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Updated: Apr 4, 2026
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Standardized Data Acquisition for Neuromelanin-Sensitive Magnetic Resonance Imaging of the Substantia Nigra
Published on: September 8, 2021
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Dysfunctional Striatal Systems in Treatment-Resistant Schizophrenia
Thomas P White1,2, Rebekah Wigton1,3,4, Dan W Joyce1
1Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
Summary
Treatment-resistant schizophrenia may be a distinct subtype. This study found reduced ventral striatum to substantia nigra connectivity in these patients, suggesting differing brain pathways in treatment resistance.
Area of Science:
- Neuroscience
- Psychiatry
- Brain Imaging
Background:
- Treatment-resistant schizophrenia (TRS) suggests a distinct subtype, but its pathophysiology remains unclear.
- Information transfer in the striatum involves striato-cortico-striatal and striato-nigro-striatal pathways.
- The striato-nigro-striatal pathway's role in schizophrenia, particularly TRS, is understudied.
Purpose of the Study:
- To investigate differing patterns of resting striatal connectivity in treatment-resistant versus non-refractory schizophrenia patients.
- To test the hypothesis of contrasting striatal connectivity in these patient groups.
Main Methods:
- Functional pathways along the striatal axis were assessed in individuals with schizophrenia stratified by treatment resistance and matched controls.
- Resting-state functional connectivity was analyzed focusing on four key striatal foci.
Main Results:
- Treatment-resistant individuals showed reduced connectivity between the ventral striatum and substantia nigra compared to non-refractory patients.
- Disturbances in corticostriatal connectivity were more widespread in the treatment-resistant group.
- A more distributed pattern of abnormal connectivity may underlie medication non-response.
Conclusions:
- Findings support pathophysiological divergence between treatment-resistant and non-refractory schizophrenia.
- Reduced ventral striatum-substantia nigra connectivity is a potential biomarker for treatment resistance.
- Altered corticostriatal networks may contribute to the inefficacy of antipsychotic medications in TRS.
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