Prevalence of Thoracic Scoliosis in Koreans Using Simple Chest Radiography

OBJECTIVES@#To provide reference data for the study and treatment of thoracic scoliosis.SUMMARY OF LITERATURE REVIEW: There have been no reports on the prevalence of thoracic scoliosis in Korea.@*MATERIALS AND METHODS@#From August 2011 to October 2012, radiographs of patients under 80 years of age who underwent routine chest radiographs were retrospectively reviewed. Based on their age when the chest radiographs were obtained, the patients were divided into 8 groups. The prevalence and angle of the curve of thoracic scoliosis were investigated in each age group, and the prevalence of thoracic scoliosis according to sex, the direction of the curve, number of vertebrae in the major curve, the location and rotation of the apical vertebrae, and osteophyte location were examined.@*RESULTS@#The prevalence of thoracic scoliosis was 2.4% (621 patients), and female patients (3.0%, 375 of 12471) showed a higher prevalence than male patients (1.8%, 246 of 13654) (p<0.001). Right curvature was present in 445 patients and left curvature in 176 patients. In each age group, the prevalence and degree of thoracic scoliosis were 1.1% (14.2°±3.2°), 2.3% (17.4°±7.7°), 2.5% (17.0°±8.9°), 1.9% (15.8°±5.9°), 1.3% (15.5°±6.6°), 2.1% (18.0°±13.6°), 2.9% (14.3°±3.6°), and 6.1% (16.2°±4.8°), respectively. The mean curvature in all scoliosis patients was 16.0°±7.0°. The angle of the curve was significantly different by sex (15.4°±7.1° for males, 16.8°±7.6° for females). The average curve angle of patients with thoracic scoliosis was 16.0°±7.0°, among whom it was 10°–20° in 533 patients, 20°–30° in 64, 30°–40° in 11, and over 40° in 13.@*CONCLUSIONS@#This study could be used as a reference point for the study and treatment of thoracic scoliosis.

Prevalence of Thoracic Scoliosis in Koreans Using Simple Chest Radiography / 대한척추외과학회지

STUDY DESIGN: A cross-sectional study. OBJECTIVES: To provide reference data for the study and treatment of thoracic scoliosis. SUMMARY OF LITERATURE REVIEW: There have been no reports on the prevalence of thoracic scoliosis in Korea. MATERIALS AND METHODS: From August 2011 to October 2012, radiographs of patients under 80 years of age who underwent routine chest radiographs were retrospectively reviewed. Based on their age when the chest radiographs were obtained, the patients were divided into 8 groups. The prevalence and angle of the curve of thoracic scoliosis were investigated in each age group, and the prevalence of thoracic scoliosis according to sex, the direction of the curve, number of vertebrae in the major curve, the location and rotation of the apical vertebrae, and osteophyte location were examined. RESULTS: The prevalence of thoracic scoliosis was 2.4% (621 patients), and female patients (3.0%, 375 of 12471) showed a higher prevalence than male patients (1.8%, 246 of 13654) (p<0.001). Right curvature was present in 445 patients and left curvature in 176 patients. In each age group, the prevalence and degree of thoracic scoliosis were 1.1% (14.2°±3.2°), 2.3% (17.4°±7.7°), 2.5% (17.0°±8.9°), 1.9% (15.8°±5.9°), 1.3% (15.5°±6.6°), 2.1% (18.0°±13.6°), 2.9% (14.3°±3.6°), and 6.1% (16.2°±4.8°), respectively. The mean curvature in all scoliosis patients was 16.0°±7.0°. The angle of the curve was significantly different by sex (15.4°±7.1° for males, 16.8°±7.6° for females). The average curve angle of patients with thoracic scoliosis was 16.0°±7.0°, among whom it was 10°–20° in 533 patients, 20°–30° in 64, 30°–40° in 11, and over 40° in 13. CONCLUSIONS: This study could be used as a reference point for the study and treatment of thoracic scoliosis.

Correction of Single Thoracic Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation: Comparison of Stainless Steel to Titanium Alloy Instruments / 대한정형외과학회잡지

PURPOSE: To compare the results of two different instruments made of stainless steel and titanium alloy for correction of single thoracic adolescent idiopathic scoliosis (AIS) using pedicle screw instrumentation. MATERIALS AND METHODS: A total of 141 patients with single thoracic AIS treated with pedicle screw instrumentation and selective thoracic fusion were retrospectively reviewed after a follow-up of 2 years. The patients had a main thoracic curve of 40° to 75° and were divided into two groups based on instrument materials; S group (stainless steel, n=90) and T group (titanium alloy, n=51). The diameter of the stainless steel rod used was 7.0 mm while that of the titanium alloy rod was 6.35 mm or 6.0 mm. Standing long-cassette radiographic measurements including various coronal and sagittal parameters for the preoperative, early postoperative and 2-year postoperative follow-up were analyzed. There were no significant differences in the preoperative curve characteristics between the two groups. RESULTS: In the S group, the preoperative main thoracic curve of 51.3°±8.4° was improved to 19.0°±7.6° (63.1% correction) and the lumbar curve of 32.3°±8.4° spontaneously decreased to 12.7°±8.2° (62.9% correction) at 2 years postoperatively. In the T group, the preoperative main thoracic curve of 49.5°±8.4° and the lumbar curve of 30.3°±8.9° was improved to 18.8°±7.4° (62.2% correction) and 11.3°±5.4° (63.3% correction), respectively. The corrections of coronal curves were not statistically different between the two groups (p>0.05). The thoracic kyphosis was changed from 16.8°±8.5° to 24.3°±6.1° in the S group and from 19.6°±11.2° to 26.6°±8.5° in the T group. There were no significant differences in the changes of sagittal curves, coronal and sagittal balances at the 2-year follow-up and the number of fused segments and used screws between the two groups (p>0.05). CONCLUSION: When conducting surgery for single thoracic AIS using pedicles screw instrumentation, two different instruments made of stainless steel and titanium alloy showed similar corrections for coronal and sagittal curves.

The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients / 대한정형외과학회잡지

PURPOSE: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. MATERIALS AND METHODS: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). RESULTS: The average age was 72.4 years (65–83 years). The average fusion segment was 4.6 segments (3–6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. CONCLUSION: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

Risk Factors for Subsequent Vertebral Compression Fracture Following Osteoporotic Compression Fracture / 대한정형외과학회잡지

PURPOSE: To evaluate the risk factors for subsequent vertebral fracture following acute osteoporotic vertebral compression fracture. MATERIALS AND METHODS: This was a multicenter retrospective study. We recruited 135 patients treated for acute osteoporotic compression fracture with available spine image taken at the 1-year follow-up mark in 3 different hospitals. The patients were divided into 2 groups in accordance with the occurrence of subsequent vertebral fracture. Variables including age, sex, bone mineral density, medical comorbidity, acute fracture level, presence of prior vertebral fracture, osteoporosis medication, and treatment method were analyzed and compared between the 2 groups. RESULTS: The new subsequent vertebral fractures were detected in 25 patients (18.5%). There were no significant differences between the 2 groups with respect to age, sex, medical comorbidity, presence of prior vertebral fracture, and acute fracture level, as shown by univariate analysis. However, in the group with subsequent vertebral fracture, more patients were treated by vertebroplasty or kyphoplasty and had a femur neck T-score of ≤-2.5, as well as poor compliance of osteoporosis medication with significant difference (p<0.05). According to the multivariate analysis, subsequent vertebral fractures were significantly influenced by vertebroplasty or kyphoplasty (p=0.003, odds ratio=4.71) and femur neck T-score of ≤-2.5 (p=0.013, odds ratio=3.47). CONCLUSION: Subsequent vertebral fractures were found in 19% at the 1-year mark after the treatment of acute osteoporotic compression fracture. The two risk factors for subsequent vertebral fractures were vertebroplasty or kyphoplasty and femur neck T-score of ≤-2.5.

Medication Persistence for Osteoporosis and Its Related Factor in Patients with Osteoporotic Compression Vertebral Fracture / 대한골다공증학회지

INTRODUCTION: Osteoporotic vertebral fractures, which account for the largest part of the disease has become important and common diseases. We studied persistence for osteoporosis medication and its related factor in patients with osteoporotic compression vertebral fracture. METHODS: A total of 458 patients that visited our outpatient clinic with osteoporotic vertebral fractures and were prescribed with osteoporosis medication at the Seoul Spine Center from January 2010 to February 2014 and were analyzed retrospectively. The male to female ratio was 403: 55 and the mean age was 75 years. Survival analysis was used with the Kaplan-Meier method. Related factor analysis was performed with the log rank test and Cox regression test. RESULTS: The survival rate at 6 months was 52%, 12 months was 40%, 24 months was 28%, and at 3 years it was 25%. There was no difference between the persistent rate according to age. Women demonstrated higher persistent rate than men in significantly. It showed a significant difference between some of the groups in accordance with the dose rate and duration of the drug dose interval. Especially, medication change group had significant higher persistence rate than not changing group. CONCLUSIONS: Persistence rate of osteoporosis drugs, decreased rapidly with the passage of time. The patients with changing medication during follow-up had significantly higher persistence ratio than those without it. The persistence rate of osteoporosis medication could be increased through actively solving the problems of the patients, which are associated with taking medication.

Analysis of Treatment Methods for Subsequent Vertebral Fractures Following Osteoporotic Compression Fractures

STUDY DESIGN: A multicenter retrospective study. OBJECTIVES: To compare the incidence and pattern of subsequent vertebral fractures following conservative treatment versus vertebroplasty or kyphoplasty for acute osteoporotic vertebral compression fractures. SUMMARY OF LITERATURE REVIEW: Previous studies suggest that new vertebral fractures may increase following vertebroplasty or kyphoplasty because bony cement inserted into the vertebral body of a fractured bone can elevate its strength and stiffness, which in turn, may increase the probability of the compression fractures. MATERIALS AND METHODS: From three hospitals, we recruited 135 patients who had been treated for acute osteoporotic compression fractures and had available spine images taken at their 1-year follow-up. The patients were divided into two groups according to treatment methods. Group C had been managed conservatively, and Group VK had undergone vertebroplasty or kyphoplasty. The two groups were compared for subsequent vertebral fractures. RESULTS: Group C consisted of 76 patients, and Group VK had 59. There were no significant differences between the two groups in terms of age, sex, medical comorbidity, body mass index (BMI), bone mineral density, presence of prior vertebral fracture or acute fracture level (p>0.05). New vertebral fractures were detected in 25 patients (19% of total subjects): 6 (8%) from Group C, and 19 (32%) from Group VK, demonstrating a significantly higher incidence in the VK group (p=0.0007). In the subgroup analysis, there was no significant difference between vertebroplasty and kyphoplasty (p>0.05). While four of the six patients (67%) in Group C had subsequent fractures in nonadjacent vertebrae, 14 of the 19 patients (74%) in Group VK had subsequent fractures in adjacent vertebrae. CONCLUSIONS: Subsequent vertebral fractures were found in 19% of subjects at one year after treatment for acute osteoporotic compression fractures. Compared with conservative treatment, vertbroplasty or kyphoplasty significantly increased the occurrence of subsequent vertebral fractures, which appeared more often in adjacent vertebrae.

Determination of the Distal Fusion Level in the Management of Thoracolumbar and Lumbar Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation

STUDY DESIGN: A retrospective study. PURPOSE: To determine the exact distal fusion level in the management of thoracolumbar/lumbar adolescent idiopathic scoliosis (TL/L AIS) using pedicle screw instrumentation (PSI). OVERVIEW OF LITERATURE: The selection of distal fusion level remains controversial in TL/L AIS. METHODS: Radiographic parameters of 66 TL/L AIS patients were analyzed. The patients were grouped according to the distal fusion level; L3 group (fusion to L3, n=58) and L4 group (fusion to L4, n=8). The L3 group was subdivided into L3A (L3 crosses the mid-sacral line with rotation of less than grade II, n=33) and L3B (L3 does not cross the mid-sacral line or rotation is grade II or more, n=25) based on both bending radiographs. All of the patients in the L4 group had the same location and rotation of L3 in bending films as that of patients in the L3B group. An unsatisfactory result was defined as a lowest instrumented vertebral tilt (LIVT) of more than 10degrees or coronal balance of more than 15 mm. RESULTS: Among the 3 groups, there was a significantly lesser correction in the TL/L curve and LIVT in the L3B group. Unsatisfactory results were obtained in 3 patients (9.1%) of the L3A group, in 15 patients (68.2%) of the L3B group, and in 1 patient (12.5%) of the L4 group with a significant difference. CONCLUSIONS: In TL/L AIS treatment with PSI, the curve can be fused to L3 with favorable radiographic outcomes when L3 crosses the mid-sacral line with rotation of less than grade II in bending films. Otherwise, fusion has to be extended to L4.

Complications of Posterior Vertebral Resection for Spinal Deformity

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the incidence and risk factors of complications following posterior vertebral resection (PVR) for spinal deformity. METHODS: A review of 233 patients treated with PVR at one institution over a nine-year period (1997 to 2005) was performed. The average age was 33.5 years. Complications were assessed in terms of surgical techniques (posterior vertebral column resection [PVCR] and decancellation osteotomy) and etiologies of deformity. RESULTS: Local kyphosis was corrected from 51.4degrees to 2.7degrees, thoracic scoliosis 63.9degrees to 24.5degrees (62.6% correction), and thoracolumbar or lumbar scoliosis 50.1degrees to 17.1degrees (67.6%). The overall incidence of complications was 40.3%. There was no significant difference between PVCR and decancellation osteotomy in the incidence of complications. There were more complications in the older patients (>35 years) than the younger (p 0.05). There was 1 mortality case by heart failure. Revision surgery was performed in 15 patients for metal failure or progressing curve. CONCLUSIONS: The overall incidence of complications of PVR was 40.3%. Older age, abundant blood loss, preoperative kyphosis, and long fusion were risk factors for complications.

Analysis of Intraoperative Neurological Complications in High-Risk Spinal Surgery with the Use of Motor Evoked Potential Monitoring

STUDY DESIGN: This is retrospective study. OBJECTIVES: To evaluate the risk of operative techniques using Motor Evoked Potential (MEP) in high-risk spinal surgery. SUMMARY OF LITERATURE REVIEW: There are few studies regarding the evaluation of operative techniques by MEP. MATERIALS AND METHODS: We studied 33 cases that had MEP during surgery from July 2007 to March 2009. Diagnoses included post-traumatic kyphosis (PTK) in eight cases, congenital deformity in eight cases, degenerative lumbar deformity in eight cases, ankylosing spondylitis (AS) in three cases, spinal tumor in three cases, adjacent segmental disease in two cases, and post-surgical kyphosis in one case. Posterior vertebral column resection (PVCR) and pedicle subtraction osteotomy (PSO) were performed in 27 cases (81.8%) and, in the others, posterior decompression with discectomy was performed. We analyzed the risk of operative techniques and evaluated the MEP. RESULTS: MEP showed abnormal signal change in five cases (PVCR: one case, compression and distraction: four cases). The AS case did not demonstrate neurological change after surgery. Though the PTK on T12 operated by PVCR case did not show an abnormal MEP result, neurological change was observed postoperatively. The sensitivity, specificity, percent of false negatives, and percent of false positives of MEP were 80.0%, 96.4%, 20.0%, and 3.6%, respectively. CONCLUSIONS: MEP monitoring is a useful method to detect neurological injury during high-risk spinal surgery with satisfactory specificity. For low sensitivity and a high false negative rate, increased monitoring of cases and continuous follow-up is needed. In conclusion, compression and distraction and PVCR are high-risk techniques in kyphotic deformity correction.

The Revision Operation Rate for Adjacent Segmental Degeneration by Survival Analysis in Mono-segment Lumbar Fusion / 대한정형외과학회잡지

PURPOSE: To analyze survival rates of patients after mono-segmental lumbar or lumbosacral fusion and to evaluate factors affecting the revision operation due to adjacent segmental degeneration. MATERIALS AND METHODS: This study enrolled 1,206 patients who had mono-segmental lumbar or lumbosacral fusion between March 1997 and December 2006 at the Seoul Spine Institute. The survival rates for the revision operation due to adjacent segmental degeneration were analyzed retrospectively. The age at index operation, sex, etiologic diagnosis, fusion method, fusion level, substance of bone graft, operator, body mass index (BMI), and smoking were considered as risk factors for the revision operation. RESULTS: There were 27 patients with a revision operation for adjacent segmental degeneration (2.24%). The average follow-up period was 39.0 months (6 months to 12 years 6 months) and the average age at operation was 47.0 years (13 to 85 years). The survival rate at 5 years was 97.3%, and at 10 years it was 89.4%. Patients less than 50 years old had a significantly lower revision operation rate than those aged 50 or more (p=0.002). When fusion between the 4th lumbar and the 5th lumbar spinal vertebrae was done, the revision operation rate was significantly higher than for other levels (p=0.003). Obese patients with BMI> or =25 had a significantly higher revision rate than did patients with BMI0.05). In multivariate analysis, age alone was a significant risk factor (p=0.048, Hazard ratio=2.50). CONCLUSION: The most important factor for survival without revision surgery for adjacent segmental degeneration following instrumented mono-segment lumbar or lumbosacral fusion is the age at index operation. Patients 50 year-old or older should be informed of the possibility of adjacent segmental disease after instrumented mono-segment lumbar or lumbosacral fusion.

Outcomes of Lateral Malleolar Saving versus Sacrificing Procedure in Transfibular Ankle Arthrodesis / 대한족부족관절학회지

PURPOSE: We analyse and report the result of transfibular ankle arthrodesis using lateral malleolar saving procedureversus lateral malleolar sacrificing procedure. MATERIALS AND METHODS: Eighteen cases of transfibular ankle arthrodesis which were performed since 2001 were included. We devided them into lateral malleolar saving and lateral malleolar sacrificing groups. We reattached and fixed lateral malleolus in 10 cases and sacrificed malleolus for morcelized bone graft in 8 cases. We evaluated clinical results by AOFAS ankle-hindfoot score, visual analogue scale (VAS) and radiological results by union time. Complications and subjective satisfaction degrees were also recorded and compared between two groups. RESULTS: Preoperative mean AOFAS score was 32 points (16~41) and VAS was 7.5 points (7~8) and they were changed into 68.6 points (61~77) and 2.8 points (2~4) postoperatively. There was no significant difference in clinical results between the two groups even though lateral malleolar saving group showed higher AOFAS score (69.4) than lateral malleolar sacrificing group (67.7). Duration of getting union was 11.3 weeks in lateral malleolar saving group and 10.6 weeks in lateral malleolar sacrificing group. There was no difference in subjective satisfaction level. There were one delayed union and one nonunion in lateral malleolar sacrificing group and one nonunion in lateral malleolar saving group. CONCLUSION: There was no difference in clinical and radiological results between lateral malleolar saving group and lateral malleolar sacrificing group of transfibular ankle arthrodesis. Therefore it may not necessary to sacrifice lateral malleolus for bone graft except very selective case for which heavy graft is needed.

Cervical and Thoracic Sagittal Curves in Thoracic Adolescent Idiopathic Scoliosis / 대한척추외과학회지

STUDY DESIGN: Prospective study OBJECTIVES: To analyze and compare the cervical and thoracic sagittal curves between normal adolescents and patients with thoracic adolescent idiopathic scoliosis (AIS). SUMMARY OF THE LITERATURE REVIEW: There are no reports on cervical sagittal curves and its correlation with thoracic sagittal curves in AIS. MATERIALS AND METHODS: The sagittal curves were analyzed in normal adolescents (N-adol group, n=23) and patients with thoracic AIS (AIS group, n=26) who had thoracic curves > or = 45degrees. Lateral standing radiographs of the cervical spine with a elbow straight and the whole spine with the hands on the clavicles were taken. The sagittal curves and balance were measured in the following segments; C2-C7, T2-T5, T5-12, T2-12, T12-S1. Cervical lordosis (C2-C7) was measured in both cervical spine radiographs and whole spine radiographs. RESULTS: In the N-adol group, the cervical lordosis was 9.2+/-14.6degrees in the cervical spine radiographs and -0.6+/-12.9degrees ('-' means kyphosis) in whole spine radiographs. In the AIS group, cervical lordosis was -5.0+/-12.9degrees in the cervical radiographs and -8.1+/-12.7degrees in the whole radiographs. The AIS group had significantly less cervical lordosis than the N-adol group. Thoracic kyphosis of T5-12 and T2-12 was 24.1+/-10.6degrees and 38.9+/-13.1degrees in the N-adol group, respectively, and 17.8+/-9.4degrees and 30.1+/-11.8degrees in the AIS group, respectively. There was a significant difference between the two groups (Ps0.05). In the AIS group, the cervical lordosis measured in the cervical spine radiograph showed a positive correlation with thoracic kyphosis of T2-5 (r=0.50, P=0.009) and T2-12 (r=0.57, P=0.003). CONCLUSIONS: AIS patients had significantly less cervical lordosis and thoracic kyphosis than normal adolescents. Decreased cervical lordosis in AIS had a significant correlation with their relative thoracic hypokyphosis.

Posterior Correction with Segmental Pedicle Screw Fixation Alone in Severe Adolescent Idiopathic Scoliosis Over 70 degrees / 대한정형외과학회잡지

PURPOSE: To evaluate the results of a posterior procedure with segmental pedicle screw fixation in severe adolescent idiopathic scoliosis > or =70 degrees. MATERIALS AND METHODS: Twenty-three adolescent idiopathic patients with a curve magnitude > or =70 degrees subject to segmental pedicle screw fixation were analyzed retrospectively with a minimum follow-up of 2 years (2-7.8 years). There were 19 females and 4 males with a mean age of 14.9 years. All patients, except for 4 patients with King type I, were subjected to thoracic curve fusion. Twenty patients showed a thoracic curve > or =70 degrees (70-96), and 4 patients had a lumbar curve > or =70 degrees (70-77), preoperatively. The preoperative and postoperative standing roentgenograms were used to check the radiological parameters. RESULTS: The mean preoperative thoracic curve was corrected from 79.5+/-9.1 degrees to 25.3+/-5.8 degrees at the most recent follow-up, showing a correction of 67.9+/-7.8% and loss of correction of 2.5+/-1.9%. The mean preoperative lumbar curve was corrected from 72.3+/-3.3 degrees to 30.0+/-10.1 degrees at the most recent follow-up (58.4+/-14.8% curve correction, 2.4+/-2.5% loss of curve correction). The mean preoperative lowest instrumented vertebral tilting was corrected from 30.0+/-7.4 degrees to 10.5+/-5.6 degrees, showing a correction of 64.8+/-20.9%. The preoperative thoracic kyphosis improved from 28.3+/-11.2 degrees (0-50 degrees) to 35.0+/-9.1 degrees (22-53 degrees) postoperatively. There was neither pseudoarthrosis nor complications related to the pedicle screws at the most recent follow-up. CONCLUSION: Segmental pedicle screw fixation without an anterior release procedure in severe adolescent idiopathic scoliosis produced a satisfactory deformity correction with no significant loss of the curve correction. This procedure obviates the need for the anterior release and reduces the complications associated with anterior surgery.

The Association between the Dopamine D1 Receptor Genotype and Treatment Response in Korean Schizophrenic Patients

BACKGROUND: Dopamine receptors have been regarded as a strong candidate involved in etiology of schizophrenia and a target for various antipsychotic drugs. The purpose of our study was to investigate whether dopamine D1 receptor(DRD1) gene polymorphisms would predict the treatment response to antipsychotics in schizophrenia. METHOD: One hundred thirty-four schizophrenic patients, who met DSM-IV criteria for schizophrenia were entered into a 48-week study. The psychopathology of the patients was assessed at baseline, 12th, 24th, 48th weeks of treatment by PANSS. Responders were defined by a 20% of the reduction in total PAnSS score at end point. The genomic DNA fragment corresponding to nucleotides of dopamine D1 receptor gene was amplified by polymerase chain reaction(PCR). RESULT: Neither allelic frequencies nor genotypes for dopamine D1 receptor differed significantly between responders and non-responders. Also, there was no difference of changes of PANSS scores among three genotype groups of the dopamine D1 receptor. CONCLUSION: Allelic variation in the dopamine D1 gene is not associated with individual differences in antipsychotic response.