The outline of the current project is to establish a cohort of patients with treatment refractory schizophrenia eligible for clozapine, to identify clinical and biological characteristics of clozapine responding patients. Patients will be offered treatment with clozapine according to national clinical guidelines. Before clozapine is initiated, patients will be offered a thoroughly neurobiological examination, and re-examination will be carried out after 12 weeks of treatment. The primary focus of the examinations will be immunological markers and autoantibodies in the blood and cerebrospinal fluid, permeability of the blood-brain barrier and magnetic resonance imaging of structural, neurochemical and functional brain changes.
Patients will be examined before and after 12 weeks of treatment with clozapine Examinations at baseline and follow up will be: * Clinical ratings * Blood inflammatory markers * Inflammatory markers in cerebro spinal fluid * MRI : examination of grey \& white matter, glutamate and GABA in Anterior Cingulate cortex and glutamate in thalamus, * selected cognitive measures
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
200
clinical doses adjusted to sideeffects and clinical effect
Mental Health Services Glostrup, Unit for Complicated Schizophrenia
Glostrup Municipality, Denmark, Denmark
RECRUITINGQalb
Quotient albumin (Qabl) in cerebrospinal fluid (CSF) compared to plasma
Time frame: Baseline
Change in Qalb
Change in quotient albumin in cerebrospinal fluid compared to plasma
Time frame: Baseline and after 12 weeks
Change in IL-6 and TGF-beta
Change in interleukin 6 (IL-6) and transcription growth factor beta (TGF-beta)
Time frame: Baseline and after 12 weeks
Change in FA, MD, AD and RD
Change in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD)
Time frame: Baseline and after 12 weeks
Change in cortical thickness as measured with FreeSurfer
Change in cortical thickness as measured with FreeSurfer
Time frame: Baseline and after 12 weeks
Change in glutamate in ACC and thalamus measured with MTI
Change in glutamate in anterior cingulate cortex (ACC) and thalamus measured with magnetic transfer imaging (MTI)
Time frame: Baseline and after 12 weeks
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