Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China.
Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
J Psychiatr Res. 2021 Jun;138:492-499. doi: 10.1016/j.jpsychires.2021.04.026. Epub 2021 Apr 30.
Cognitive impairment is one of the core symptoms of schizophrenia patients. There are often various differences in the efficacy of different antipsychotics in the treatment of cognitive impairment by sex. The purpose of this study was to explore whether there are gender differences in the association between serum BDNF levels and cognitive performance in patients with schizophrenia taking different antipsychotics.
We used Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to assess the cognitive function of three groups of schizophrenia patients (420 on clozapine, 183 on risperidone, 215 on typical antipsychotic drugs) and 467 healthy controls. Positive and Negative Syndrome Scale (PANSS) was used to assess schizophrenia symptoms of patients. Enzyme-Linked ImmunoSorbent Assay was used to measure serum brain-derived neurotrophic factor (BDNF) levels.
Among the patients taking clozapine and typical antipsychotic drugs, the RBANS total score, immediate memory, attention, and delayed memory subscores in females were higher than those in males (all p < 0.05). The RBANS total score and the delayed memory subscores in female patients taking risperidone were higher than those in male patients (all p < 0.05). Significant correlation between BDNF and cognition only existed in male patients taking clozapine, male patients taking risperidone, and male and female patients taking typical antipsychotic drugs (all p < 0.05).
Regardless of antipsychotic effect, the cognitive function of female patients is better compared to that of male patients. For male patients, the association between BDNF and cognitive performance exists in each medication group. For female patients, this significant association was only shown in the typical antipsychotic group, but not in the clozapine and risperidone groups.
认知障碍是精神分裂症患者的核心症状之一。不同的抗精神病药物在治疗认知障碍方面的疗效往往存在性别差异。本研究旨在探讨不同性别抗精神病药物治疗的精神分裂症患者血清脑源性神经营养因子（BDNF）水平与认知表现之间是否存在关联。
我们使用重复性成套神经心理状态测验（RBANS）评估三组精神分裂症患者（氯氮平组 420 例，利培酮组 183 例，典型抗精神病药组 215 例）和 467 例健康对照者的认知功能。阳性和阴性综合征量表（PANSS）用于评估患者的精神分裂症症状。酶联免疫吸附试验用于测量血清脑源性神经营养因子（BDNF）水平。
在服用氯氮平和典型抗精神病药的患者中，女性的 RBANS 总分、即刻记忆、注意力和延迟记忆子评分均高于男性（均 P<0.05）。服用利培酮的女性患者的 RBANS 总分和延迟记忆子评分高于男性患者（均 P<0.05）。仅在服用氯氮平的男性患者、服用利培酮的男性患者以及服用典型抗精神病药的男性和女性患者中，BDNF 与认知之间存在显著相关性（均 P<0.05）。
无论抗精神病药物的疗效如何，女性患者的认知功能均优于男性患者。对于男性患者，BDNF 与认知表现之间的关联存在于每个药物治疗组中。对于女性患者，这种显著的相关性仅在典型抗精神病药组中显示，而在氯氮平和利培酮组中未显示。
