Department of Medicine, College of Medicine, National Cheng Kung University, Taiwan.
Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng University, Tainan, Taiwan; School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan.
J Psychiatr Res. 2024 May;173:333-339. doi: 10.1016/j.jpsychires.2024.03.049. Epub 2024 Mar 28.
Inflammation impairs cognitive function in healthy individuals and people with psychiatric disorders, such as bipolar disorder (BD). This effect may also impact emotion recognition, a fundamental element of social cognition. Our study aimed to investigate the relationships between pro-inflammatory cytokines and emotion recognition in euthymic BD patients and healthy controls (HCs).
We recruited forty-four euthymic BD patients and forty healthy controls (HCs) and measured their inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and TNF-α. We applied validated cognitive tasks, the Wisconsin Card-Sorting Test (WCST) and Continuous Performance Test (CPT), and a social cognitive task for emotion recognition, Diagnostic Analyses of Nonverbal Accuracy, Taiwanese Version (DANVA-2-TW). We analyzed the relationships between cytokines and cognition and then explored possible predictive factors of sadness recognition accuracy.
Regarding pro-inflammatory cytokines, TNF-α was elevated in euthymic BD patients relative to HCs. In euthymic BD patients only, higher TNF-α levels were associated with lower accuracy of sadness recognition. Regression analysis revealed that TNF-α was an independent predictive factor of sadness recognition in patients with euthymic BD when neurocognition was controlled for.
We demonstrated that enhanced inflammation, indicated by increased TNF-α, was an independent predictive factor of impaired sadness recognition in BD patients but not in HCs. Our findings suggested a direct influence of TNF-α on sadness recognition and indicated vulnerability to depression in euthymic BD patients with chronic inflammation.
炎症会损害健康个体和精神疾病患者（如双相情感障碍 (BD)）的认知功能。这种影响也可能影响情绪识别，情绪识别是社会认知的基本要素。我们的研究旨在调查双相情感障碍患者和健康对照组 (HC) 中促炎细胞因子与情绪识别之间的关系。
我们招募了 44 名病情稳定的双相情感障碍患者和 40 名健康对照组 (HC)，并测量了他们的炎症标志物，包括高敏 C 反应蛋白 (hs-CRP)、白细胞介素 6 (IL-6) 和肿瘤坏死因子-α (TNF-α)。我们应用了经过验证的认知任务，威斯康星卡片分类测试 (WCST) 和连续性能测试 (CPT)，以及用于情绪识别的社会认知任务，即台湾版诊断性非言语准确性分析 (DANVA-2-TW)。我们分析了细胞因子与认知之间的关系，然后探讨了悲伤识别准确性的可能预测因素。
关于促炎细胞因子，病情稳定的双相情感障碍患者的 TNF-α 水平高于 HCs。仅在病情稳定的双相情感障碍患者中，较高的 TNF-α 水平与悲伤识别准确性较低相关。回归分析表明，在控制神经认知的情况下，TNF-α 是病情稳定的双相情感障碍患者悲伤识别的独立预测因子。
我们证明，炎症增强，表现为 TNF-α 增加，是双相情感障碍患者悲伤识别受损的独立预测因子，但在 HCs 中则不是。我们的发现表明 TNF-α 对悲伤识别有直接影响，并表明慢性炎症的病情稳定的双相情感障碍患者易患抑郁症。
