Prefrontal cortical sulcal widening associated with poor treatment response to clozapine

Increased sulcal widening in the prefrontal cortex of patients with schizop hrenia may be associated with a poor treatment response to clozapine. To fu rther evaluate this, we examined data from patients treated with clozapine in our center. Patients with the greatest degree of improvement (n = 26) an d those with no improvement (n = 10) were compared. Computerized tomography (CT) scans were rated blindly on a visual scale of prefrontal sulcal widen ing. Patients with the greatest degree of functional improvement had signif icantly less prefrontal sulcal widening than those whose symptoms remained unchanged. There was no relationship between clozapine response and general sulcal widening. These data support the link between the superior therapeu tic efficacy of clozapine and the integrity of the prefrontal cortex. (C) 2 001 Elsevier Science B.V. All rights reserved.