Anterior cingulate GABA and functional connectivity associated with initial treatment response in first-episode schizophrenia.
Tianhao Gao, Robert C Smith, Xuan Li et al.
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In 30 seconds
This randomized study examined whether anterior cingulate cortex (ACC) GABA levels and functional connectivity were associated with initial antipsychotic response in 87 people with first-episode schizophrenia. Participants were assessed at baseline and week 8 and classified as first-trial responders (FTR; n = 52) or first-trial failures (FTF; n = 35). ACC GABA levels were significantly higher in FTR than FTF patients and were associated with clinical response. FTF patients also showed greater visual-network functional connectivity, while within this group ACC GABA was positively correlated with ACC functional connectivity.
Key findings
- ACC GABA levels were significantly higher in first-trial responders than in first-trial failures.
- Higher ACC GABA levels were significantly associated with clinical response.
- First-trial failures showed hyperactive visual-network functional connectivity compared with responders.
- Among first-trial failures, ACC GABA was positively correlated with ACC functional connectivity.
Why it matters
The findings link neurochemical and connectivity measures in the ACC with early antipsychotic response in first-episode schizophrenia. They suggest these measures may help clarify biological differences between responders and nonresponders, while the observed associations do not establish that GABA causes treatment response or that modifying GABA would improve outcomes.
What to keep in mind
The abstract reports associations between imaging measures and response but does not establish causality. Follow-up for symptom assessment was limited to baseline and week 8.