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接受持续抗精神病治疗的男性精神分裂症患者的脑源性神经营养因子、性激素与认知功能衰退

Brain-derived neurotrophic factor, sex hormones and cognitive decline in male patients with schizophrenia receiving continuous antipsychotic therapy.

作者信息

Li Jin, Xiao Wen-Huan, Ye Fei, Tang Xiao-Wei, Jia Qiu-Fang, Zhang Xiao-Bin

机构信息

Department of Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China.

Department of Psychiatry, Affiliated Wutaishan Hospital of Medical College of Yangzhou University, Yangzhou 225000, Jiangsu Province, China.

出版信息

World J Psychiatry. 2023 Dec 19;13(12):995-1004. doi: 10.5498/wjp.v13.i12.995.

Abstract

BACKGROUND

There are systematic differences in clinical features between women and men with schizophrenia (SCZ). The regulation of sex hormones may play a potential role in abnormal neurodevelopment in SCZ. Brain-derived neurotrophic factor (BDNF) and sex hormones have complex interacting actions that contribute to the etiology of SCZ.

AIM

To investigate the influence of BDNF and sex hormones on cognition and clinical symptomatology in chronic antipsychotic-treated male SCZ patients.

METHODS

The serum levels of follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), progesterone, testosterone (T), prolactin (PRL) and BDNF were compared between chronic antipsychotic-treated male (CATM) patients with SCZ ( = 120) and healthy controls ( = 120). The Positive and Negative Syndrome Scale was used to quantify SCZ symptoms, while neuropsychological tests were used to assess cognition. Neuropsychological tests, such as the Digit Cancellation Test (DCT), Semantic Verbal Fluency (SVF), Spatial Span Test (SS), Paced Auditory Serial Addition Test (PASAT), Trail Making Task (TMT-A), and Block Design Test (BDT), were used to assess executive functions (BDT), attention (DCT, TMT-A), memory (SS, PASAT), and verbal proficiency (SVF).

RESULTS

Although E2 levels were significantly lower in the patient group compared to the healthy controls, T, PRL, and LH levels were all significantly higher. Additionally, the analysis revealed that across the entire sample, there were positive correlations between E2 Levels and BDNF levels as well as BDNF levels and the digital cancellation time. In CATM patients with SCZ, a significant correlation between the negative symptoms score and PRL levels was observed.

CONCLUSION

Sex hormones and BDNF levels may also be linked to cognitive function in patients with chronic SCZ.

摘要

背景

精神分裂症(SCZ)女性和男性患者的临床特征存在系统性差异。性激素调节可能在SCZ异常神经发育中发挥潜在作用。脑源性神经营养因子(BDNF)和性激素具有复杂的相互作用,这有助于SCZ的病因学研究。

目的

研究BDNF和性激素对慢性抗精神病药物治疗的男性SCZ患者认知和临床症状的影响。

方法

比较慢性抗精神病药物治疗的男性SCZ患者(n = 120)和健康对照者(n = 120)的血清促卵泡激素、黄体生成素(LH)、雌二醇(E2)、孕酮、睾酮(T)、催乳素(PRL)和BDNF水平。使用阳性和阴性症状量表量化SCZ症状,同时使用神经心理学测试评估认知。神经心理学测试,如数字划消测试(DCT)、语义言语流畅性测试(SVF)、空间广度测试(SS)、听觉序列加法测试(PASAT)、连线测验(TMT-A)和积木设计测试(BDT),用于评估执行功能(BDT)、注意力(DCT、TMT-A)、记忆力(SS、PASAT)和言语能力(SVF)。

结果

与健康对照者相比,患者组的E2水平显著降低,而T、PRL和LH水平均显著升高。此外,分析显示在整个样本中,E2水平与BDNF水平以及BDNF水平与数字划消时间之间存在正相关。在慢性抗精神病药物治疗的男性SCZ患者中,观察到阴性症状评分与PRL水平之间存在显著相关性。

结论

性激素和BDNF水平也可能与慢性SCZ患者的认知功能有关。

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