Szeszko Philip R, McNamara Robert K, Gallego Juan A, Malhotra Anil K, Govindarajulu Usha, Peters Bart D, Robinson Delbert G
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; James J. Peters VA Medical Center, Mental Illness Research, Education and Clinical Center, Bronx, NY, United States of America.
Department of Psychiatry and Behavioral Neuroscience, Lipidomics Research Program, University of Cincinnati, Cincinnati, OH, United States of America.
Schizophr Res. 2021 Feb;228:180-187. doi: 10.1016/j.schres.2020.11.050. Epub 2021 Jan 11.
Alterations in polyunsaturated fatty acids (PUFAs), including omega-3 and omega-6, have been implicated in the pathophysiology of psychotic disorders, but little is known about their associations with neuropsychological functioning. The present study includes 46 recent-onset psychosis patients who participated in a larger (n = 50) double blind, placebo-controlled randomized clinical trial comparing 16 weeks of treatment with either risperidone + fish oil (FO) (EPA 740 mg and DHA 400 mg daily) or risperidone + placebo and completed neuropsychological assessments at the baseline timepoint. We investigated the relationship between baseline omega-3 (i.e., eicosapentaenoic acid, EPA; docosapentaenoic acid, DPA and docosahexaenoic acid, DHA) and omega-6 (i.e., arachidonic acid, AA) PUFA with baseline MATRICS Consensus Cognitive Battery (MCCB) and Brief Psychiatric Rating Scale (BPRS) scores. Twenty-five patients had neuropsychological data available at 16 weeks following participation in the clinical trial, which included 12 patients assigned to risperidone + FO and 13 patients assigned to risperidone + placebo. At baseline both higher DHA and EPA correlated significantly with better social cognition after controlling for functioning on other neuropsychological domains, total BPRS score, AA level and substance use. Also, at baseline higher AA correlated significantly with hostility/uncooperativeness after controlling for DHA + EPA + DPA, overall neuropsychological functioning and substance use. Patients treated with risperidone + FO demonstrated a significant longitudinal increase in social cognition that was significantly higher at 16 weeks compared to patients treated with risperidone + placebo. DHA also correlated significantly with social cognition at the 16-week timepoint. This study provides novel evidence for a differential role of omega-3 vs. omega-6 PUFA in neuropsychological deficits and symptoms in recent-onset psychosis and its treatment.
多不饱和脂肪酸（PUFA）的改变，包括ω-3和ω-6脂肪酸，与精神障碍的病理生理学有关，但人们对它们与神经心理功能的关联知之甚少。本研究纳入了46名近期发病的精神病患者，他们参与了一项更大规模（n = 50）的双盲、安慰剂对照随机临床试验，该试验比较了16周的利培酮 + 鱼油（FO）（每日EPA 740毫克和DHA 400毫克）或利培酮 + 安慰剂治疗，并在基线时间点完成了神经心理评估。我们研究了基线时ω-3（即二十碳五烯酸，EPA；二十二碳五烯酸，DPA和二十二碳六烯酸，DHA）和ω-6（即花生四烯酸，AA）PUFA与基线时MATRICS共识认知电池（MCCB）和简明精神病评定量表（BPRS）评分之间的关系。25名患者在参与临床试验后的16周有神经心理数据，其中包括12名分配到利培酮 + FO组的患者和13名分配到利培酮 + 安慰剂组的患者。在基线时，在控制了其他神经心理领域的功能、BPRS总分、AA水平和物质使用情况后，较高的DHA和EPA均与较好的社会认知显著相关。此外，在基线时，在控制了DHA + EPA + DPA、整体神经心理功能和物质使用情况后，较高的AA与敌意/不合作显著相关。接受利培酮 + FO治疗的患者在社会认知方面表现出显著的纵向增加，与接受利培酮 + 安慰剂治疗的患者相比，在16周时显著更高。DHA在16周时间点也与社会认知显著相关。本研究为ω-3与ω-6 PUFA在近期发病精神病的神经心理缺陷和症状及其治疗中的不同作用提供了新证据。
