015 Citation: Rusdi M, Tahir FM, Abu Bakar AZ, Rusdi H, Mahmood MR, et al. (2022) Challenges in diagnosing Treatment-Resistant Schizophrenia (TRS) with Frontal Lobe Atrophy from MRI Imaging: Case Study. Imaging J Clin Medical Sci 9(1): 015-017. DOI: https://dx.doi.org/10.17352/2455-8702.000137 https://dx.doi.org/10.17352/ijcms DOI: 2455-8702 ISSN: CLINICAL GROUP Introduction Schizophrenia is a common psychiatric disorder [1], characterized by positive and negative symptoms in which the latter is a result of progressive deterioration of frontal lobe function. These symptoms may overlap with frontal lobe syndromes such as Fronto-Temporal Dementia (FTD) where behavioral changes are more prominent than memory loss. This provides difficulty in distinguishing both disorders apart Abstract The diagnostic criteria for the behavioral variant of frontotemporal dementia were revised recently. Distinguishing both disorders apart as brain imaging studies in patients with schizophrenia also demonstrate changes in the frontal and temporal lobes which can help in the diagnostic process. This paper highlights the challenges in diagnosing Treatment-Resistant Schizophrenia (TRS) with a differential diagnosis of Fronto-Temporal Dementia (FTD) from magnetic resonance imaging (MRI) imaging. From the diagnosis of the case study, it can be summarized that frontotemporal atrophy is often associated with FTD but it may also occur in a patient suffering from schizophrenia. This provides a challenge for medical practitioners to distinguish between FTD and schizophrenia as disinhibition and executive dysfunction may prominent in schizophrenia with (Frontotemporal Atrophy) FTA. Case Study Challenges in diagnosing Treatment-Resistant Schizophrenia (TRS) with Frontal Lobe Atrophy from MRI Imaging: Case Study Mardhiyah Rusdi 1,2 , Faiz Md Tahir 1 , Ahmad Zafri Abu Bakar 1 , Hashlina Rusdi 3 , Mohamad Rusop Mahmood 4 and Roshidah Rusdi 4 * 1 Department of Psychiatry and Mental Health, Tengku Ampuan Afzan Hospital (HTAA), 25200 Kuantan, Pahang Darul Makmur, Malaysia 2 Vector Borne Disease Control Unit, Pahang State Health Department, A1-A7 Lorong IM 14/30, Bandar Indera Mahkota, 25200 Kuantan, Pahang Darul Makmur, Malaysia 3 Centre for Foundation Studies in Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia 4 Centre for Functional Materials and Nanotechnology, Institute of Science, Universiti Teknologi MARA, 40450 Shah Alam, Selangor Malaysia Received: 05 September, 2022 Accepted: 28 September, 2022 Published: 29 September, 2022 *Corresponding author: Roshidah Rusdi, Centre for functional materials and nanotechnology, Institute of Science, Universiti Teknologi MARA, 40450 Shah Alam Selangor Malaysia, E-mail: ORCID: https://orcid.org/0000-0001-5059-9312 Keywords: Fronto-Temporal Dementia (FTD); Treatment-Resistant Schizophrenia (TRS); Psychiatric disorder; MRI Copyright License: © 2022 Rusdi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. https://www.peertechzpublications.com as brain imaging studies in patients with schizophrenia also demonstrate changes in the frontal and temporal lobes. This paper highlights the challenges in diagnosing Treatment- Resistant Schizophrenia (TRS) with a differential diagnosis of FTD. Case Mr. H is a 44 years old Malay man noted to be socially withdrawn and displayed disorganized behavior since the age