Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
Psychiatry Res. 2018 Feb;260:60-66. doi: 10.1016/j.psychres.2017.11.044. Epub 2017 Nov 21.
Memory impairment in psychosis may be mediated through detrimental effects of hypothalamic-pituitary-adrenal (HPA) axis function. This study prospectively investigated the relationship between cortisol, sulphate dehydroepiandrosterone (DHEA(S) and cortisol: DHEA(S) ratio and memory in 35 first-episode psychosis (FEP) patients during the first 12 weeks of treatment and 23 healthy controls (HC).
Morning blood sampling and tests of attention, working memory and verbal memory occurred at baseline and 12-week follow-up.
FEP and HC groups did not significantly differ in levels of cortisol, DHEA(S) or their ratio at baseline or over 12-weeks. The FEP group performed significantly below HC on all cognitive measures at baseline and over 12-weeks. Cortisol levels were unrelated to cognition in both groups. At baseline, DHEA(S) was positively associated with attention in HCs, but negatively associated with attention in FEP participants. Change in DHEA(S) was negatively associated with change in memory over 12-weeks in both groups. At 12-weeks, there was a negative correlation between the cortisol: DHEA(S) ratio and attention in both groups.
These findings are mostly in contrast to findings in chronic schizophrenia. Investigation at different illness phases and over longer-follow-up periods is required to determine the complex relationship between HPA-axis and memory functioning in psychosis.
精神分裂症患者的记忆障碍可能是通过下丘脑-垂体-肾上腺(HPA)轴功能的不利影响介导的。本研究前瞻性地调查了 35 例首发精神分裂症(FEP)患者在治疗的前 12 周和 23 名健康对照者(HC)中皮质醇、硫酸脱氢表雄酮(DHEA[S])和皮质醇:DHEA[S]比值与记忆之间的关系。
在基线和 12 周随访时进行了清晨采血和注意力、工作记忆和言语记忆测试。
FEP 和 HC 组在基线或 12 周内皮质醇、DHEA[S]或其比值均无显著差异。FEP 组在基线和 12 周内所有认知测试中的表现均明显低于 HC。在两组中,皮质醇水平与认知均无关。在基线时,DHEA[S]与 HC 的注意力呈正相关,但与 FEP 参与者的注意力呈负相关。在两组中,DHEA[S]的变化与 12 周内记忆的变化呈负相关。在 12 周时,两组之间皮质醇:DHEA[S]比值与注意力呈负相关。
这些发现与慢性精神分裂症的发现大多相反。需要在不同的疾病阶段和更长的随访期进行研究,以确定 HPA 轴与精神分裂症记忆功能之间的复杂关系。