Abstract Clozapine is the gold-standard treatment for treatment-resistant schizophrenia (TRS), yet its mechanism of action remains unclear. Previous studies implicated the caudate nucleus as a potential key region of clozapine-related structural changes. Texture analysis (TA), a quantitative image analysis technique that may sensitively capture subtle alterations of the underlying tissue microstructure, was utilized to investigate changes in the caudate following 18 weeks of clozapine treatment.