Department of Psychiatry, Shanghai Jingan Mental Health Center, Shanghai 200436, China.
Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang 325005, China.
Chin Med J (Engl). 2018 Oct 5;131(19):2297-2301. doi: 10.4103/0366-6999.241802.
Risperidone and paliperidone have been the mainstay treatment for schizophrenia and their potential role in neuroprotection could be associated with brain-derived neurotrophic factor (BDNF) and N400 (an event-related brain potential component). So far, different effects on both BDNF and N400 were reported in relation to various antipsychotic treatments. However, few studies have been conducted on the mechanism of risperidone and paliperidone on BDNF and N400. This study aimed to compare the effects of risperidone and paliperidone on BDNF and the N400 component of the event-related brain potential in patients with first-episode schizophrenia.
Ninety-eight patients with first-episode schizophrenia were randomly divided into the risperidone and paliperidone groups and treated with risperidone and paliperidone, respectively, for 12 weeks. Serum BDNF level, the latency, and amplitude of the N400 event-related potential before and after the treatment and Positive and Negative Syndrome Scale (PANSS) scores were compared between the two groups.
A total of 94 patients were included in the final analysis (47 patients in each group). After the treatment, the serum BDNF levels in both groups increased (all P < 0.01), while no significant difference in serum BDNF level was found between the groups before and after the treatment (all P > 0.05). After the treatment, N400 amplitudes were increased (from 4.73 ± 2.86 μv and 4.51 ± 4.63 μv to 5.35 ± 4.18 μv and 5.52 ± 3.08 μv, respectively) under congruent condition in both risperidone and paliperidone groups (all P < 0.01). Under incongruent conditions, the N400 latencies were shortened in the paliperidone group (from 424.13 ± 110.42 ms to 4.7.41 ± 154.59 ms, P < 0.05), and the N400 amplitudes were increased in the risperidone group (from 5.80 ± 3.50 μv to 7.17 ± 5.51 μv, P < 0.01). After treatment, the total PANSS score in both groups decreased significantly (all P < 0.01), but the difference between the groups was not significant (P > 0.05). A negative correlation between the reduction rate of the PANSS score and the increase in serum BDNF level after the treatment was found in the paliperidone group but not in the risperidone group.
Both risperidone and paliperidone could increase the serum BDNF levels in patients with first-episode schizophrenia and improve their cognitive function (N400 latency and amplitude), but their antipsychotic mechanisms might differ.
利培酮和帕利哌酮一直是精神分裂症的主要治疗方法，它们在神经保护方面的作用可能与脑源性神经营养因子（BDNF）和 N400（事件相关脑电位成分）有关。到目前为止，不同的抗精神病药物治疗对 BDNF 和 N400 都有不同的影响。然而，关于利培酮和帕利哌酮对 BDNF 和 N400 的作用机制的研究较少。本研究旨在比较利培酮和帕利哌酮对首发精神分裂症患者 BDNF 和事件相关脑电位 N400 成分的影响。
98 例首发精神分裂症患者随机分为利培酮组和帕利哌酮组，分别给予利培酮和帕利哌酮治疗 12 周。比较两组患者治疗前后血清 BDNF 水平、N400 事件相关电位潜伏期和振幅及阳性和阴性症状量表（PANSS）评分。
共有 94 例患者进入最终分析（每组 47 例）。治疗后，两组血清 BDNF 水平均升高（均 P<0.01），但治疗前后两组血清 BDNF 水平差异无统计学意义（均 P>0.05）。治疗后，利培酮组和帕利哌酮组在一致条件下 N400 振幅均增加（分别从 4.73±2.86μv 和 4.51±4.63μv 增加至 5.35±4.18μv 和 5.52±3.08μv，均 P<0.01）。在不一致条件下，帕利哌酮组 N400 潜伏期缩短（从 424.13±110.42ms 缩短至 4.7.41±154.59ms，P<0.05），利培酮组 N400 振幅增加（从 5.80±3.50μv 增加至 7.17±5.51μv，P<0.01）。治疗后，两组患者的 PANSS 总分均明显下降（均 P<0.01），但两组间差异无统计学意义（P>0.05）。帕利哌酮组治疗后血清 BDNF 水平的降低率与 PANSS 评分的降低率呈负相关，但利培酮组无此相关性。
利培酮和帕利哌酮均可增加首发精神分裂症患者的血清 BDNF 水平，改善认知功能（N400 潜伏期和振幅），但两者的抗精神病机制可能不同。
