Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
Department of Automation, Shanghai Jiao Tong University, Shanghai, China.
Asia Pac Psychiatry. 2022 Dec;14(4):e12516. doi: 10.1111/appy.12516. Epub 2022 Jun 2.
Impaired sensitivity of the skin flush response to niacin is found in approximately 30% of patients with schizophrenia. Although the niacin response abnormality (NRA) may serve as a useful endophenotype for schizophrenia, few studies have directly replicated NRA in patients with first-episode psychosis (FEP).
In total, 204 patients with FEP, 16 with psychotic mood disorder (PMD), and 68 healthy controls (HC) were included. The log (EC ) values represent the concentration of methyl nicotinate required to elicit a half-maximal blood flow (MBF) response, and the MBF value was calculated. The NRA was defined as having log (EC ) molar value above the 90% and an MBF value below the 60% of those in the HC group.
In total, 13.7% of the FEP, 12.5% of the PMD, and 7.4% of the HC group met the definition of NRA. Significant differences were found in the log (EC ) values between the FEP and HC groups (p = .014) and in the MBF between the FEP and PMD groups (p = .011). Patients with FEP and NRA had more severe negative symptoms than those with a normal niacin response.
These data represent the NRA in patients with FEP, defining a small subgroup of patients with early-phase psychosis possessing a clinically significant phospholipid-signaling defect.
大约 30%的精神分裂症患者存在皮肤潮红反应对烟碱敏感性受损。虽然烟碱反应异常（NRA）可能是精神分裂症的一个有用的内表型，但很少有研究直接在首发精神病（FEP）患者中复制 NRA。
共纳入 204 例 FEP 患者、16 例精神病性心境障碍（PMD）患者和 68 例健康对照（HC）。log（EC）值表示产生半最大血流（MBF）反应所需的甲基烟碱浓度，并且计算了 MBF 值。NRA 的定义为 log（EC）摩尔值高于 HC 组的 90%，MBF 值低于 HC 组的 60%。
FEP 组、PMD 组和 HC 组分别有 13.7%、12.5%和 7.4%的患者符合 NRA 定义。FEP 组和 HC 组之间的 log（EC）值存在显著差异（p=0.014），FEP 组和 PMD 组之间的 MBF 存在显著差异（p=0.011）。具有 NRA 的 FEP 患者的阴性症状比具有正常烟碱反应的患者更严重。
这些数据代表了 FEP 患者的 NRA，定义了一小部分具有临床显著磷脂信号缺陷的早期精神病患者亚组。
