Stålberg Gabriella, Ekselius Lisa, Lindström Leif H, Larhammar Dan, Bodén Robert
Department of Neuroscience, Psychiatry, Uppsala University, SE-751 85 Uppsala, Sweden.
Department of Neuroscience, Unit of Pharmacology, Uppsala University, Box 593, SE-751 24 Uppsala, Sweden.
Schizophr Res. 2014 Jul;156(2-3):223-7. doi: 10.1016/j.schres.2014.04.006. Epub 2014 May 3.
There is a lack of biomarkers in schizophrenia and the mechanisms underlying the observed deficits in social functioning are poorly understood. This cohort study aimed to explore whether neurotransmitter neuropeptide Y (NPY) in cerebrospinal fluid (CSF) from patients with schizophrenia is correlated to social function and clinical variables. A further aim was to determine whether baseline levels of NPY were associated with subsequent 3-year outcome. Fifty-six consecutively admitted patients with schizophrenia were included and underwent lumbar puncture and symptom ratings before antipsychotic treatment. NPY levels in CSF were determined by radioimmunoassay. Social function (Social Competence and Social Interest) was assessed by Nurses' Observation Scale for Inpatient Evaluation while psychiatric symptoms were rated using the Comprehensive Psychopathological Rating Scale. Three-year outcome was assessed with the Strauss-Carpenter Outcome Scale. Cross-sectional analysis showed a correlation between level of NPY and Social Competence at index admission (r(s)=0.37, p<0.05). The longitudinal analysis (i.e., at the 3-year follow-up) indicated that, for each standard deviation increase in baseline NPY, there was an increased risk of being unemployed (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.07-3.82), having moderate or severe symptoms (OR 3.09, CI 1.30-7.32) or being hospitalized at least 6 months the previous year (OR 3.24, CI 1.09-9.64). However, NPY was not correlated to Social Interest or clinical variables at index admission. In conclusion, NPY levels in CSF are correlated to Social Competence and seem to predict some aspects of longitudinal outcome in schizophrenia.
精神分裂症缺乏生物标志物，且对观察到的社会功能缺陷背后的机制了解甚少。这项队列研究旨在探讨精神分裂症患者脑脊液（CSF）中的神经递质神经肽Y（NPY）是否与社会功能和临床变量相关。另一个目的是确定NPY的基线水平是否与随后3年的预后相关。纳入了56例连续入院的精神分裂症患者，在接受抗精神病药物治疗前进行了腰椎穿刺和症状评定。通过放射免疫测定法测定脑脊液中的NPY水平。使用护士住院患者评估观察量表评估社会功能（社会能力和社会兴趣），同时使用综合精神病理评定量表对精神症状进行评分。使用施特劳斯 - 卡彭特结果量表评估3年预后。横断面分析显示，入院时NPY水平与社会能力之间存在相关性（r(s)=0.37，p<0.05）。纵向分析（即3年随访时）表明，基线NPY每增加一个标准差，失业风险增加（优势比[OR] 2.02，95%置信区间[CI] 1.07 - 3.82），出现中度或重度症状的风险增加（OR 3.09，CI 1.30 - 7.32），或前一年至少住院6个月的风险增加（OR 3.24，CI 1.09 - 9.64）。然而，入院时NPY与社会兴趣或临床变量无关。总之，脑脊液中的NPY水平与社会能力相关，似乎可以预测精神分裂症纵向预后的某些方面。
