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Breithaupt L, Holsen LM, Ji C, Hu J, Petterway F, Rosa-Caldwell M, Nilsson IA, Thomas JJ, Williams KA, Boutin R, Slattery M, Bulik CM, Arnold SE, Lawson EA, Misra M, Eddy KT. Identification of State Markers in Anorexia Nervosa: Replication and Extension of Inflammation-Associated Biomarkers Using Multiplex Profiling. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100332. [PMID: 38989135 PMCID: PMC11233894 DOI: 10.1016/j.bpsgos.2024.100332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/12/2024] [Accepted: 04/01/2024] [Indexed: 07/12/2024] Open
Abstract
Background Proteomics offers potential for detecting and monitoring anorexia nervosa (AN) and its variant, atypical AN (atyp-AN). However, research has been limited by small protein panels, a focus on adult AN, and lack of replication. Methods In this study, we performed Olink multiplex profiling of 92 inflammation-related proteins in females with AN/atyp-AN (n = 64), all of whom were ≤90% of expected body weight, and age-matched healthy control individuals (n = 44). Results Five proteins differed significantly between the primary AN/atyp-AN group and the healthy control group (lower levels: HGF, IL-18R1, TRANCE; higher levels: CCL23, LIF-R). The expression levels of 3 proteins (lower IL-18R1, TRANCE; higher LIF-R) were uniquely disrupted in participants with AN in our primary model. No unique expression levels emerged for atyp-AN. In the total sample, 12 proteins (ADA, CD5, CD6, CXCL1, FGF-21, HGF, IL-12B, IL18, IL-18R1, SIRT2, TNFSF14, TRANCE) were positively correlated with body mass index and 5 proteins (CCL11, FGF-19, IL8, LIF-R, OPG) were negatively correlated with body mass index in our primary models. Conclusions Our results replicate the results of a previous study that demonstrated a dysregulated inflammatory status in AN and extend those results to atyp-AN. Of the 17 proteins correlated with body mass index, 11 were replicated from a previous study that used similar methods, highlighting the promise of inflammatory protein expression levels as biomarkers of AN disease monitoring. Our findings underscore the complexity of AN and atyp-AN by highlighting the inability of the identified proteins to differentiate between these 2 subtypes, thereby emphasizing the heterogeneous nature of these disorders.
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Affiliation(s)
- Lauren Breithaupt
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
| | - Laura M. Holsen
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
- Division of Women’s Health, Departments of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Chunni Ji
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
- Division of Women’s Health, Departments of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jie Hu
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Department of Anesthesia, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Felicia Petterway
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Megan Rosa-Caldwell
- Department of Neurology, Beth Israel Deaconess Hospital, Boston, Massachusetts
- Department of Neurology, Harvard Medical School, Boston, Massachusetts
| | - Ida A.K. Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Centre for Eating Disorders Innovation, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer J. Thomas
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
| | - Kyle A. Williams
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Pediatric Neuropsychiatry and Immunology Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Regine Boutin
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Meghan Slattery
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Steven E. Arnold
- Department of Neurology, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Elizabeth A. Lawson
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Madhusmita Misra
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Neuroendocrine Unit, Massachusetts General Children’s Hospital, Boston, Massachusetts
| | - Kamryn T. Eddy
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
- Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts
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Ding M, Zhang S, Zhu Z, Cai R, Fang J, Zhou C, Zhang X, Fang X. Influencing factors of different metabolic status in hospitalized patients with schizophrenia. Front Psychiatry 2024; 15:1436142. [PMID: 39091455 PMCID: PMC11291240 DOI: 10.3389/fpsyt.2024.1436142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/02/2024] [Indexed: 08/04/2024] Open
Abstract
Objective The aim of this study was to explore the risk factors for different metabolic status in patients with schizophrenia. Methods A total of 968 hospitalized patients with schizophrenia were recruited. Fasting blood glucose (GLU) and lipid profile, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were measured. Schizophrenia patients were divided into four groups: normal metabolism and weight (NMNW), abnormal metabolism and normal weight (AMNW), normal metabolism and overweight/obesity (NMO), and abnormal metabolism and overweight/obesity (AMO). Results Our results showed that NMNW, AMNW, NMO, and AMO accounted for 25.3%, 12.7%, 25.4%, and 36.6%, respectively. There were significant differences in age, disease duration, body mass index (BMI), waist circumference, chronic disease, systolic blood pressure (SBP), diastolic blood pressure (DBP), GLU, TG, TC, HDL-C, and LDL-C among these four groups (all p < 0.05). With the NMNW group as the reference, the disordered multiple classification regression analysis showed that chronic disease was a significant risk factor for AMNW (OR = 5.271, 95% CI = 3.165 to 8.780, p < 0.001) and AMO (OR = 3.245, 95% CI = 2.004 to 5.254, p < 0.001), age was an important protective factor for NMO (OR = 0.968, 95% CI = 0.943 to 0.994, p = 0.015) and AMO (OR = 0.973, 95% CI = 0.948 to 0.999, p < 0.042), waist circumference was a significant risk factor for NMO (OR = 1.218, 95% CI = 1.180 to 1.257, p < 0.001) and AMO (OR = 1.252, 95% CI = 1.212 to 1.291, p < 0.001), and college education was an obvious protective factor for AMO (OR = 0.343, 95% CI = 0.123 to 0.953, p < 0.040) among patients with schizophrenia. Conclusion The findings of our study underscored the importance of factors such as age, education level, chronic disease, and waist circumference when exploring the influencing factors and biological mechanisms of obesity-related metabolic problems in schizophrenia patients.
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Affiliation(s)
- Mubing Ding
- Department of Psychiatry, Beijing Anding Hospital Affiliated to Capital Medical University Wuhu Hospital & Wuhu Fourth People’s Hospital, Wuhu, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shaotong Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zaochen Zhu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Renliang Cai
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jin Fang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chao Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangrong Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyu Fang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Gangadin SS, Enthoven AD, van Beveren NJM, Laman JD, Sommer IEC. Immune Dysfunction in Schizophrenia Spectrum Disorders. Annu Rev Clin Psychol 2024; 20:229-257. [PMID: 38996077 DOI: 10.1146/annurev-clinpsy-081122-013201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
Evidence from epidemiological, clinical, and biological research resulted in the immune hypothesis: the hypothesis that immune system dysfunction is involved in the pathophysiology of schizophrenia spectrum disorders (SSD). The promising implication of this hypothesis is the potential to use existing immunomodulatory treatment for innovative interventions for SSD. Here, we provide a selective historical review of important discoveries that have shaped our understanding of immune dysfunction in SSD. We first explain the basic principles of immune dysfunction, after which we travel more than a century back in time. Starting our journey with neurosyphilis-associated psychosis in the nineteenth century, we continue by evaluating the role of infections and autoimmunity in SSD and findings from assessment of immune function using new techniques, such as cytokine levels, microglia density, neuroimaging, and gene expression. Drawing from these findings, we discuss anti-inflammatory interventions for SSD, and we conclude with a look into the future.
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Affiliation(s)
- S S Gangadin
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;
| | - A D Enthoven
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;
| | - N J M van Beveren
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
- Parnassia Group for Mental Health Care, The Hague and Rotterdam, The Netherlands
| | - J D Laman
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - I E C Sommer
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;
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Dongxia L, Li M, Yingying F. Can neurocognition, brain neurotrophic factor, triglyceride, and total cholesterol predict suicidal ideation in first-episode Han Chinese patients with schizophrenia? Brain Behav 2024; 14:e3499. [PMID: 38680078 PMCID: PMC11056701 DOI: 10.1002/brb3.3499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/10/2024] [Accepted: 04/03/2024] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVE Previous studies have suggested that the suicide rate of patients with schizophrenia is high. This study investigates factors influencing suicidal ideation in first-episode schizophrenia patients, focusing on cognitive function, brain-derived neurotrophic factor (BDNF), triglyceride (TG), and total cholesterol (TC) in patients with first-episode schizophrenia. METHODS A total of 123 patients with first-episode schizophrenia and 38 healthy controls were included in the study. The patients were divided into suicidal and nonsuicidal ideation groups based on the Beck Scale for Suicidal Ideation, and they were assessed with Positive and Negative Syndrome Scale (PANSS). Cognitive function was assessed using the Chinese version of the MATRICS consensus cognitive battery (MCCB) and the serum BDNF, TG, and TC were detected. The main statistical methods include t-test, χ2 test, multivariate logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and the DeLong test. RESULTS 26.02% of patients exhibited suicidal ideation. Higher PANSS and TC levels were risk factors, while higher MCCB scores and BDNF levels were protective factors. ROC analysis indicated AUCs of 0.630, 0.724, and 0.762 for serum BDNF, PANSS, and MCCB, respectively, with a combined AUC of 0.870. CONCLUSION Serum BDNF level, PANSS score, and MCCB score can be used as auxiliary predictors of suicidal ideation in schizophrenic patients. Combining these three indicators can effectively predict suicidal ideation in schizophrenic patients.
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Affiliation(s)
- Li Dongxia
- Wuhan Mental Health CenterWuhan Psychological HospitalWuhan CityChina
| | - Ma Li
- Wuhan Mental Health CenterWuhan Psychological HospitalWuhan CityChina
| | - Feng Yingying
- Wuhan Mental Health CenterWuhan Psychological HospitalWuhan CityChina
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Zhang Y, Tang W, Tang B, Fan K, Zhao K, Fang X, Lin H. Altered mitochondrial lymphocyte in overweight schizophrenia patients treated with atypical antipsychotics and its association with cognitive function. Front Immunol 2024; 14:1325495. [PMID: 38235140 PMCID: PMC10791827 DOI: 10.3389/fimmu.2023.1325495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
Objective Increasing evidence indicated that schizophrenia and obesity are associated with altered mitochondrial and immune function. In this study, we investigated the levels of CRP (C-reactive protein) and mitochondrial lymphocytes in chronically treated schizophrenia patients with atypical antipsychotic medications and further explored the relationship between mitochondrial lymphocyte and weight gain as well as cognitive function in these patients. Methods We evaluated the mitochondrial lymphocyte count of 97 patients (53 overweight, 44 non-overweight) and 100 healthy controls using mitochondrial fluorescence staining and flow cytometry (NovoCyte, Agilent Technologies, US). The serum CRP was measured by high-sensitivity enzyme-linked immunosorbent assay (ELISA). Clinical symptoms and cognitive function of the patients were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results The results showed that mitochondrial lymphocyte counts of CD3+ T, CD3+CD4+ T, and CD3+CD8+ T cells in schizophrenia patients were higher than in the control group (p < 0.05). Additionally, overweight patients had significantly higher mitochondrial lymphocyte counts of CD3+ T and CD3+CD4+ T cells compared to schizophrenia patients with normal weight. Stratified analysis by gender revealed that there was a statistically significant difference in CD3+CD4+ mitochondrial lymphocyte count in male patients (p = 0.014) and a marginal trend toward significance in female patients (p = 0.058). Furthermore, the mitochondrial lymphocyte counts of CD3+ T and CD3+CD4+ T cells, as well as CRP levels, were positively correlated with BMI in schizophrenia patients, but the mitochondrial lymphocyte counts of CD3+CD4+ T cells were negatively correlated with the language scale in the RBANS. Conclusion Our study results provide evidence for the association between altered mitochondrial T lymphocyte and weight gain as well as cognitive impairment in schizophrenia patients treated with atypical antipsychotic medications.
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Affiliation(s)
- Yaoyao Zhang
- Department of Psychiatry, The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, China
| | - Wei Tang
- Department of Psychiatry, The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, China
| | - Bei Tang
- Department of Education, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kaili Fan
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang, China
| | - Ke Zhao
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinyu Fang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hui Lin
- Department of Psychiatry, The Second People`s Hospital of YuHuan, Taizhou, Zhejiang, China
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Mrozek W, Socha J, Sidorowicz K, Skrok A, Syrytczyk A, Piątkowska-Chmiel I, Herbet M. Pathogenesis and treatment of depression: Role of diet in prevention and therapy. Nutrition 2023; 115:112143. [PMID: 37562078 PMCID: PMC10299949 DOI: 10.1016/j.nut.2023.112143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 08/12/2023]
Abstract
In recent years, there has been a significant increase in depression, which is related to, among other things, the COVID-19 pandemic. Depression can be fatal if not treated or if treated inappropriately. Depression is the leading cause of suicide attempts. The disease is multifactorial, and pharmacotherapy often fails to bring satisfactory results. Therefore, increasingly more importance is attached to the natural healing substances and nutrients in food, which can significantly affect the therapy process and prevention of depressive disorders. A proper diet is vital to preventing depression and can be a valuable addition to psychological and pharmacologic treatment. An inadequate diet may reduce the effectiveness of antidepressants or increase their side effects, leading to life-threatening symptoms. This study aimed to review the literature on the pathogenesis of the development and treatment of depression, with particular emphasis on dietary supplements and the role of nutrition in the prevention and treatment of depressive disorders.
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Affiliation(s)
- Weronika Mrozek
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Justyna Socha
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Klara Sidorowicz
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Aleksandra Skrok
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Aleksandra Syrytczyk
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | | | - Mariola Herbet
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland.
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Aygun H, Akin AT, Kızılaslan N, Sumbul O, Karabulut D. Electrophysiological, histopathological, and biochemical evaluation of the protective effect of probiotic supplementation against pentylenetetrazole-induced seizures in rats. Eur J Neurol 2023; 30:3540-3550. [PMID: 35429204 DOI: 10.1111/ene.15359] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Research on the relationship between the gut microbiome and epilepsy is accumulating. The present study was conducted to evaluate the effect of probiotic supplementation on pentylenetetrazole (PTZ)-induced seizures in rats. METHODS Twenty-one adult male Wistar albino rats were included. The animals were divided into three groups of seven rats. Group 1 was a control group, whereas Group 2 rats received PTZ treatment and Group 3 rats had PTZ+PB (probiotic) treatment. For 6 weeks, Groups 1 and 2 were given saline (1 ml), whereas Group 3 had probiotic supplement. In the 5th week, tripolar electrodes were attached to the rats. Electrophysiological, behavioral, biochemical, and immunohistochemical evaluations were performed in the 6 weeks after the treatment. RESULTS PB treatment significantly reduced seizures. In the PTZ group, expression levels of brain-derived neurotrophic factor, nerve growth factor (NGF), and Sox2 (SRY sex-determining region Y-box 2) in rat brains decreased significantly compared to the control group, whereas the expression levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), total oxidant status (TOS), and nitric oxide (NO) levels increased. In the PTZ+PB group, NGF expression increased significantly compared to the PTZ group, whereas TNF-α, IL-6, TOS, and NO levels decreased. In histopathological examination, an abundance of necrotic neurons was notable in the PTZ group, which was less in the PTZ+PB group. In addition, body weight of the group supplemented with probiotics decreased after the treatment. CONCLUSIONS Our results suggest that probiotic supplementation may alleviate seizure severity and exert neuroprotective effects by reducing neuroinflammation and oxidative stress and altering the expression of neurotrophins in epileptogenic brains.
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Affiliation(s)
- Hatice Aygun
- Department of Physiology, Faculty of Medicine, University of Tokat Gaziosmanpasa, Tokat, Turkey
| | - Ali Tuğrul Akin
- Department of Biology, Faculty of Science and Literature, University of Erciyes, Kayseri, Turkey
| | - Nildem Kızılaslan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Tokat Gaziosmanpasa, Tokat, Turkey
| | - Orhan Sumbul
- Department of Neurology, Faculty of Medicine, University of Tokat Gaziosmanpasa, Tokat, Turkey
| | - Derya Karabulut
- Department of Histology-Embryology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
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Fang X, Gao C, Wu W, Hu X, Shao M, Zhou C, Cai R, Fang J, Li Y, Xu Y, Zhang X. The role of the gut microbiome in weight-gain in schizophrenia patients treated with atypical antipsychotics: Evidence based on altered composition and function in a cross-sectional study. Psychiatry Res 2023; 328:115463. [PMID: 37717547 DOI: 10.1016/j.psychres.2023.115463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES We aimed to explore the interconnection between the weight-gain in schizophrenia patients with atypical antipsychotic treatment and gut microbiome. METHODS This study employed a cross-sectional design, encompassing a total of 88 schizophrenia patients with long-term atypical antipsychotic treatment. The 16S rRNA gene sequencing was used to identify gut microbiome contents. RESULTS No significant differences in alpha diversity between normal-weight and overweight schizophrenia treated with atypical antipsychotics. The beta diversity analysis showed that overweight patients clustered tightly while normal-weight patients clustered widely. For taxonomic composition, overweight patients had a lower relative abundance in Porphyromonadaceae at family level and Butyrivibrio at genus level, but higher relative abundance in Ruminococcus2 and Clostridium_XIVa at genus level than normal-weight patients. Function prediction revelated that four pathways (including Cell cycle, Non-homologous end-joining, Vibrio cholerae infection and Meiosis-yeast) were significantly different between groups. Correlation analysis indicated that Klebsiella, Butyrivibrio, Unassigned, Methanosphaera, Holdemania, Anaerotruncus were negatively, while Veillonella was positively correlated with BMI in patients. CONCLUSION Our findings offer evidence that perturbations in the gut microbiome composition, encompassing taxa such as Porphyromonadaceae, Butyrivibrio, Ruminococcus2, and Clostridium_XIVa, in conjunction with distinct functional pathways including Cell cycle, Non-homologous end-joining, Vibrio cholerae infection, and Meiosis-yeast, might contribute to the weight-gain in schizophrenia treated with atypical antipsychotics.
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Affiliation(s)
- Xinyu Fang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chunying Gao
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China; Department of Psychiatry, Changzhou De'an Hospital, Changzhou, China
| | - Weifeng Wu
- Department of Hepatology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China; Nanjing Public Health and Medical Center, Nanjing, China
| | - Xiuxiu Hu
- Department of Psychiatry, Jiangning District Second People' s Hospital, Nanjing, China
| | - Miaomiao Shao
- Department of Psychiatry, Jiangning District Second People' s Hospital, Nanjing, China
| | - Chou Zhou
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Renliang Cai
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jin Fang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Li
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Yue Xu
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China; The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Cao T, Wang L, Jiao S, Chen H, Lin C, Zhang B, Cai H. The Involvement of PGRMC1 Signaling in Cognitive Impairment Induced by Long-Term Clozapine Treatment in Rats. Neuropsychobiology 2023; 82:346-358. [PMID: 37673050 DOI: 10.1159/000533148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 07/09/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Progesterone receptor component 1 (PGRMC1) has been identified as a potential target in atypical antipsychotic drug-induced metabolic disturbances as well as neuroprotection in the central nervous system. In our study, we aimed to figure out the essential role of PGRMC1 signaling pathway underlying clozapine-induced cognitive impairment. METHODS In male SD rats, we utilized recombinant adeno-associated viruses (BBB 2.0) and the specific inhibitor of PGRMC1 (AG205) to regulate the expression of PGRMC1 in the brain, with a special focus on the hippocampus. Treatments of clozapine and AG205 were conducted for 28 days, and subsequent behavioral tests including modified elevated plus maze and Morris water maze were conducted to evaluate the cognitive performance. Hippocampal protein expressions were measured by Western blotting. RESULTS Our study showed that long-term clozapine administration led to cognitive impairment as confirmed by behavioral tests as well as histopathological examination in the hippocampus. Clozapine inhibited neural survival through the PGRMC1/EGFR/GLP1R-PI3K-Akt signaling pathway, leading to a decrease in the downstream survival factor, brain-derived neurotrophic factor (BDNF), and simultaneously promoted neural apoptosis in the rat hippocampus. Intriguingly, by targeting at the hippocampal PGRMC1, we found that inhibiting PGRMC1 mimics, while its upregulation notably mitigates clozapine-induced cognitive impairment through PGRMC1 and its downstream signaling pathways. CONCLUSION PGRMC1-overexpression could protect hippocampus-dependent cognitive impairment induced by clozapine. This effect appears to arise, in part, from the upregulated expression of PGRMC1/EGFR/GLP1R and the activation of downstream PI3K-Akt-BDNF and caspase-3 signaling pathways.
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Affiliation(s)
- Ting Cao
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
| | - LiWei Wang
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
| | - ShiMeng Jiao
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui Chen
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
| | - ChenQuan Lin
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
| | - BiKui Zhang
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, China
| | - HuaLin Cai
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, China
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10
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Mao J, Fan K, Zhang Y, Wen N, Fang X, Ye X, Chen Y. 10 Hz repetitive transcranial magnetic stimulation (rTMS) may improve cognitive function: An exploratory study of schizophrenia patients with auditory hallucinations. Heliyon 2023; 9:e19912. [PMID: 37809845 PMCID: PMC10559318 DOI: 10.1016/j.heliyon.2023.e19912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/18/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives Cognitive impairment in schizophrenia patients with auditory hallucinations is more prominent compared to those without. Our study aimed to investigate the cognitive improvement effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) in schizophrenia with auditory hallucinations. Methods A total of 60 schizophrenic patients with auditory hallucinations in this study were randomly assigned to sham or active group. Both groups received 10 Hz or sham rTMS targeted in left DLPFC for 20 sessions. The Positive and Negative Syndrome Scale (PANSS), the Auditory Hallucination Rating Scale (AHRS), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Udvalg for Kliniske Under-sogelser (UKU) side effect scale were used to measure psychiatric symptoms, auditory hallucinations, cognition, and side reaction, respectively. Results Our results indicated that the active group experienced greater improvements in RBANS-total score (P = 0.043) and immediate memory subscale score (P = 0.001). Additionally, the PANSS-total score, negative and positive subscale score were obviously lower in the active group compared to the sham group (all P < 0.050). Furthermore, our study found that the improvement of RBANS-total score was positively associated with the decline of positive factor score, and the improvement of language score in RBANS was positively associated with the reduction in PANSS-total scale, negative and positive subscale score in the real stimulation group (all P < 0.050). Conclusion Our results demonstrated that a four-week intervention of 10 Hz rTMS over the left DLPFC can improve cognition (particularly immediate memory) among schizophrenia patients with auditory hallucinations. Future studies with larger sample size are needful to verify our preliminary findings.
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Affiliation(s)
- Jiankai Mao
- Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, PR China
| | - Kaili Fan
- Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, PR China
| | - Yaoyao Zhang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, PR China
| | - Na Wen
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, PR China
| | - Xinyu Fang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiangming Ye
- Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, PR China
| | - Yi Chen
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, Zhejiang, PR China
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11
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Li S, Lu C, Kang L, Li Q, Chen H, Zhang H, Tang Z, Lin Y, Bai M, Xiong P. Study on correlations of BDNF, PI3K, AKT and CREB levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia. BMC Psychiatry 2023; 23:225. [PMID: 37013544 PMCID: PMC10071748 DOI: 10.1186/s12888-023-04718-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/25/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The pathogenesis of schizophrenia is still unknown. Nearly a half of schizophrenic patients have depressive symptoms and even some impulsive behaviors. The definite diagnosis of schizophrenia is an immense challenge. Molecular biology plays an essential role in the research on the pathogenesis of schizophrenia. OBJECTIVE This study aims to analyze the correlations of serum protein factor levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia. METHODS Seventy drug-naïve patients with first-episode schizophrenia and sixty-nine healthy volunteers from the health check center in the same period participated in this study. In both the patient group and control group, brain-derived neurotrophic factor (BDNF), phosphatidylin-ositol-3-kinase (PI3K), protein kinase B (AKT), and cAMP-response element binding protein (CREB) levels in the peripheral blood were tested by enzyme-linked immunosorbent assay (ELISA). The depressive emotion and impulsive behaviors were evaluated with Chinese versions of the Calgary Depression Scale for Schizophrenia (CDSS) and Short UPPS-P Impulsive Behavior Scale (S-UPPS-P), respectively. RESULTS The serum levels of BDNF, PI3K, and CREB in the patient group were lower than those in the control group, while AKT level, total CDSS score and total S-UPPS-P score were all higher. In the patient group, total CDSS score, and total S-UPPS-P score were both correlated negatively with BDNF, PI3K, and CREB levels but positively with AKT level, and the lack-of-premeditation (PR) sub-scale score was not significantly correlated with BDNF, PI3K, AKT, and CREB levels. CONCLUSION Our study results showed that the peripheral blood levels of BDNF, PI3K, AKT, and CREB in drug-naïve patients with first-episode schizophrenia were significantly different from those in the control group. The levels of these serum protein factors are promising biomarkers to predict schizophrenic depression and impulsive behaviors.
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Affiliation(s)
- Shan Li
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cailian Lu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lin Kang
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qianqian Li
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongxu Chen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Han Zhang
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ziling Tang
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yanwen Lin
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Meiyan Bai
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Peng Xiong
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China.
- Yunnan Clinical Research Center for Mental Disorders, First Affiliated Hospital of Kunming Medical University, Kunming, China.
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12
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Wang D, Wang Y, Chen Y, Yu L, Wu Z, Liu R, Ren J, Fang X, Zhang C. Differences in inflammatory marker profiles and cognitive functioning between deficit and nondeficit schizophrenia. Front Immunol 2022; 13:958972. [PMID: 36341400 PMCID: PMC9627304 DOI: 10.3389/fimmu.2022.958972] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Deficit schizophrenia (DS) patient is a homogenous subtype of schizophrenia that includes primary and enduring negative symptoms. This study aimed to compare the differences in cognitive functioning and plasma levels of C-reactive protein (CRP) and inflammatory cytokines among DS patients, nondeficit schizophrenia (NDS) patients, and healthy controls (HCs). A total of 141 schizophrenia patients and 67 HCs were included in this study. The schizophrenia patients were divided into DS (N= 51) and NDS (N=90) groups based on the Proxy for the Deficit Syndrome Scale (PDS). The Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to evaluate the clinical symptoms and cognitive performances, respectively. The plasma level of CRP, IL-1β, Il-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, TNF-α, and IFN-γ were measured using enzyme-linked immunosorbent assays (ELISAs). Our results showed that DS patients had the worst cognitive performance, especially in the immediate memory, attention, and language dimensions, compared to the NDS and HC groups. Compared to the HCs group, DS patients had higher levels of CRP, IL-1β, IL-6, IL-8, IFN-γ, and total proinflammatory cytokines, and NDS patients had higher levels of IL-1β, IFN-γ, and proinflammatory cytokines. We also found that CRP levels were significantly increased in DS patients compared to NDS patients. Moreover, stepwise logistic regression analysis revealed that CRP is an independent risk factor for DS. Sex stratification analysis showed significant differences in almost all cytokines in female samples but not in male samples. The significant differences in cognitive performance and inflammatory components among groups suggest that deficit syndrome is an independent endophenotype of schizophrenia patients with unique immune-inflammatory features, but may have sex characteristics.
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Affiliation(s)
- Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zenan Wu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruimei Liu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Fang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Xinyu Fang, ; Chen Zhang,
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Xinyu Fang, ; Chen Zhang,
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13
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Melatonin treatment improves cognitive deficits by altering inflammatory and neurotrophic factors in the hippocampus of obese mice. Physiol Behav 2022; 254:113919. [PMID: 35858673 DOI: 10.1016/j.physbeh.2022.113919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/09/2022] [Accepted: 07/15/2022] [Indexed: 01/10/2023]
Abstract
Overweight and obesity are associated with an increased risk of developing dementia and cognitive deficits. Neuroinflammation is one of the most important mechanisms behind cognitive impairment in obese patients. In recent years, the neuroendocrine hormone melatonin has been suggested to have therapeutic effects for memory decline in several neuropsychiatric and neurological conditions. However, the effects of melatonin on cognitive function under obesity conditions still need to be clarified. The purpose of this study was to determine whether melatonin treatment can improve cognitive impairment in obese mice. To this end, male C57BL6 mice were treated with a high-fat diet (HFD) for 20 weeks to induce obesity. The animal received melatonin for 8 weeks. Cognitive functions were evaluated using the Y maze, object recognition test, and the Morris water maze. We measured inflammatory cytokines including tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-17A, and brain-derived neurotrophic factor (BDNF) in the hippocampus of obese mice. Our results show that HFD-induced obesity significantly impaired working, spatial and recognition memory by increasing IFN-γ and IL-17A and decreasing BDNF levels in the hippocampus of mice. On the other hand, melatonin treatment effectively improved all cognitive impairments and reduced TNF-α, IFN-γ, and IL-17A and elevated BDNF levels in the hippocampus of obese mice. Taken together, this study suggests that melatonin treatment could have a beneficial role in the treatment of cognitive impairment in obesity.
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14
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Zheng W, Jiang WL, Zhang X, Cai DB, Sun JW, Yin F, Ren PC, Zhao M, Wu HW, Xiang YQ, Liang WN, Zheng W. Use of the RBANS to Evaluate Cognition in Patients with Schizophrenia and Metabolic Syndrome: a Meta-Analysis of Case-Control Studies. Psychiatr Q 2022; 93:137-149. [PMID: 33751356 DOI: 10.1007/s11126-021-09889-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 12/26/2022]
Abstract
Schizophrenia is associated with an increased risk of metabolic syndrome (MetS), which is an important risk factor for developing cognitive impairment in the general population. A few case-control studies have explored the relationship between MetS and cognitive deficits in individuals with schizophrenia but with inconsistent findings. This meta-analysis of case-control studies was carried out to explore the association between MetS and cognitive performance in patients with schizophrenia. Only case-control studies assessing the association of cognitive function and MetS in patients with schizophrenia were identified. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scale. Six case-control studies (n = 992) comparing cognition between patients with schizophrenia with MetS (n = 426) and those without MetS (n = 566) using the RBANS were identified. Compared to patients with schizophrenia without MetS, patients with schizophrenia and MetS had significantly more impairments in RBANS total scores [standardized mean difference (SMD) = -0.26, 95% confidence interval (CI): -0.51 to -0.02; I2 = 72%; p = 0.03], immediate memory (SMD = -0.32, 95% CI: -0.54 to -0.10; I2 = 66%; p = 0.005), attention (SMD = -0.29, 95% CI: -0.56 to -0.02; I2 = 77%; p = 0.03), and delayed memory (SMD = -0.24, 95% CI: -0.46 to -0.03; I2 = 64%; p = 0.03). No group difference was found regarding visuospatial skills and language (p > 0.05). This meta-analysis found that schizophrenia patients with MetS had worse performance on certain cognitive tasks than non-MetS patients.
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Affiliation(s)
- Wei Zheng
- Xiamen Xian Yue Hospital, Xiamen, China
| | | | - Xun Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Dong-Bin Cai
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Jia-Wei Sun
- The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fei Yin
- Harbin Medical University Daqing Campus, Daqing, China
| | | | - Min Zhao
- Shanghai Mental Health Center, Jiao Tong University School of Medicine Shanghai, Shanghai, China
| | - Hua-Wang Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Ying-Qiang Xiang
- Mental Health Prevention Hospital of Haidian District in Beijing, Beijing, China
| | - Wan-Nian Liang
- Wanke School of Public Health, Tsinghua University, Beijing, China.
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
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15
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Mukherjee S, Skrede S, Milbank E, Andriantsitohaina R, López M, Fernø J. Understanding the Effects of Antipsychotics on Appetite Control. Front Nutr 2022; 8:815456. [PMID: 35047549 PMCID: PMC8762106 DOI: 10.3389/fnut.2021.815456] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/10/2021] [Indexed: 12/16/2022] Open
Abstract
Antipsychotic drugs (APDs) represent a cornerstone in the treatment of schizophrenia and other psychoses. The effectiveness of the first generation (typical) APDs are hampered by so-called extrapyramidal side effects, and they have gradually been replaced by second (atypical) and third-generation APDs, with less extrapyramidal side effects and, in some cases, improved efficacy. However, the use of many of the current APDs has been limited due to their propensity to stimulate appetite, weight gain, and increased risk for developing type 2 diabetes and cardiovascular disease in this patient group. The mechanisms behind the appetite-stimulating effects of the various APDs are not fully elucidated, partly because their diverse receptor binding profiles may affect different downstream pathways. It is critical to identify the molecular mechanisms underlying drug-induced hyperphagia, both because this may lead to the development of new APDs, with lower appetite-stimulating effects but also because such insight may provide new knowledge about appetite regulation in general. Hence, in this review, we discuss the receptor binding profile of various APDs in relation to the potential mechanisms by which they affect appetite.
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Affiliation(s)
- Sayani Mukherjee
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway
| | - Silje Skrede
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Section of Clinical Pharmacology, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Edward Milbank
- NeurObesity Group, Department of Physiology, Center for Research in Molecular Medicine and Chronic Diseases, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Madrid, Spain.,SOPAM, U1063, INSERM, University of Angers, SFR ICAT, Bat IRIS-IBS, Angers, France
| | | | - Miguel López
- NeurObesity Group, Department of Physiology, Center for Research in Molecular Medicine and Chronic Diseases, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Madrid, Spain
| | - Johan Fernø
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway
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16
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Dombi ZB, Szendi I, Burnet PWJ. Brain Derived Neurotrophic Factor and Cognitive Dysfunction in the Schizophrenia-Bipolar Spectrum: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:827322. [PMID: 35686181 PMCID: PMC9170985 DOI: 10.3389/fpsyt.2022.827322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/27/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Cognitive impairment is a core feature of disorders on the schizophrenia-bipolar spectrum, i.e., schizophrenia, bipolar disorder, and schizoaffective disorder. Brain-derived neurotrophic factor (BDNF) has been proposed to be a biomarker of cognitive impairment in these disorders as it plays a critical role in neuroplasticity and proposed to mediate some of the psychotropic effects of medication. However, despite numerous studies investigating the association between circulating BDNF and these disorders, no solid conclusions have been drawn regarding its involvement in cognitive impairment. OBJECTIVES The current systematic review and meta-analysis aims to examine blood BDNF levels and cognitive dysfunction in patients on the schizophrenia-bipolar spectrum as well as to evaluate whether circulating BDNF measurements can act as a biomarker for cognitive dysfunction. METHODS Studies were identified by searching Embase and Medline databases for English language articles published in peer-reviewed journals between 2000 January and 2021 June according to the PRISMA guidelines. A total of 815 articles were identified of which 32 met the inclusion criteria for the systematic review - reporting on comparisons between blood BDNF levels and cognitive functions of schizophrenia or bipolar disorder patients versus healthy controls (no studies involving schizoaffective patients were specifically obtained for the time being). Twenty-four of these studies (19 with schizophrenia and 5 with bipolar disorder patients) were eligible to be included in the meta-analysis. RESULTS Our findings indicated that circulating BDNF levels were significantly reduced in patients experiencing an acute episode of schizophrenia or bipolar disorder compared to healthy controls. Cognitive function was also found to be significantly worse in patients, however, correlations between BDNF levels and cognitive impairment were not always detected. Interventions, especially pharmacotherapy seemed to improve certain aspects of cognition and increase circulating BDNF levels. CONCLUSION Circulating BDNF alone does not seem to be a valid biomarker of cognitive dysfunction in patients with disorders on the schizophrenia-bipolar spectrum, owing to several confounding factors. Changes of the circulating levels of BDNF should be evaluated in a wider context of other stress-, immune-, and inflammatory-related factors.
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Affiliation(s)
- Zsófia B Dombi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Medical Division, Gedeon Richter Plc., Budapest, Hungary
| | - István Szendi
- Department of Psychiatry, Kiskunhalas Semmelweis Hospital, Kiskunhalas, Hungary.,Department of Software Engineering, University of Szeged, Szeged, Hungary
| | - Philip W J Burnet
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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17
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Liu R, Tang W, Wang W, Xu F, Fan W, Zhang Y, Zhang C. NLRP3 Influences Cognitive Function in Schizophrenia in Han Chinese. Front Genet 2021; 12:781625. [PMID: 34956329 PMCID: PMC8702823 DOI: 10.3389/fgene.2021.781625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022] Open
Abstract
It has been proposed that immune abnormalities may be implicated with pathophysiology of schizophrenia. The nod-like receptor pyrin domain-contraining protein 3 (NLRP3) can trigger immune-inflammatory cascade reactions. In this study, we intended to identify the role of gene encoding NLRP3 (NLRP3) in susceptibility to schizophrenia and its clinical features. For the NLRP3 mRNA expression analysis, 53 drug-naïve patients with first-episode schizophrenia and 56 healthy controls were enrolled. For the genetic study, a total of 823 schizophrenia patients and 859 controls were recruited. Among them, 239 drug-naïve patients with first-episode schizophrenia were enrolled for clinical evaluation. There is no significant difference in NLRP3 mRNA levels between patients with schizophrenia and healthy controls (p = 0.07). We did not observe any significant differences in allele and genotype frequencies of rs10754558 polymorphism between the schizophrenia and control groups. We noticed significant differences in the scores of RBANS attention and total scores between the patients with different genotypes of rs10754558 polymorphism (p = 0.001 and p < 0.01, respectively). Further eQTL analysis presented a significant association between the rs10754558 polymorphism and NLRP3 in frontal cortex (p = 0.0028, p = 0.028 after Bonferroni correction). Although our findings did not support NLRP3 confer susceptibility to schizophrenia, NLRP3 may be a risk factor for cognitive impairment, especially attention deficit in this disorder.
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Affiliation(s)
- Ruimei Liu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Tang
- Department of Psychiatry, The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weiping Wang
- Department of Psychiatry, Jinhua Second Hospital, Jinhua, China
| | - Feikang Xu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weixing Fan
- Department of Psychiatry, Jinhua Second Hospital, Jinhua, China
| | - Yi Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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18
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Liu J, Xiu M, Liu H, Wang J, Li X. Plasma Lysophosphatidylcholine and Lysophosphatidylethanolamine Levels Were Associated With the Therapeutic Response to Olanzapine in Female Antipsychotics-naïve First-episode Patients With Schizophrenia. Front Pharmacol 2021; 12:735196. [PMID: 34603051 PMCID: PMC8481943 DOI: 10.3389/fphar.2021.735196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/06/2021] [Indexed: 01/31/2023] Open
Abstract
Background: Accumulating studies have shown that the pathophysiology of schizophrenia may be associated with aberrant lysophospolipid metabolism in the early stage of brain development. Recent evidence demonstrates that antipsychotic medication can regulate the phospholipase activity. However, it remains unclear whether lysophospolipid is associated with the therapeutic response to antipsychotic medication in schizophrenia. This study aimed to investigate the influence of olanzapine monotherapy on lysophosphatidylcholine (LPC) and lysophosphatidylethanolamine (LPE) and the association between symptom improvement and changes of LPC and LPE levels during treatment in antipsychotic-naïve first-episode (ANFE) patients. Materials and Methods: The psychotic symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). 25 ANFE patients were treated with olanzapine for 1 mo. The levels of LPC and LPE were determined and psychotic symptoms were assessed at baseline and at 1-mo follow-up. Results: Relative to baseline, the psychotic symptoms were significantly reduced after olanzapine treatment, except for negative symptoms. Moreover, the levels of most LPC and LPE increased after treatment. Interestingly, increased LPC(18:3) and LPC(20:2) levels were positively associated with the reduction rates of PANSS positive subscore. In addition, baseline levels of LPE(20:5), LPE(18:3) and LPE(22:5) were predictors for the reduction of positive symptoms. Conclusion: Our study reveals that the levels of lysophospolipid are associated with the improvement of positive symptoms, indicating that LPC may be a potential therapeutic target for olanzapine in schizophrenia. Moreover, baseline LPE levels were predictive biomarkers for the therapeutic response to olanzapine in the early stage of treatment in ANFE patients.
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Affiliation(s)
- Jiahong Liu
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meihong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Haixia Liu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Jun Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Xirong Li
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
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19
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Ren J, Zhang C. Rethinking olanzapine therapy for schizophrenia. Asian J Psychiatr 2021; 62:102741. [PMID: 34216978 DOI: 10.1016/j.ajp.2021.102741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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20
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Liu JH, Chen N, Guo YH, Guan XN, Wang J, Wang D, Xiu MH. Metabolomics-based understanding of the olanzapine-induced weight gain in female first-episode drug-naïve patients with schizophrenia. J Psychiatr Res 2021; 140:409-415. [PMID: 34144444 DOI: 10.1016/j.jpsychires.2021.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 12/22/2022]
Abstract
Previous studies have demonstrated that patients with schizophrenia (SZ) have greater rate of metabolic disorder as compared with the control population, which likely be the consequence of use of atypical antipsychotics. Olanzapine is a widely used antipsychotic, which increases the weight of SZ patients. However, the underlying mechanism remains poorly understood. Here we report the metabolomics-based understanding of the weight gain induced by olanzapine. 57 first-episode drug-naïve patients (FEDN) were recruited, of whom 27 patients completed a 4-week clinical trial. We then profiled the metabolomes of their plasma with the LC-MS-based nontargeted metabolomics approach at the baseline and after olanzapine monotherapy for 4 weeks. We observed that the plasma of the olanzapine-treated patient had significantly higher lysophosphatidylcholine (LysoPC), lysophosphatidylethanolamine (LysoPE) and lower carnitine as compared with that of the baseline plasma samples. Moreover, regression analyses indicated that the change of LysoPC(14:0) level was an independent contributor to the olanzapine-induced weight gain. Our study suggests that the metabolomics-based approach may facilitate the identification of biomarkers associated with the metabolic disorder causing by antipsychotic in schizophrenia patients.
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Affiliation(s)
- Jia Hong Liu
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Nan Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Yan Hong Guo
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - Xiao Ni Guan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Jun Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Mei Hong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China.
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21
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Kalejahi P, Kheirouri S, Noorazar SG, Sanayei M. The relationship between brain-derived neurotrophic factor and metabolic syndrome in patients with chronic schizophrenia: A systematic review. Neuropeptides 2021; 87:102135. [PMID: 33812160 DOI: 10.1016/j.npep.2021.102135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/18/2021] [Accepted: 02/28/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND & AIMS Schizophrenia is a serious long-term disorder in which the metabolic complications and abnormalities of the brain-derived neurotrophic factor (BDNF) can be found. In this study, we conducted a systematic review of the relationship between BDNF, metabolic syndrome (MetS) and its components in schizophrenic patients. METHODS Data were collected mainly from PubMed, Google Scholar, Scopus, and ProQuest databases. The keywords related to the BDNF, MetS, schizophrenia were searched. Two reviewers independently screened 1061 abstracts. And eventually, a total of 7 studies (6 observational and 1 interventional) was included in the systematic reviews. RESULTS Four of the 7 study ascertained statistically significant inverse relationship between serum BDNF levels and MetS in schizophrenic patients. While in the other two studies, there was no inverse relationship. In the last selected study, the researchers found a weak association between the Val66Met polymorphism in BDNF Gene and clozapine-induced MetS. CONCLUSION Although this relationship could not be determined but BDNF levels appear to be reduced in schizophrenic patients with MetS and factors such as sex and antipsychotic class differentiation, sampling and methodology and episodes of illness could play a role in the results and outcomes.
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Affiliation(s)
- Parinaz Kalejahi
- Department of Community Nutrition, Faculty of Nutrition and Food sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sorayya Kheirouri
- Department of Community Nutrition, Faculty of Nutrition and Food sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Seyyed Gholamreza Noorazar
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahzad Sanayei
- Department of Community Nutrition, Faculty of Nutrition and Food sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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22
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Gluten and FODMAPs Relationship with Mental Disorders: Systematic Review. Nutrients 2021; 13:nu13061894. [PMID: 34072914 PMCID: PMC8228761 DOI: 10.3390/nu13061894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
Nowadays, gluten and FODMAP food components (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are increasingly studied due to their possible relation with extraintestinal-associated conditions. In recent years, gluten-free diets (GFD) and low-FODMAP diets (LFD) are becoming more popular not only in order to avoid the food components that cause intolerances or allergies in some people, but also due to the direct influence of marketing movements or diet trends on feeding habits. Likewise, neurological and psychiatric diseases are currently of increasing importance in developed countries. For this reason, a bibliographic systematic review has been carried out to analyse whether there is a pathophysiological relationship between the dietary intake of gluten or FODMAPs with mental disorders. This review collects 13 clinical and randomized controlled trials, based on the PRISMA statement, which have been published in the last ten years. Based on these results, limiting or ruling out gluten or FODMAPs in the diet might be beneficial for symptoms such as depression, anxiety (7 out of 7 articles found any positive effect), or cognition deficiency (improvements in several cognition test measurements in one trial), and to a lesser extent for schizophrenia and the autism spectrum. Nevertheless, further studies are needed to obtain completely reliable conclusions.
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23
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El Massry M, Alaeddine LM, Ali L, Saad C, Eid AA. Metformin: A Growing Journey from Glycemic Control to the Treatment of Alzheimer's Disease and Depression. Curr Med Chem 2021; 28:2328-2345. [PMID: 32900343 DOI: 10.2174/0929867327666200908114902] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/30/2020] [Accepted: 07/07/2020] [Indexed: 11/22/2022]
Abstract
Metabolic stress, transduced as an altered cellular redox and energy status, presents as the main culprit in many diseases, including diabetes. However, its role in the pathology of neurological disorders is still not fully elucidated. Metformin, a biguanide compound, is an FDA approved antidiabetic drug generally used for the treatment of type 2 diabetes. The recently described wide spectrum of action executed by this drug suggests a potential therapeutic benefit in a panoply of disorders. Current studies imply that metformin could play a neuroprotective role by reversing hallmarks of brain injury (metabolic dysfunction, neuronal dystrophy and cellular loss), in addition to cognitive and behavioral alterations that accompany the onset of certain brain diseases such as Alzheimer's disease (AD) and depression. However, the mechanisms by which metformin exerts its protective effect in neurodegenerative disorders are not yet fully elucidated. The aim of this review is to reexamine the mechanisms through which metformin performs its function while concentrating on its effect on reestablishing homeostasis in a metabolically disturbed milieu. We will also highlight the importance of metabolic stress, not only as a component of many neurological disorders, but also as a primary driving force for neural insult. Of interest, we will explore the involvement of metabolic stress in the pathobiology of AD and depression. The derangement in major metabolic pathways, including AMPK, insulin and glucose transporters, will be explored and the potential therapeutic effects of metformin administration on the reversal of brain injury in such metabolism dependent diseases will be exposed.
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Affiliation(s)
- Mohamed El Massry
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Bliss Street, 11-0236, Riad El-Solh 1107-2020, Beirut, Lebanon
| | - Lynn M Alaeddine
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Bliss Street, 11-0236, Riad El-Solh 1107-2020, Beirut, Lebanon
| | - Leen Ali
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Bliss Street, 11-0236, Riad El-Solh 1107-2020, Beirut, Lebanon
| | - Celine Saad
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Bliss Street, 11-0236, Riad El-Solh 1107-2020, Beirut, Lebanon
| | - Assaad A Eid
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Bliss Street, 11-0236, Riad El-Solh 1107-2020, Beirut, Lebanon
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24
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Hagi K, Nosaka T, Dickinson D, Lindenmayer JP, Lee J, Friedman J, Boyer L, Han M, Abdul-Rashid NA, Correll CU. Association Between Cardiovascular Risk Factors and Cognitive Impairment in People With Schizophrenia: A Systematic Review and Meta-analysis. JAMA Psychiatry 2021; 78:510-518. [PMID: 33656533 PMCID: PMC7931134 DOI: 10.1001/jamapsychiatry.2021.0015] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Schizophrenia is associated with cognitive dysfunction and cardiovascular risk factors, including metabolic syndrome (MetS) and its constituent criteria. Cognitive dysfunction and cardiovascular risk factors can worsen cognition in the general population and may contribute to cognitive impairment in schizophrenia. OBJECTIVE To study the association between cognitive dysfunction and cardiovascular risk factors and cognitive impairment in individuals with schizophrenia. DATA SOURCES A search was conducted of Embase, Scopus, MEDLINE, PubMed, and Cochrane databases from inception to February 25, 2020, using terms that included synonyms of schizophrenia AND metabolic adversities AND cognitive function. Conference proceedings, clinical trial registries, and reference lists of relevant publications were also searched. STUDY SELECTION Studies were included that (1) examined cognitive functioning in patients with schizophrenia or schizoaffective disorder; (2) investigated the association of cardiovascular disease risk factors, including MetS, diabetes, obesity, overweight, obesity or overweight, hypertension, dyslipidemia, and insulin resistance with outcomes; and (3) compared cognitive performance of patients with schizophrenia/schizoaffective disorder between those with vs without cardiovascular disease risk factors. DATA EXTRACTION AND SYNTHESIS Extraction of data was conducted by 2 to 3 independent reviewers per article. Data were meta-analyzed using a random-effects model. MAIN OUTCOMES AND MEASURES The primary outcome was global cognition, defined as a test score using clinically validated measures of overall cognitive functioning. RESULTS Twenty-seven studies involving 10 174 individuals with schizophrenia were included. Significantly greater global cognitive deficits were present in patients with schizophrenia who had MetS (13 studies; n = 2800; effect size [ES] = 0.31; 95% CI, 0.13-0.50; P = .001), diabetes (8 studies; n = 2976; ES = 0.32; 95% CI, 0.23-0.42; P < .001), or hypertension (5 studies; n = 1899; ES = 0.21; 95% CI, 0.11-0.31; P < .001); nonsignificantly greater deficits were present in patients with obesity (8 studies; n = 2779; P = .20), overweight (8 studies; n = 2825; P = .41), and insulin resistance (1 study; n = 193; P = .18). Worse performance in specific cognitive domains was associated with cognitive dysfunction and cardiovascular risk factors regarding 5 domains in patients with diabetes (ES range, 0.23 [95% CI, 0.12-0.33] to 0.40 [95% CI, 0.20-0.61]) and 4 domains with MetS (ES range, 0.15 [95% CI, 0.03-0.28] to 0.40 [95% CI, 0.20-0.61]) and hypertension (ES range, 0.15 [95% CI, 0.04-0.26] to 0.27 [95% CI, 0.15-0.39]). CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, MetS, diabetes, and hypertension were significantly associated with global cognitive impairment in people with schizophrenia.
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Affiliation(s)
- Katsuhiko Hagi
- Medical Affairs, Sumitomo Dainippon Pharma, Tokyo, Japan
| | - Tadashi Nosaka
- Medical Affairs, Sumitomo Dainippon Pharma, Tokyo, Japan
| | - Dwight Dickinson
- Clinical and Translational Neuroscience Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | | | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore,Department of Psychosis, Institute of Mental Health, Singapore,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Joseph Friedman
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York
| | - Laurent Boyer
- Aix-Marseille University, Public Health, Chronic Diseases and Quality of Life, Research Unit, Marseille, France
| | - Mei Han
- School of Medicine, University of Wollongong, Wollongong, Australia,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | | | - Christoph U. Correll
- Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York,Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York,Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York,Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany
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25
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Zeng C, Yang P, Cao T, Gu Y, Li N, Zhang B, Xu P, Liu Y, Luo Z, Cai H. Gut microbiota: An intermediary between metabolic syndrome and cognitive deficits in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110097. [PMID: 32916223 DOI: 10.1016/j.pnpbp.2020.110097] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/29/2020] [Accepted: 09/01/2020] [Indexed: 12/12/2022]
Abstract
Gut microbiome interacts with the central nervous system tract through the gut-brain axis. Such communication involves neuronal, endocrine, and immunological mechanisms, which allows for the microbiota to affect and respond to various behaviors and psychiatric conditions. In addition, the use of atypical antipsychotic drugs (AAPDs) may interact with and even change the abundance of microbiome to potentially cause adverse effects or aggravate the disorders inherent in the disease. The regulate effects of gut microbiome has been described in several psychiatric disorders including anxiety and depression, but only a few reports have discussed the role of microbiota in AAPDs-induced Metabolic syndrome (MetS) and cognitive disorders. The following review systematically summarizes current knowledge about the gut microbiota in behavior and psychiatric illness, with the emphasis of an important role of the microbiome in the metabolism of schizophrenia and the potential for AAPDs to change the gut microbiota to promote adverse events. Prebiotics and probiotics are microbiota-management tools with documented efficacy for metabolic disturbances and cognitive deficits. Novel therapies for targeting microbiota for alleviating AAPDs-induced adverse effects are also under fast development.
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Affiliation(s)
- CuiRong Zeng
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - Ping Yang
- Department of Psychiatry, The Second People's Hospital of Hunan Province, Changsha 410007, Hunan Province, China
| | - Ting Cao
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - YuXiu Gu
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - NaNa Li
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - BiKui Zhang
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - Ping Xu
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - YiPing Liu
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - ZhiYing Luo
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China
| | - HuaLin Cai
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan Province, China.
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26
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Sahpolat M, Ayar D, Ari M, Karaman MA. Elevated Monocyte to High-density Lipoprotein Ratios as an Inflammation Markers for Schizophrenia Patients. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:112-116. [PMID: 33508794 PMCID: PMC7851456 DOI: 10.9758/cpn.2021.19.1.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/30/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022]
Abstract
Objective Monocyte to high density lipoprotein ratio (MHR) is a new instrument for giving notice inflammation, which plays a main role in schizophrenia. Thus, in this study, our goal was to investigate the possible association between MHR and schizophrenia. Methods The participants of this study consisted of 75 schizophrenia patients and 74 healthy individuals (control group). The Positive and Negative Syndrome Scale was used to collect data from the patient group. Complete blood count parameters and lipid profile were analyzed in all study participants. Results The patients with schizophrenia had higher MHR values (15.04 ± 3.31 in schizophrenia patients and 12.62 ± 2.99 in controls; p = 0.001). Monocyte counts and MHR of the schizophrenia patients were significantly higher than the control group. There was a significant and positive correlation between age, body mass index, severity of disease and MHR. Conclusion To our knowledge, this study was the first to demonstrate inflammatory markers such as MHR levels in schizophrenia patients. Both monocyte counts and MHR values in schizophrenia patients were higher than the control group. MHR might be an available and useful inflammatory marker to evaluate inflammation in schizophrenia patients.
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Affiliation(s)
- Musa Sahpolat
- Department of Psychiatry, Kilis State Hospital, Turkey
| | - Duygu Ayar
- Yusuf Serefoglu Faculty of Health Sciences, Kilis 7 Aralık University, Kilis, Turkey
| | - Mustafa Ari
- Department of Psychiatry, Mustafa Kemal University Tayfur Ata Sokmen Faculty of Medicine, Hatay, Turkey
| | - Mehmet Akif Karaman
- Department of Psychological Counseling and Guidance, Kilis 7 Aralık University, Kilis, Turkey
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27
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Nieto RR, Carrasco A, Corral S, Castillo R, Gaspar PA, Bustamante ML, Silva H. BDNF as a Biomarker of Cognition in Schizophrenia/Psychosis: An Updated Review. Front Psychiatry 2021; 12:662407. [PMID: 34220575 PMCID: PMC8242210 DOI: 10.3389/fpsyt.2021.662407] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/16/2021] [Indexed: 12/12/2022] Open
Abstract
Brain Derived Neurotrophic Factor (BDNF) has been linked to cognitive symptoms of schizophrenia, which has been documented in previous reviews by several authors. However, a trend has recently emerged in this field moving from studying schizophrenia as a disease to studying psychosis as a group. This review article focuses on recent BDNF studies in relation to cognition in human subjects during different stages of the psychotic process, including subjects at high risk of developing psychosis, patients at their first episode of psychosis, and patients with chronic schizophrenia. We aim to provide an update of BDNF as a biomarker of cognitive function on human subjects with schizophrenia or earlier stages of psychosis, covering new trends, controversies, current research gaps, and suggest potential future developments in the field. We found that most of current research regarding BDNF and cognitive symptoms in psychosis is done around schizophrenia as a disease. Therefore, it is necessary to expand the study of the relationship between BDNF and cognitive symptoms to psychotic illnesses of different stages and origins.
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Affiliation(s)
- Rodrigo R Nieto
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago, Chile.,Departamento de Neurociencias, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andrea Carrasco
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago, Chile
| | - Sebastian Corral
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago, Chile.,Facultad de Psicología, Universidad San Sebastián, Santiago, Chile
| | - Rolando Castillo
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago, Chile.,Departamento de Neurología y Psiquiatría, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Universidad de Chile, Santiago, Chile
| | - Pablo A Gaspar
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago, Chile.,Departamento de Neurociencias, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Departamento de Neurología y Psiquiatría, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Universidad de Chile, Santiago, Chile.,Biomedical Neuroscience Institute, Universidad de Chile, Santiago, Chile
| | - M Leonor Bustamante
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Programa de Genética Humana, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Hernan Silva
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago, Chile.,Biomedical Neuroscience Institute, Universidad de Chile, Santiago, Chile
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28
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Sahpolat M, Ari M. Higher prevalence of metabolic syndrome and related factors in patients with first-episode psychosis and schizophrenia: a cross-sectional study in Turkey. Nord J Psychiatry 2021; 75:73-78. [PMID: 32886012 DOI: 10.1080/08039488.2020.1815080] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Schizophrenia patients (SPP) have an increased risk of metabolic syndrome (MetS) and are twice more likely to experience diabetes mellitus and obesity than the general population. AIMS The main purpose of this study was to assess the prevalence of MetS and its components in first-episode psychosis patients (FEPP) and SPP. METHODS This study consisted a total of 38 untreated FEPP, 40 SPP and 41 randomly selected healthy volunteers admitted to the psychiatric outpatient clinic. The diagnosis of MetS was made based on Adult Treatment Panel III (ATP III), ATP III-A and International Diabetes Federation (IDF) criteria. RESULTS The prevalence of MetS was 26.3, 28.9 and 31.5% according to ATP III, ATP III-A and IDF criteria in the FEPP, respectively. The prevalence of MetS was 37.5, 40 and 42.5% according to ATP III, ATP III-A and IDF criteria in the SPP, respectively. The prevalence of MetS was 9.7, 9.7 and 12.2% according to ATP III, ATP III-A and IDF criteria in the control group, respectively. The prevalence of MetS was higher in female patients than male patients based on all three diagnostic criteria. The MetS patients had a higher mean of age, a longer duration of disease, and treatment compared to patients without MetS. CONCLUSION The current study found that FEPP and SPP had an increased prevalence of MetS. Especially, clinicians should pay attention to MetS in SPP due to the presence of risk factors, such as advanced age, being female, and long duration of disease and treatment.
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Affiliation(s)
- Musa Sahpolat
- Department of Psychiatry, Kilis State Hospital, Kilis, Turkey
| | - Mustafa Ari
- Tayfur Ata Sokmen Faculty of Medicine, Department of Psychiatry, Mustafa Kemal University, Hatay, Turkey
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29
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Cheng P, Wang L, Xu L, Zhou Y, Zhang L, Li W. Factors Related to the Length of Stay for Patients With Schizophrenia: A Retrospective Study. Front Psychiatry 2021; 12:818254. [PMID: 35140640 PMCID: PMC8818940 DOI: 10.3389/fpsyt.2021.818254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/16/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The length of stay (LOS) of patients with schizophrenia has been a wide concern of researchers. Reasonable management of the LOS to achieve a balance between quality of treatment and efficient medical source allocation has become a significant issue in clinical work in psychiatry. Figuring out the factors related to the LOS of schizophrenia patients can help optimize its management by the hospital. METHOD The essential information of patients was obtained from the electronic medical record system. The variables were divided into the following kinds: demographic, clinical, and biochemical. Univariate analysis and multivariate analysis were conducted to find the potential factors related to the LOS of schizophrenia patients. Receiver operating characteristic analyses were conducted to evaluate the accuracy of judging the LOS of the regression model. RESULT A total of 1,160 patients with schizophrenia were enrolled in our research. Our results demonstrated that the status of unmarried (single, separated, divorced, or widowed) and the abnormality of thyroid-stimulating hormone (TSH) were risk factors for the longer LOS of schizophrenia patients. The area under the curve was 0.576, which meant that the regression model had a certain predictive value. CONCLUSION To our knowledge, this research is the first study to analyze the effect of various factors, including the biochemical index, on the LOS of a single type of mental disorder. Marital status and TSH were proven to be related to the LOS of schizophrenia patients. The results of this study provided reference factors of LOS for clinical psychiatry, which will be helpful to the management of hospitalization and in optimizing the allocation of medical sources.
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Affiliation(s)
- Peng Cheng
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lirong Wang
- Xiangya School of Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Lizhi Xu
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ying Zhou
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Zhang
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Weihui Li
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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Wen N, Chen L, Miao X, Zhang M, Zhang Y, Liu J, Xu Y, Tong S, Tang W, Wang M, Liu J, Zhou S, Fang X, Zhao K. Effects of High-Frequency rTMS on Negative Symptoms and Cognitive Function in Hospitalized Patients With Chronic Schizophrenia: A Double-Blind, Sham-Controlled Pilot Trial. Front Psychiatry 2021; 12:736094. [PMID: 34539472 PMCID: PMC8446365 DOI: 10.3389/fpsyt.2021.736094] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/11/2021] [Indexed: 11/25/2022] Open
Abstract
This study aimed to evaluate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) over left dorsolateral pre-frontal cortex (DLPFC) in ameliorating negative symptoms and cognitive impairments in patients with chronic schizophrenia. Fifty-two patients with chronic schizophrenia were randomly assigned to two groups: active rTMS group and sham rTMS group, with existing antipsychotic drugs combined 20 sessions of 10 Hz active/sham rTMS over DLPFC (20 min/session, 5 times/week). The PANSS, RBANS, and SCWT were used to evaluate the clinical symptoms and cognitive functions of the patients. Our results indicated significant improvements in clinical symptoms (PANSS total and subscale scores) and cognitive functions (RBANS total and subscale scores, card 1 and card 3 of the SCWT test) (All p <0.05) after 4-week intervention both in active and sham rTMS group. Moreover, the active rTMS group showed more effective on ameliorating negative symptoms (p = 0.002), immediate memory (p = 0.016) and delayed memory (p = 0.047) compared to the sham group. Interestingly, PANSS negative symptom scores was negatively correlated with RBANS language scores in the real stimulation group (p = 0.046). The study found that the high frequency rTMS stimulation over left DLPFC as a supplement to antipsychotics may have potential benefits in improving clinical symptoms and cognitive functions in patients with chronic schizophrenia.
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Affiliation(s)
- Na Wen
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China.,School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Lei Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xuemeng Miao
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Min Zhang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yaoyao Zhang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wei Tang
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Mengpu Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jiahong Liu
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Siyao Zhou
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xinyu Fang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Ke Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.,Department of Psychiatry, The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
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Chen J, Lu W, Zhang Y, Fan W, Tang W, Zhang C. FADS1 modulates metabolic syndrome in schizophrenia patients receiving olanzapine monotherapy. Asian J Psychiatr 2020; 54:102352. [PMID: 32801079 DOI: 10.1016/j.ajp.2020.102352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 12/18/2022]
Abstract
In this study, we hypothesized that fatty acid desaturase-1 (FADS1) and fatty acid desaturase-2 (FADS2) may mediate metabolic syndrome (MetS) in patients receiving olanzapine monotherapy. 216 schizophrenia patients were recruited. There is a significant difference between the patients with or without MetS in term of the expression of FADS1 mRNA (F = 4.58, P = 0.03), but not FADS2 mRNA (F = 1.29, P = 0.26). We observed a positive association between FADS1 mRNA and high-density lipoprotein cholesterol (P = 0.04), and a negative association between FADS1 mRNA and systolic blood pressure (P = 0.04). Our findings implied that FADS1 may be an important genetic modifier that can regulate olanzapine-associated metabolic disturbance.
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Affiliation(s)
- Jianmin Chen
- Department of Psychiatry, Jinhua Second Hospital, Jinhua, Zhejiang, China
| | - Weihong Lu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weixing Fan
- Department of Psychiatry, Jinhua Second Hospital, Jinhua, Zhejiang, China
| | - Wei Tang
- Department of Psychiatry, Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Abstract
Our previous genetic study identified a variant rs1344706 in the zinc finger protein 804A (ZNF804A) gene conferring susceptibility to bipolar disorder subtype I (BD-I) in Han Chinese. Literature documented that this variant may affect brain structure and function. As such, we attempted to identify whether the rs1344706 polymorphism influences cognitive function in patients with bipolar disorder I. We recruited 177 patients with bipolar disorder in remission period. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The single nucleotide polymorphisms (SNP) rs1344706 was genotyped using TaqMan assays. Analysis of covariance (ANCOVA) analysis showed a significant genotypic effect on RBANS immediate memory (P = 0.002) and total score (P = 0.001). Post hoc analysis showed that the patients with T/T genotype have lower RBANS immediate memory and total scores than those with T/G or G/G genotypes. When the patients were stratified by sex, such significances are only seen in male patients, but not female patients. Our findings suggested a sex-specific effect of ZNF804A rs1344706 polymorphism on cognitive function in patients with bipolar disorder-I.
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Omega-3 fatty acids ameliorate cognitive dysfunction in schizophrenia patients with metabolic syndrome. Brain Behav Immun 2020; 88:529-534. [PMID: 32304881 DOI: 10.1016/j.bbi.2020.04.034] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 11/23/2022] Open
Abstract
Our previous study showed that metabolic abnormalities reduced the levels of brain-derived neurotrophic factor (BDNF) and deteriorated cognitive performance in patients with schizophrenia. Inflammation may play a key role in this process. Omega-3 fatty acids have been documented to ameliorate inflammation. Therefore, we hypothesized that omega-3 fatty acids may be of value in enhancing BDNF levels and improving cognitive function in patients with schizophrenia with metabolic syndrome (MetS). We recruited 80 patients with both schizophrenia and MetS who received long-term olanzapine monotherapy. The enzyme-linked immunosorbent assay was used to measure the plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). The patients were randomly assigned to the OMG-3 group (n = 40) or the placebo group (n = 40). Of the 80 patients who consented to the study, 72 completed this 12-week RCT. The primary outcome was the changes from baseline to 12 weeks in clinical characteristics and the levels of BDNF, CRP, IL-6 and TNF-α. There was a significant correlation between omega-3 fatty acid treatment and enhanced delayed memory factor in the RBANS assessment (Fgroup×time = 6.82; df = 1, 66; P = 0.01) when the patients completed this study. Along with cognitive improvement, omega-3 fatty acids enhanced BDNF (Fgroup×time = 4.93; df = 1, 66; P = 0.03) and reduced CRP (Fgroup×time = 17.11; df = 1, 66; P < 0.01), IL-6 (Fgroup×time = 9.71; df = 1, 66; P < 0.004) and TNF-α (Fgroup×time = 6.71; df = 1, 66; P = 0.012) levels after 12 weeks of treatment. The changes in BDNF levels are negatively correlated with the changes in TNF-α levels (r = -0.37, P = 0.03) but not with the changes in CRP and IL-6 levels. Our findings provide suggestive evidence that omega-3 fatty acids have beneficial effects on cognitive function in patients with MetS, which is paralleled by enhanced BDNF levels.
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Adamowicz K, Kucharska-Mazur J. Dietary Behaviors and Metabolic Syndrome in Schizophrenia Patients. J Clin Med 2020; 9:jcm9020537. [PMID: 32079084 PMCID: PMC7073719 DOI: 10.3390/jcm9020537] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 12/12/2022] Open
Abstract
The metabolic syndrome (MS) is highly prevalent in schizophrenia patients, resulting from both pharmacotherapy and their lifestyle. To avoid its development, the analysis of patients' eating behaviors followed by the necessary nutritional changes should become a routine element of treatment. The aim of this study is to investigate the effect of dietary habits on the course of schizophrenia and MS, cognitive performance, symptom severity, and subjective assessment of eating behaviors in schizophrenia patients. Total of 87 participants (63.2% women) aged 19 to 67 years (M = 41.67; SD = 12.87), of whom 60 met the IDF criteria for MS, completed the PANSS, the verbal fluency test, the Stroop Color-Word Test, and the digit span task, followed by a thorough nutritional interview. There were no significant differences in the dietary behaviors between investigated schizophrenia patients with and without comorbid MS. Interestingly, their eating habits compared quite favorably to those described in the literature. No associations were found between positive eating habits and other tested variables in patients with MS. They were, however, linked to lower PANSS scores in the entire sample. In addition, positive eating habits correlated with better cognitive performance and a more adequate subjective assessment of dietary habits. It would be amiss to assume that schizophrenia patients lack the ability to control their eating behaviors. Nutrition education may foster desirable dietary changes and improve the sense of agency, thus helping to reduce symptom severity and enhancing cognitive performance in this patient population.
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Fang X, Yu L, Wang D, Chen Y, Wang Y, Wu Z, Liu R, Ren J, Tang W, Zhang C. Association Between SIRT1, Cytokines, and Metabolic Syndrome in Schizophrenia Patients With Olanzapine or Clozapine Monotherapy. Front Psychiatry 2020; 11:602121. [PMID: 33324265 PMCID: PMC7723842 DOI: 10.3389/fpsyt.2020.602121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: Previous studies consistently showed the interaction between Sirtuin 1 (SIRT1) and immune inflammation is significantly related to metabolic abnormalities, but their role in the pathogenesis of metabolic syndrome caused by second-generation antipsychotics (SGAs) in schizophrenia patients largely remains unknown. Hence, the present study aimed to fill this gap. Methods: A total of 54 schizophrenia patients with olanzapine or clozapine monotherapy [metabolic syndrome (MetS)/non-MetS patients, 27/27] and 67 healthy subjects were recruited in the present study. The Positive and Negative Syndrome Scale was used, and the plasma levels of SIRT1, interleukin 6 (IL-6), IL-8, IL-10, and tumor necrosis factor α (TNF-α) were measured. Results: The results showed that schizophrenia patients treated with olanzapine or clozapine (both MetS and non-MetS groups) had significantly higher plasma levels of IL-6, IL-10, and TNF-α compared to normal controls (all P < 0.05). Moreover, the MetS patients exhibited markedly lower plasma levels of SIRT1 and higher plasma levels of IL-6 than non-MetS patients and normal controls (all P < 0.05). However, there were no significant differences in IL-8 levels between groups. Our correlation analysis showed that SIRT1 was significantly correlated with diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol in schizophrenia patients. The stepwise logistic regression analysis further identified the IL-6 × SIRT1 (β = -0.463, t = 10.040, P = 0.002) as the influencing factor for the MetS in the patients. Conclusion: Our preliminary findings suggest that SIRT1 interacted with inflammatory cytokines associated with MetS in schizophrenia patients treated with SGA monotherapy.
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Affiliation(s)
- Xinyu Fang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zenan Wu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruimei Liu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Tang
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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A comprehensive analysis of GSK3B variation for schizophrenia in Han Chinese individuals. Asian J Psychiatr 2020; 47:101832. [PMID: 31665698 DOI: 10.1016/j.ajp.2019.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 01/09/2023]
Abstract
Glycogen synthase kinase-3B (GSK-3B) is thought to be involved in numerous neuronal functions and is implicated in the pathophysiology of schizophrenia. Interestingly, a functional polymorphism, rs3755557, in the GSK3B promoter region has been consistently reported to be a risk factor for schizophrenia in southwestern and northwestern Han Chinese individuals. In this study, we carried out a comprehensive analysis of the association of the rs3755557 polymorphism within GSK3B and schizophrenia in Han Chinese individuals. We recruited 782 patients with schizophrenia and 807 healthy controls from eastern China. In total, 143 drug-naïve patients with first-episode schizophrenia were enrolled for the evaluation of clinical features. We did not observe significant differences in genotype or allele distribution of the rs3755557 polymorphism between the schizophrenia and control groups in eastern Chinese individuals. After pooling these data of 2188 subjects with schizophrenia and 2885 healthy controls, we observed a significant difference in the A allele distribution of the rs3755557 polymorphism between schizophrenia patients and controls (Z = 4.13 P < 0.01). We further examined the relationship between the rs3755557 polymorphism and the clinical features of schizophrenia by comparing scores of the The Positive and Negative Syndrome Scale (PANSS) and The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) with the genotypes of the rs3755557 polymorphism. There were significant differences in the scores of RBANS attention, delayed memory and total scores between the patients with the A allele and those without the A allele (P = 0.03, 0.01 and 0.01 after Bonferroni correction, respectively). Our eQTL analysis showed a significant association between the rs3755557 polymorphism and GSK3B expression in the hippocampus (P = 0.027). Our findings indicated that the rs3755557 polymorphism may confer susceptibility to schizophrenia and cognitive dysfunction in Han Chinese individuals.
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Alvarez-Herrera S, Escamilla R, Medina-Contreras O, Saracco R, Flores Y, Hurtado-Alvarado G, Maldonado-García JL, Becerril-Villanueva E, Pérez-Sánchez G, Pavón L. Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics. Front Endocrinol (Lausanne) 2020; 11:195. [PMID: 32373066 PMCID: PMC7186385 DOI: 10.3389/fendo.2020.00195] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/18/2020] [Indexed: 12/15/2022] Open
Abstract
Atypical antipsychotics (AAP) or second-generation antipsychotics are the clinical option for schizophrenia treatment during acute psychoses, but they are also indicated for maintenance during lifetime, even though they are being used for other psychiatric conditions in clinical practice such as affective disorders and autism spectrum disorder, among others. These drugs are differentiated from typical antipsychotics based on their clinical profile and are a better choice because they cause fewer side effects regarding extrapyramidal symptoms (EPS). Even though they provide clear therapeutic benefits, AAP induce peripheral effects that trigger phenotypic, functional, and systemic changes outside the Central Nervous System (CNS). Metabolic disease is frequently associated with AAP and significantly impacts the patient's quality of life. However, other peripheral changes of clinical relevance are present during AAP treatment, such as alterations in the immune and endocrine systems as well as the intestinal microbiome. These less studied alterations also have a significant impact in the patient's health status. This manuscript aims to revise the peripheral immunological, endocrine, and intestinal microbiome changes induced by AAP consumption recommended in the clinical guidelines for schizophrenia and other psychiatric disorders.
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Affiliation(s)
- Samantha Alvarez-Herrera
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Raúl Escamilla
- Clínica de Esquizofrenia, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Oscar Medina-Contreras
- Laboratorio de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
| | - Ricardo Saracco
- Clínica de Esquizofrenia, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Yvonne Flores
- Clínica de Esquizofrenia, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Gabriela Hurtado-Alvarado
- Area of Neurosciences, Department of Biology of Reproduction, CBS, Universidad Autonoma Metropolitana-Iztapalapa, Mexico City, Mexico
| | - José Luis Maldonado-García
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Enrique Becerril-Villanueva
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Gilberto Pérez-Sánchez
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Lenin Pavón
- Laboratorio de Psicoinmunología, Dirección de Investigaciones en Neurociencias del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
- *Correspondence: Lenin Pavón
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Adamowicz K, Mazur A, Mak M, Samochowiec J, Kucharska-Mazur J. Metabolic Syndrome and Cognitive Functions in Schizophrenia-Implementation of Dietary Intervention. Front Psychiatry 2020; 11:359. [PMID: 32425834 PMCID: PMC7203414 DOI: 10.3389/fpsyt.2020.00359] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 04/08/2020] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The co-existence of schizophrenia and metabolic syndrome is a widely described phenomenon that contributes to the worse functioning of patients in everyday life. A relatively new area of research is the relationship between metabolic syndrome (MS) and cognitive function in patients with schizophrenia. The aim of the study was to verify the relationship between the presence of metabolic syndrome and cognitive function of patients with schizophrenia and to assess the possibility of changing cognitive function by introducing appropriate dietary intervention. MATERIALS AND METHODS The study involved 87 individuals diagnosed with schizophrenia according to ICD-10 criteria, aged 19 to 67 years (M = 41.67; SD = 11.87). Patients were in the remission phase of schizophrenia, all using antipsychotics for pharmacological treatment. From a group of 83 patients with schizophrenia and diagnosed metabolic syndrome (according to IDF criteria) 30 patients were randomly assigned to an experimental group-with dietary intervention, 29 patients-to group without dietary intervention, 24 patients with schizophrenia without metabolic syndrome was a comparison group. All groups were evaluated for cognitive function using Stroop Test, Trail Making Test (TMT), Verbal Fluency Test, Digit Span Backwards Test. In the experimental group a dietary intervention was applied, which was to provide the examined person with a 7-day dietary plan with reduced calorie content, in compliance with the Mediterranean diet. RESULTS After the dietary intervention there was a significant improvement in the number of errors made in the third Stroop Test (p <0.001), the time taken to complete the Point Linking Test was shortened (Test B; p = 0.005), there was an improvement in Verbal Fluency Test in "animals" category (p = 0.006) "sharp objects" category (p = 0.009), the number of repeated digits has increased in Digit Span Test in "forward" category (p = 0.001) and overall completion of the test (p = 0.021). In the group of patients with MS without dietary intervention, the results of cognitive tests remained mostly unchanged. CONCLUSIONS Change of eating habits may be a significant element of a holistic approach to the problems of treatment of schizophrenia.
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Affiliation(s)
- Katarzyna Adamowicz
- Department and Clinic of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Aleksandra Mazur
- Department of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Monika Mak
- Department and Clinic of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Jerzy Samochowiec
- Department and Clinic of Psychiatry, Pomeranian Medical University, Szczecin, Poland
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Fang X, Chen Y, Wang Y, Ren J, Zhang C. Depressive symptoms in schizophrenia patients: A possible relationship between SIRT1 and BDNF. Prog Neuropsychopharmacol Biol Psychiatry 2019; 95:109673. [PMID: 31247244 DOI: 10.1016/j.pnpbp.2019.109673] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/04/2019] [Accepted: 06/17/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Depressive symptoms are commonly seen in schizophrenia. Increasing evidence implicates that both SIRT1 and BDNF closely related to the development of depression. So we here aimed to explore the effect of BDNF and SIRT1 on the depressive symptoms, and also explore the risk factors for the depressive symptoms in schizophrenia patients. METHODS A group of 203 participants (case/controls, 174/29) was recruited in the present work. Significant depression was classified by the CDSS score 7 or above. The psychotic symptoms and cognitive functions in schizophrenia patients were evaluated by PANSS and RBANS respectively. And the plasma concentration of SIRT1 and BDNF were measured in 167 participants (case/controls, 138/29). RESULTS Compared to healthy subjects, schizophrenia patients exhibited notably lower levels of BDNF (P < 0.05). And we observed that patients with depression displayed a worse psychotic symptom (P < 0.01), a poorer cognitive function(P < 0.05), as well as lower plasma BDNF and SIRT1 levels (Bonferroni corrected P < 0.05) compared to those no depressive patients. And the SIRT1 levels were positively correlated with BDNF levels in the case group (P < 0.001). And the regression analysis showed that negative symptoms and general psychopathology in PANSS, attention and delayed memory in RBANS, BDNF and SIRT1 were independent risk factors for depressive symptoms in schizophrenia. CONCLUSION Aside from the association with psychotic symptoms, we provided evidence suggesting that low BDNF and SIRT1 concentration value may be responsible for the occurrence of depression in schizophrenic patients.
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Affiliation(s)
- Xinyu Fang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Fang X, Chen L, Wang D, Yu L, Wang Y, Chen Y, Ren J, Tang W, Zhang C. Metabolic profiling identifies TC and LDL as potential serum biomarkers for depressive symptoms in schizophrenia. Psychiatry Res 2019; 281:112522. [PMID: 31521045 DOI: 10.1016/j.psychres.2019.112522] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 01/25/2023]
Abstract
This study aimed to explore the relationship between serum levels of cardiometabolic biomarkers and depressive symptoms in schizophrenia patients treated with atypical antipsychotics. A total of 210 patients with schizophrenia and 70 healthy controls were recruited in our present study. All patients were rated on the 17-item Hamilton Depression Rating Scale (HAMD-17) to measure depressive symptoms and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. Serum cardiometabolic biomarkers (HDL, LDL, TC, TG, GLU) in all participants were measured. Our results showed that schizophrenia patients had higher levels of serum GLU, TG, TC, LDL and BMI, but lower levels of HDL than controls (all P < 0.05). Compared to patients without depressive symptoms, those with depressive symptoms showed higher PANSS total, general psychopathology, positive and negative symptom scores (all p < 0.05), as well as higher serum levels of LDL (p < 0.001) and TC (p = 0.011). In addition, our correlation analysis showed that serum LDL (P < 0.001) and TC (P = 0.045) levels were positively associated with HAMD total scores in schizophrenia patients after age, sex and education levels were controlled. Our results suggest the appearance of depression in schizophrenia patients may be associated with high levels of metabolic parameters, especially TC and LDL.
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Affiliation(s)
- Xinyu Fang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lixian Chen
- The Second People's Hospital of Yuhuan, Zhejiang, China
| | - Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wei Tang
- Wenzhou Kangning Hospital, Wenzhou Medical University, Zhejiang, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Xiu MH, Wang DM, Du XD, Chen N, Tan SP, Tan YL, Yang FD, Cho RY, Zhang XY. Interaction of BDNF and cytokines in executive dysfunction in patients with chronic schizophrenia. Psychoneuroendocrinology 2019; 108:110-117. [PMID: 31255950 DOI: 10.1016/j.psyneuen.2019.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/15/2019] [Accepted: 06/11/2019] [Indexed: 12/21/2022]
Abstract
Multiple lines of evidence indicate that patients with chronic schizophrenia (SCZ) display executive dysfunction across the illness course. However, the potential molecular pathophysiologic mechanisms remain poorly elucidated. Neurodevelopmental changes caused by alterations of inflammatory mediators and neurotrophins have been shown to occur in the earliest stages of SCZ, and be associated with executive dysfunction (ED) in SCZ. Therefore, the current study was to investigate whether the interplay between BDNF and inflammatory mediators was involved in the disruption of executive function of long-term hospitalized patients with chronic SCZ. Serum cytokines and BDNF levels were measured in 112 long-term hospitalized patients with chronic SCZ and 44 healthy normal controls. Executive functions were assessed by verbal fluency tests (VFT), the Stroop word-color test (Stroop), and the Wisconsin card sorting tests (WCST).The results showed that the patients had higher IL-2, IL-6, IL-8, but lower TNF-α and BDNF compared to control subjects. In the patient group, BDNF was positively associated with IL-2 and IL-8 levels, while lower BDNF levels were correlated with ED measured by VFT and WCST tests. Multiple stepwise regression analyses confirmed that BDNF × IL-8 and BDNF × TNF-α were factors influencing the total score of VFT, while BDNF × IL-8 and BDNF × TNF-α were recognized as influencing factors for WCST scores. Our results suggest complex interactions between BDNF and cytokines were involved in the pathophysiology of executive function impairments in patients with SCZ.
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Affiliation(s)
- Mei Hong Xiu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dong Mei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang Dong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Nan Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shu Ping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Fu De Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Chellappa SA, Pathak AK, Sinha P, Jainarayanan ASHWINK, Jain S, Brahmachari SK. Meta-analysis of genomic variants and gene expression data in schizophrenia suggests the potential need for adjunctive therapeutic interventions for neuropsychiatric disorders. J Genet 2019. [DOI: 10.1007/s12041-019-1101-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Effects of omega-3 fatty acids on metabolic syndrome in patients with schizophrenia: a 12-week randomized placebo-controlled trial. Psychopharmacology (Berl) 2019; 236:1273-1279. [PMID: 30519766 DOI: 10.1007/s00213-018-5136-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/22/2018] [Indexed: 12/11/2022]
Abstract
RATIONALE Individuals with schizophrenia are at increased risk of developing metabolic syndrome (MetS) due to their lifestyle and antipsychotic treatment. Our previous study showed that patients with both schizophrenia and MetS present an increased expression and production of tumor necrosis factor-alpha (TNF-alpha). Omega-3 fatty acids have a documented role in suppressing TNF-alpha; therefore, we hypothesized that they may be of value in relieving inflammation and improving metabolic disturbance in patients with both schizophrenia and MetS. OBJECTIVES This study employed a randomized placebo-controlled trial to investigate the effects of omega-3 fatty acids on MetS in patients with schizophrenia. METHODS We recruited 80 patients with both schizophrenia and MetS who received long-term olanzapine monotherapy. The patients were randomly assigned to the OMG-3 group (n = 40) or the placebo group (n = 40). RESULTS Patients with both schizophrenia and MetS had significantly higher levels of TNF-alpha than the control subjects (Z = - 4.37, P < 0.01). There was a significant correlation between omega-3 fatty acid treatment and reduced triglyceride (TG) levels (Fgroup × time = 13.42; df = 1, 66; P < 0.01) when the patients completed this study. Along with metabolic improvement, omega-3 fatty acids decreased TNF-alpha levels after 12 weeks of treatment (Fgroup × time = 6.71; df = 1, 66; P = 0.012). We also found that the extent of TNF-alpha decrease was significantly correlated with that of TG decrease (r = 0.38, P = 0.001). CONCLUSIONS Our findings provide suggestive evidence that omega-3 fatty acids have beneficial effects on TG metabolism in patients with both schizophrenia and MetS that parallel decreased inflammation levels.
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Fang X, Wang Y, Chen Y, Ren J, Zhang C. Association between IL-6 and metabolic syndrome in schizophrenia patients treated with second-generation antipsychotics. Neuropsychiatr Dis Treat 2019; 15:2161-2170. [PMID: 31534339 PMCID: PMC6681158 DOI: 10.2147/ndt.s202159] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 07/02/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Second-generation antipsychotics (SGAs) have a high risk of causing metabolic syndrome (MetS). There is accumulating evidence supporting the fact that the activation of inflammatory pathway contributes to the development of MetS and further aggravates cognitive impairment. This study aimed to investigate the relationship between interleukin-6 (IL-6), cognitive function, and MetS in schizophrenia patients treated with SGAs. METHODS One hundred and seventy-four patients with schizophrenia using SGAs were divided into MetS and non-MetS group, based on the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. Cognitive function was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A total of 138 patients and 29 healthy controls were examined in the plasma IL-6 levels. RESULTS The prevalence of MetS in schizophrenia patients treated with SGAs was 33% in this study. There were no significant differences in cognitive functions (both RBANS total score and subscale score) between MetS and non-Mets patients (P>0.05). Patients with MetS had higher plasma levels of IL-6 compared to non-MetS patients (P=0.019). However, such difference was only found in male patients (male: P=0.012; female: P=0.513). The partial correlational analysis further showed that IL-6 levels were notably negative related to the HDL levels in male schizophrenia patients after age, years of education, body mass index (BMI), age of onset, total disease course, and equal dose of olanzapine were controlled (male: P=0.009; female: P=0.450). In addition, the multiple regression analysis (stepwise model) performed in the male patient subgroup showed that IL-6 (beta =-0.283, t=-2.492, P=0.015) was an independent contributor to the HDL levels. However, the IL-6 was not an independent contributor to the HDL levels in female patients. CONCLUSION Our findings provide evidence suggesting that the immune-inflammatory effect of IL-6 on SGAs-induced MetS may be in a gender manner.
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Affiliation(s)
- Xinyu Fang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Andiné P, Bergman H. Focus on Brain Health to Improve Care, Treatment, and Rehabilitation in Forensic Psychiatry. Front Psychiatry 2019; 10:840. [PMID: 31849721 PMCID: PMC6901922 DOI: 10.3389/fpsyt.2019.00840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/22/2019] [Indexed: 01/05/2023] Open
Affiliation(s)
- Peter Andiné
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Henrik Bergman
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Fang X, Chen Y, Wang Y, Zhang C. Identification of risk factors for suicidal ideation in patients with schizophrenia. Psychiatry Res 2019; 271:195-199. [PMID: 30500709 DOI: 10.1016/j.psychres.2018.11.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/05/2018] [Accepted: 11/21/2018] [Indexed: 12/21/2022]
Abstract
Patients with schizophrenia have a high risk for suicide, and therefore, identification of risk factors for suicidal ideation (SI) may be helpful to reduce suicide rate. This study aimed to detect which clinical symptoms and biochemical parameters were most strongly associated with SI. A total of 174 patients and 35 healthy controls were enrolled in our study. Patients were evaluated by the Positive and Negative Syndrome Scale (PANSS), Scale of Assessment Negative Symptoms (SANS) and the Calgary Depression Scale for Schizophrenia (CDSS) for psychiatric and depressive symptoms, and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) for cognitive function. We examined the levels of prolactin (PRL) and metabolic parameters in all participants. Our results showed a significantly increased level of PRL in patients compared to the controls before (t = 10.414, P < 0.001) and after (F = 31.308, P < 0.001) covariates were controlled for. In addition, we found that patients with SI had significantly higher PRL levels than those without SI (t = 2.586, P = 0.011). And there were positive correlations between serum PRL levels (r = 0.194, P = 0.010), serum fasting triglyceride levels (TG) (r = 0.188, P = 0.013), and RBANS visuospatial skill subscores (r = 0.162, P = 0.036) and SI severity. Finally, the stepwise multiple linear regression analysis revealed that SI severity was significantly associated with PRL levels, fasting TG levels and RBANS visuospatial skill subscores. This study provides support that greater cognitive ability, specifically visuospatial skill, PRL and TG, may confer an elevated risk for more severe SI in schizophrenia patients.
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Affiliation(s)
- Xinyu Fang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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BDNF as a pharmacogenetic target for antipsychotic treatment of schizophrenia. Neurosci Lett 2018; 726:133870. [PMID: 30312750 DOI: 10.1016/j.neulet.2018.10.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/04/2018] [Accepted: 10/08/2018] [Indexed: 01/03/2023]
Abstract
Antipsychotic drugs remain the mainstay of pharmacotherapy for schizophrenia. As there are large individual variations in efficacy and side-effects of antipsychotic drugs, there is a strong demand for personalized medication to treat schizophrenia. Pharmacogenetic research into antipsychotic drugs has examined a number of genetic variants and only a few polymorphisms have been found which promise to be associated with the therapeutic efficacy and side-effects of antipsychotic drugs. Brain-derived neurotrophic factor (BDNF) is a neurotrophin that plays a major role in neurogenesis and neuroplasticity, and in the modulation of several neurotransmitter systems including the dopaminergic system involved in the pathophysiology of schizophrenia. This review focused on the association between the BDNF gene Val66Met polymorphism and antipsychotic drugs. The BDNF Val66Met polymorphism has been related to the pathophysiology of schizophrenia, psychotic symptomatology, cognition, efficacy and side-effects of antipsychotic drugs. The BDNF Val66Met variants could be a promising target for antipsychotic medication options or developing next generation antipsychotic drugs. However, some studies showed inconsistent results due to sample size, ethnic differences and different antipsychotic drugs. Further studies will be required in this area to confirm the effect of the BDNF Val66Met polymorphism in the pathophysiology of schizophrenia and patients' response to antipsychotic drugs, especially in a larger sample size and in different ethnic populations.
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Kao ACC, Burnet PWJ, Lennox BR. Can prebiotics assist in the management of cognition and weight gain in schizophrenia? Psychoneuroendocrinology 2018; 95:179-185. [PMID: 29883788 DOI: 10.1016/j.psyneuen.2018.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/14/2018] [Accepted: 05/18/2018] [Indexed: 01/11/2023]
Abstract
Schizophrenia is among the top half of the 25 leading causes of disabilities worldwide with a 10-20 year decrease in life expectancy. Ineffective pharmacotherapy in the management of cognitive deficits and weight gain are known to be significant contributors; therefore interventions that may mitigate one, or both, of these parameters would be highly beneficial. Manipulation of the gut microbiome using dietary supplements such as prebiotics may be one such intervention. Preclinical studies have shown that a 2-4 week dietary supplementation with a prebiotic has beneficial effects on learning and memory, and prevents pro-inflammatory signals that are detrimental to cognitive processes. Furthermore, prebiotics influence metabolism, and in obesity they increase the expression of anorexigenic gut hormones such as peptide tyrosine tyrosine, glucagon-like peptide 1 and leptin, as well as decrease levels of orexigenic hormones such as ghrelin. Despite compelling evidence for the pro-cognitive and neuroprotective effects of prebiotics in rodents, their ability to alleviate cognitive deficits or enhance cognition needs to be evaluated in humans. Here we suggest that important symptoms associated with schizophrenia, such as cognitive impairment and weight gain, may benefit from concurrent prebiotic therapy.
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Affiliation(s)
- Amy Chia-Ching Kao
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom
| | - Philip W J Burnet
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom
| | - Belinda R Lennox
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom.
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Zhang C, Mao Y, Song L. Precise treatments for schizophrenia: where is the way forward? Gen Psychiatr 2018; 31:e000002. [PMID: 30582112 PMCID: PMC6211279 DOI: 10.1136/gpsych-2018-000002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 07/08/2017] [Accepted: 07/15/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yemeng Mao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lisheng Song
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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50
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Zhang Y, Fang X, Fan W, Tang W, Cai J, Song L, Zhang C. Brain-derived neurotrophic factor as a biomarker for cognitive recovery in acute schizophrenia: 12-week results from a prospective longitudinal study. Psychopharmacology (Berl) 2018; 235:1191-1198. [PMID: 29392373 DOI: 10.1007/s00213-018-4835-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 01/14/2018] [Indexed: 12/22/2022]
Abstract
RATIONALE It is generally accepted that impaired cognitive function is a core feature of schizophrenia. There is evidence for the role of brain-derived neurotrophic factor (BDNF) in cognitive function. Olanzapine was reported to yield cognitive improvement in patients with schizophrenia. OBJECTIVES In this study, we performed a prospective, open-label, 12-week observation trial to investigate whether peripheral BDNF may represent a potential biomarker for the effect of cognitive improvement induced by olanzapine in patients with schizophrenia. METHODS In total, 95 patients with acute schizophrenia were enrolled in the study. We also recruited 72 healthy individuals for a control group. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate symptom severity and treatment response. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Plasma BDNF levels were measured with an enzyme-linked immunosorbent assay. RESULTS Of the 95 patients consented into the study, 68 completed the 12-week follow up. Our results showed that schizophrenia patients with acute exacerbation had significantly poorer performance than that of the controls (Ps < 0.01). A significantly decreased plasma level of BDNF in patients was observed compared with the controls (F = 7.77, P = 0.006). A significant improvement in each PANSS subscore and total score was observed when the patients completed this study (Ps < 0.01). Additionally, 12-week olanzapine treatment exhibited significant improvements in RBANS immediate memory, attention, and total scores (P = 0.018, 0.001, and 0.007, respectively). Along with the clinical improvement, plasma BDNF levels after 12-week olanzapine monotherapy (4.67 ± 1.74 ng/ml) were also significantly increased compared with those at baseline (3.38 ± 2.11 ng/ml) (P < 0.01). Spearman's correlation analysis showed that the increase in plasma levels of BDNF is significantly correlated with the change in the RBANS total scores (r = 0.28, P = 0.02) but not with the change in the PANSS total scores (r = - 0.18, P = 0.13). There is a significant correlation of BDNF increase with the change of RBANS attention subscore (r = 0.27, P = 0.028). CONCLUSIONS Our findings suggest that olanzapine improves psychiatric symptoms and cognitive dysfunction, particularly attention and immediate memory, in patients with acute schizophrenia, in parallel with increased plasma BDNF levels. Plasma BDNF levels may be a potential biomarker for cognitive recovery in acute schizophrenia.
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Affiliation(s)
- Yi Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Fang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weixing Fan
- Department of Psychiatry, Jinhua Second Hospital, Jinhua, Zhejiang, China
| | - Wei Tang
- Department of Psychiatry, Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jun Cai
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lisheng Song
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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