White matter connectivity related to paliperidone treatment response in patients with schizophrenia = 조현병 환자에서 팔리페리돈 치료 반응과 연관된 뇌 백질 연결성

국문 초록 (Abstract)

본 연구의 목적은 조현병 환자의 팔리페리돈 항 정신병 약물 치료 초기의 뇌 백질 연결성과 치료 반응과의 연관성에 대해 알아보고자 한 것이다. 41명의 조현병 환자와 성별 및 나이에서 유사한 17명의 건강 대조군이 연구에 참여하였다. 모든 참가자는 치료 초기에 3 Tesla 뇌 자기 공명 영상 촬영을 하였다. Tract-Based Spatial Statistics를 이용한 화소 기반 통계법을 통해 분획 이방성(fractional anisotropy) 자료를 분석하였다. 치료 시작점과 치료 후 8주차에 Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS)를 이용하여 조현병 환자의 치료 반응을 평가하였다. 조현병 환자에서, corpus callosum, corona radiata, internal capsule, external capsule, superior longitudinal fasciculus와 전두엽, 측두엽 부위의 뇌 백질 분획 이방성 수치와 8주 간의 치료 반응 사이에서 통계적으로 유의한 음의 상관관계가 관찰되었다. 본 연구는 조현병 환자에서 팔리페리돈 치료 반응은 전두-측두-변연계 부위의 뇌 백질 연결성과 관계가 있다는 것을 보고하였으며, 향후 추가적 연구를 통해 확증된다면, 이는 조현병 환자에서 팔리페리돈 치료 반응을 예측하는 인자로서 사용될 수 있을 가능성을 제시한다.

다국어 초록 (Multilingual Abstract)

The objective of this study is to examine whether white matter (WM) connectivity of patients with schizophrenia at early stage of treatment is related to treatment response after paliperidone extended-release (ER) treatment. Forty-one patients with schizophrenia and 17 age- and sex-matched healthy control subjects were included in this study. Brain magnetic resonance scans at 3 Tesla were conducted at early stage of treatment. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics. At baseline and 8 weeks after paliperidone treatment, patients were assessed using the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Positive Symptoms (SAPS), and the Scale for the Assessment of Negative Symptoms (SANS). Among the patients with schizophrenia, the FA values of corpus callosum, corona radiata, internal capsule, external capsule, superior longitudinal fasciculus, and fronto-temporal WM regions showed significant negative correlations with scores of the treatment response. The current study suggests that the treatment response after paliperidone ER treatment may be associated with the fronto-temporo-limbic WM connectivity at early stage of treatment in patients with schizophrenia, and it could be used as a predictor of treatment response to paliperidone ER treatment after studies with large samples verify these results.

목차 (Table of Contents)

• I. INTRODUCTION 1
• II. MATERIALS AND METHODS 6
• 1. Subjects 6
• 2. Clinical assessment 7
• 3. MRI procedure 10
• 4. Genotype analysis 10
• 5. Statistical analysis 12
• Ⅲ. RESULTS 14
• 1. Sociodemographic and clinical characteristics 14
• 2. Genetic analysis 18
• 3. Correlation analysis between WM connectivity at early stage of treatment and treatment response 18
• 4. Comparison of the WM connectivity at early stage of treatment between the symptomatic remission group and the non-remission group for subgroup analysis in patients with schizophrenia 23
• IV. DISCUSSION 25
• V. CONCLUSION 32
• REFERENCES 33
• ABSTRACT IN ENGLISH 40