Moderators and mediators of antipsychotic response in delusional disorder: Further steps are needed

Table 2 Therapeutic implications of brain lesions in delusional disorder

Ref.	Study design	Imaging method	Age	Contrast group	DD type	Main findings
Moderators of treatment response (structural brain findings)
Miller et al[45], 1989	Prospect	CT, MRI	Case 1: 86	Schizophr (n = 1)	Persecutory	Structural brain disease in all 3 cases contributed to treatment resistance
			Case 2: 72	Bipolar disorder (n = 1)
			Case 3: 62
Mediators of treatment response (changes in functional brain findings)
Wada et al[69], 1999	Case report	SPECT	Age = 78	-	Somatic	Reduced regional cerebral blood flow in the left temporal and parietal lobes improved at remission
Ota et al[70], 2003	Case report	SPECT	Age = 72	-	Somatic	Decreased perfusion in the left temporal and parietal lobes improved after treatment
Hayashi et al[71], 2004	Case report	SPECT	Age = 77	-	Somatic	Reduced regional cerebral blood flow in the left temporal and parietal lobes improved after treatment
Narumoto et al[74], 2006	Case report	SPECT	Age = 82	-	Somatic	Global decrease in rCBF
						Reversed in all non-stroke areas after remission
Hayashi et al[72], 2010	Case report	SPECT	Age = 42	-	Somatic	Reduced regional cerebral blood flow in the left temporal and parietal lobes normalized after treatment
Freudenmann et al[48], 2010	Prospect.	PET	Age = 27	Organic DD (n = 1)	Somatic	SPECT: D2R occupancy predicted remission
		SPECT				PET: Glucose metabolism in putamen and thalamus did not normalize with remission
Uezato et al[73], 2012	Case report	SPECT	Age = 53	-	Somatic	Hyperperfusion in the right temporal lobe normalized after electroconvulsive therapy

DD: Delusional disorder; CT: Computerized tomography; MRI: Magnetic resonance imaging; SPECT: Single photon emission computed tomography; rCBF: Regional cerebral blood flow; PET: Positron emission tomography. DaT: Striatal dopamine transporter; D2R: D2 receptor.