Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Int J Neuropsychopharmacol. 2023 Aug 29;26(8):576-583. doi: 10.1093/ijnp/pyad040.
Impaired antioxidant defense is implicated in the pathophysiology of schizophrenia, and superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) are 3 first-line endogenous antioxidants. Various cognitive functions decline differently during the schizophrenia course. The characteristic roles of the 3 antioxidants in clinical and cognitive profiles in acute and chronic phases of schizophrenia require study.
We recruited 311 patients with schizophrenia, including 92 acutely exacerbated patients who had been off antipsychotics for at least 2 weeks and 219 chronic patients who had been stable on medication for at least 2 months. Blood SOD, CAT, and GSH levels; clinical symptoms; and 9 cognitive test scores were measured.
Blood CAT levels were higher in the acute patients than in the chronic patients, whereas SOD and GSH levels were similar to one another. Higher CAT levels were correlated with less positive symptoms, better working memory and problem solving in the acute phase, and less negative symptoms, less general psychopathology, better global assessment of function, and better cognitive function (in speed of processing, attention, problem solving) in the chronic period. Higher SOD levels were correlated with better global assessment of function in the acute phase and better speed of processing, working memory, and verbal learning and memory in the chronic period. GSH influenced neither clinical nor cognitive manifestations.
This study showed that blood CAT affected different clinical and cognitive domains between acute and chronic stages of schizophrenia, SOD influenced cognitive functions in chronic state, but GSH affected none. Further studies are needed to explore the underlying mechanisms.
抗氧化防御功能受损与精神分裂症的病理生理学有关，超氧化物歧化酶（SOD）、过氧化氢酶（CAT）和谷胱甘肽（GSH）是 3 种主要的内源性抗氧化剂。各种认知功能在精神分裂症病程中下降程度不同。3 种抗氧化剂在精神分裂症急性期和慢性期的临床和认知特征中的作用需要进一步研究。
我们招募了 311 名精神分裂症患者，包括 92 名抗精神病药物停药至少 2 周的急性恶化患者和 219 名药物稳定至少 2 个月的慢性患者。测量了血液 SOD、CAT 和 GSH 水平、临床症状和 9 项认知测试分数。
急性患者的血液 CAT 水平高于慢性患者，而 SOD 和 GSH 水平相似。较高的 CAT 水平与急性期较少的阳性症状、较好的工作记忆和解决问题能力，以及慢性期较少的阴性症状、较轻的一般精神病学症状、较好的总体功能评估和较好的认知功能（在处理速度、注意力、解决问题方面）相关。较高的 SOD 水平与急性期的总体功能评估和慢性期的处理速度、工作记忆和言语学习记忆较好相关。GSH 既不影响临床症状也不影响认知表现。
本研究表明，血液 CAT 影响精神分裂症急性期和慢性期不同的临床和认知领域，SOD 影响慢性期的认知功能，但 GSH 没有影响。需要进一步研究探索潜在的机制。
