A Case-Control Study On Corpus Callosum Volume and Clinical Correlates in Treatment-Resistant and Responsive Schizophrenia Patients: Addressing MRI Analysis within Single-Subject and a Novel Artificial Intelligence Paradigm.
Authors
Affiliations (7)
Affiliations (7)
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Rome, Italy.
- Department of Mental Health Protection and Promotion, Unit of Addiction Pathology, ASL di Rieti, Rieti, Rome, Italy.
- Villa Von Siebenthal Neuropsychiatric Clinic, Department of Neuropsychiatry, Genzano di Roma, Rome, Italy.
- UOC DSMDP District ASL ROMA 6, TSMREE, Velletri, Rome, Italy.
- A.T. Beck Institute - Diagnostic, Research and Training Centre in CognitiveBehavioural Psychotherapy, Rome, Italy.
- Laboratory of Molecular and Translational Psychiatry, Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples 'Federico II', and Clinical Section of Psychiatry and Psychology, Unit for Treatment Resistant Psychoses, Naples, Italy.
- University of Naples Federico II Laboratory of Molecular and Translational Psychiatry Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Naples Italy.
Abstract
The corpus callosum (CC) is critical for inter-hemispheric integration, and its structural abnormalities have been implicated in the neurobiology of schizophrenia (SCZ). Approximately 20-35% of SCZ patients exhibit resistance to antipsychotics and are classified as treatment-resistant schizophrenia (TRS). To date, no studies have specifically analyzed CC morphology in TRS compared to healthy controls (HCs) and treatment-responsive SCZ patients (non-TRS). The study included 75 HCs and 97 SCZ patients (39 TRS and 58 non-TRS, including cannabis users and non-users). Participants underwent cross-sectional assessment using the Neurological Evaluation Scale (NES), the Brief Assessment of Cognition in Schizophrenia, and the Positive and Negative Syndrome Scale (PANSS). CC volume was measured via MRI and analyzed with a novel artificial intelligence program (MRI-AI) for single-subject assessment, with findings confirmed through group-level voxel-based morphometry (VBM). TRS patients exhibited significantly higher total PANSS (p < 0.001) and NES (p < 0.001) scores and performed worse on working memory tasks compared to non-TRS patients. MRI-AI identified CC volume reduction in 55.88% of TRS patients (TRS CC: 3.02 mL vs. non-TRS with cannabis use: 3.69 mL; without cannabis use: 3.28 mL; p = 0.002). VBM confirmed significant CC volume reduction in TRS patients relative to HCs (p = 0.004). Cannabis use in non-TRS patients did not significantly affect CC volume or cognitive performance. TRS is associated with pronounced neurological, cognitive, and clinical dysfunctions. Aberrant CC volume may contribute to TRS pathogenesis and executive function deficits. MRI-AI provides a robust, single-subject approach for characterizing CC abnormalities in schizophrenia, offering potential for personalized clinical assessment.