistant patients or longitudinally assessed the effects of clozapine treatment. We identified 330 articles, of which 61 met the inclusion criteria. Replicated differences between treatment-resistant and treatment-responsive patients include reductions in grey matter and perfusion of frontotemporal regions, and increases in white matter and basal ganglia perfusion, with effect sizes ranging from 0·4 to greater than 1. Clozapine treatment led to reductions in caudate nucleus volume in three separate studies. The available evidence supports the hypothesis that some of the neurobiological changes seen in treatment-resistant schizophrenia lie along a continuum with treatment-responsive schizophrenia, whereas other differences are categorical in nature and have potential to be used as biomarkers. However, further replication is needed, and for neuroimaging findings to be clinically translatable, future studies need to focus on a-priori hypotheses and be adequately powered.

Indexed as

Drug ResistanceAntipsychotic AgentsBrainClinical Trials as TopicHumansSchizophreniaTreatment OutcomeAntipsychotic Agents

Identifiers

PMID26948188
PMCPMC5796640
OpenAlexW2290746927

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.