Quantified EEG changes associated with a positive clinical response to clozapine in schizophrenia

1. The authors conducted a retrospective exploratory computerized EEG study on the effect of clozapine in treatment-refractory schizophrenics, 10 high-responders (HRs) and 10 low-responders (LRs), in an attempt to correlate amplitude but especially coherence changes with a positive clinical response to clozapine. 2. EEGs with eyes closed were obtained before and during a clozapine treatment. Both groups had a similar drug profile with regards to non-clozapine medication. Probability maps were computed to illustrate changes of amplitude and coherence (for all combinations of paired electrodes) for 4 frequency bands (theta, alpha, beta 1 and 2). 3. The effect on AMPLITUDE was a generalized increase in lower bands and a decrease in anterior regions in higher bands of both HRs and LRs. Considerable changes of COHERENCE were observed on a wide set of paired electrodes in most frequency bands with some electrodes involved in HRs but uninvolved or differently involved in LRs suggesting differences in selected brain regions. 4. Changes of coherence but not amplitude were correlated with changes on the BPRS, thus to clinical improvement, and concerned mostly the right anterior-medial temporal (T4) and central (C4) electrodes paired with prefrontal electrodes, left central (C3), temporal (T3) and parietal (P3) electrodes in the theta band. 5. Clozapine has both generalized and regional effects as can be suspected considering its effect on many subtypes of brain receptors. A brain dysfunction centralized on the right anterior-medial temporal region may characterize treatment-refractory schizophrenics.