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Xu XJ, Liu TL, He L, Pu B. Changes in neurotransmitter levels, brain structural characteristics, and their correlation with PANSS scores in patients with first-episode schizophrenia. World J Clin Cases 2023; 11:5215-5223. [PMID: 37621579 PMCID: PMC10445057 DOI: 10.12998/wjcc.v11.i22.5215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND In patients with schizophrenia, the brain structure and neurotransmitter levels change, which may be related to the occurrence and progression of this disease. AIM To explore the relationships between changes in neurotransmitters, brain structural characteristics, and the scores of the Positive and Negative Symptom Scale (PANSS) in patients with first-episode schizophrenia. METHODS The case group comprised 97 patients with schizophrenia, who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022. The control group comprised 100 healthy participants. For all participants, brain structural characteristics were explored by measuring brain dopamine (DA), glutamic acid (Glu), and gamma-aminobutyric acid (GABA) levels, with magnetic resonance imaging. The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis. Linear correlation analysis was used to analyze the correlations between neurotransmitters, brain structural characteristics, and PANSS scores. RESULTS Patients in the case group had higher levels of DA and lower levels of Glu and GABA, greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group (P < 0.05). Patients with positive schizophrenia symptoms had significantly higher levels of DA, Glu, and GABA than those with negative symptoms (P < 0.05). In patients with positive schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical and horizontal distances between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). In patients with negative schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical distance between the corpus callosum and the infrafornix, horizontal distance between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). CONCLUSION In patients with first-episode schizophrenia, DA levels increased, Glu and GABA levels decreased, the thickness of the corpus callosum increased, and these variables were correlated with PANSS scores.
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Affiliation(s)
- Xian-Jia Xu
- The Fifth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Tang-Long Liu
- Department of Science and Education, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Liang He
- The Sixteenth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Ben Pu
- The Twelfth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
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Xu XJ, Liu TL, He L, Pu B. Changes in neurotransmitter levels, brain structural characteristics, and their correlation with PANSS scores in patients with first-episode schizophrenia. World J Clin Cases 2023; 11:5209-5217. [DOI: 10.12998/wjcc.v11.i22.5209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND In patients with schizophrenia, the brain structure and neurotransmitter levels change, which may be related to the occurrence and progression of this disease.
AIM To explore the relationships between changes in neurotransmitters, brain structural characteristics, and the scores of the Positive and Negative Symptom Scale (PANSS) in patients with first-episode schizophrenia.
METHODS The case group comprised 97 patients with schizophrenia, who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022. The control group comprised 100 healthy participants. For all participants, brain structural characteristics were explored by measuring brain dopamine (DA), glutamic acid (Glu), and gamma-aminobutyric acid (GABA) levels, with magnetic resonance imaging. The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis. Linear correlation analysis was used to analyze the correlations between neurotransmitters, brain structural characteristics, and PANSS scores.
RESULTS Patients in the case group had higher levels of DA and lower levels of Glu and GABA, greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group (P < 0.05). Patients with positive schizophrenia symptoms had significantly higher levels of DA, Glu, and GABA than those with negative symptoms (P < 0.05). In patients with positive schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical and horizontal distances between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). In patients with negative schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical distance between the corpus callosum and the infrafornix, horizontal distance between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05).
CONCLUSION In patients with first-episode schizophrenia, DA levels increased, Glu and GABA levels decreased, the thickness of the corpus callosum increased, and these variables were correlated with PANSS scores.
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Affiliation(s)
- Xian-Jia Xu
- The Fifth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Tang-Long Liu
- Department of Science and Education, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Liang He
- The Sixteenth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Ben Pu
- The Twelfth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
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Mororó LG, Guimarães AL, Costa AC, Genaro L, Cavalcanti MT, Scoriels L, Panizzutti R. Association between motivation and engagement with changes in cognition and symptoms after digital cognitive training in schizophrenia. Schizophr Res 2023; 251:1-9. [PMID: 36527953 DOI: 10.1016/j.schres.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/14/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Digital cognitive training can remediate cognitive deficits present in schizophrenia. However, limited motivation and engagement may impact adherence to training. Therefore, identifying factors that may enhance (facilitators) or decrease (barriers) engagement in digital cognitive training and possibly modulate its effects are of great clinical relevance. METHODS We measured cognition, symptom severity, motivation (semi-structured interview), and engagement (adapted Utrecht Work Engagement Scale - UWES) of 27 patients with schizophrenia after a 40-h digital cognitive training. The interview transcript quotes were coded and categorized into facilitators and barriers. Thereafter, we tested the association of motivation and engagement with changes in cognition and symptoms after training. RESULTS The facilitator 'good performance' and the barrier 'difficult exercise' were associated with larger gains in attention (p = 0.03) and reasoning and problem solving (p = 0.02), respectively. 'Poor performance' was associated with smaller gains in global cognition (p < 0.01), attention (p = 0.03), and working memory (p = 0.02). The facilitator 'welcoming setting' was associated with larger reductions in the negative (p = 0.01) and total (p = 0.01) symptoms measured by the Positive and Negative Syndrome Scale. The UWES engagement scale was associated with different facilitators and barriers that emerged from the interview, an indication of consistency among both qualitative and quantitative assessments. DISCUSSION Using a mixed quantitative and qualitative research design, we showed associations between motivation and engagement and the response to digital cognitive training in schizophrenia. Facilitators and barriers were associated with engagement, gains in cognition, and reduced symptoms after the intervention, providing insights on how to increase engagement in the digital cognitive training delivered to subjects with schizophrenia.
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Affiliation(s)
- Luana G Mororó
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Anna Luiza Guimarães
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Ana Carolina Costa
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Larissa Genaro
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Maria T Cavalcanti
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Linda Scoriels
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris, Inserm 1266, Paris, France
| | - Rogerio Panizzutti
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil.
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Guimarães AL, Richer Araujo Coelho D, Scoriels L, Mambrini J, Ribeiro do Valle Antonelli L, Henriques P, Teixeira-Carvalho A, Assis Martins Filho O, Mineo J, Bahia-Oliveira L, Panizzutti R. Effects of Toxoplasma gondii infection on cognition, symptoms, and response to digital cognitive training in schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:104. [PMID: 36434103 PMCID: PMC9700796 DOI: 10.1038/s41537-022-00292-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/28/2022] [Indexed: 11/27/2022]
Abstract
Studies indicate that neuroscience-informed digital cognitive training can remediate cognitive impairments in schizophrenia, but the factors contributing to these deficits and response to treatment remain unclear. Toxoplasma gondii is a neuroinvasive parasite linked to cognitive decline that also presents a higher prevalence in schizophrenia. Here, we compared the cognition and symptom severity of IgG seropositive (TOXO+; n = 25) and seronegative (TOXO-; n = 35) patients who participated in a randomized controlled trial of digital cognitive training. At baseline, TOXO+ subjects presented lower global cognition than TOXO- (F = 3.78, p = 0.05). Specifically, TOXO+ subjects showed worse verbal memory and learning (F = 4.48, p = 0.03), social cognition (F = 5.71, p = 0.02), and higher antibody concentrations were associated with increased negative (r = 0.42, p = 0.04) and total (r = 0.40, p = 0.04) schizophrenia symptoms. After training, the TOXO+ group showed higher adherence to the intervention (X2 = 9.31, p = 0.03), but there were no differences in changes in cognition and symptoms between groups. These findings highlight the association between seropositivity to T. gondii and deteriorated cognition and symptoms in schizophrenia. Further research is needed to assess the specific efficacy of digital cognitive training on this population.
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Affiliation(s)
- Anna Luiza Guimarães
- grid.8536.80000 0001 2294 473XInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil ,grid.8536.80000 0001 2294 473XInstituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - David Richer Araujo Coelho
- grid.8536.80000 0001 2294 473XDepartamento de Imunoparasitologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Linda Scoriels
- grid.8536.80000 0001 2294 473XInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil ,grid.8536.80000 0001 2294 473XInstituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Juliana Mambrini
- grid.418068.30000 0001 0723 0931Instituto René Rachou, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Priscilla Henriques
- grid.418068.30000 0001 0723 0931Instituto René Rachou, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Andréa Teixeira-Carvalho
- grid.418068.30000 0001 0723 0931Instituto René Rachou, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - José Mineo
- grid.411284.a0000 0004 4647 6936Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Lilian Bahia-Oliveira
- grid.8536.80000 0001 2294 473XDepartamento de Imunoparasitologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogério Panizzutti
- grid.8536.80000 0001 2294 473XInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil ,grid.8536.80000 0001 2294 473XInstituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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