Markiewicz Renata, Markiewicz-Gospodarek Agnieszka, Trubalski Mateusz, Łoza Bartosz
Occupational Therapy Laboratory, Medical University of Lublin, 7 Chodźki St., 20-093 Lublin, Poland.
Department of Normal, Clinical and Imaging Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland.
J Clin Med. 2024 Jul 10;13(14):4035. doi: 10.3390/jcm13144035.
Reelin is a neuropeptide responsible for the migration and positioning of pyramidal neurons, interneurons, and Purkinje cells. In adulthood, it still supports neuroplasticity, especially dendritic spines formation and glutamatergic neurotransmission. Genetic studies have confirmed the involvement of reelin system failure in the etiopathogenesis of mental diseases, including schizophrenia. Given the role of reelin in brain cytoarchitectonics and the regularly observed reduction in its activity in prefrontal areas in cases of schizophrenia, dysfunction of the reelin pathway fits the neurodevelopmental hypothesis of schizophrenia, both as a biochemical predisposition and/or the ultimate trigger of psychosis and as a biosocial factor determining the clinical course, and finally, as a potential target for disease monitoring and treatment. The purpose of this study was to examine associations of the reelin blood level with clinical and neurocognitive parameters during an intensive, structured neurofeedback therapy of patients with schizophrenia. Thirty-seven male patients with paranoid schizophrenia were randomly divided into two groups: a group with 3-month neurofeedback as an add-on to ongoing antipsychotic treatment (NF, N18), and a control group with standard social support and antipsychotic treatment (CON, N19). The reelin serum concentration, clinical and neurocognitive tests were compared between the groups After 3-month trial (T2), the reelin serum level increased in the NF group vs. the CON group. The negative and general symptoms of PANSS (Positive and Negative Syndrome Scale) were reduced significantly more in the NF group at T2, and the d2 (d2 Sustained Attention Test and BCIS (Beck Cognitive Insight Scale) scores improved only in the NF group. The AIS scores improved more dynamically in the NF group, but not enough to differentiate them from the CON group at T2. The clinical and neurocognitive improvement within the 3-month NF add-on therapy trial was associated with a significant increase of reelin serum level in schizophrenia patients.
Reelin是一种神经肽，负责锥体神经元、中间神经元和浦肯野细胞的迁移和定位。在成年期，它仍然支持神经可塑性，特别是树突棘的形成和谷氨酸能神经传递。遗传学研究已证实Reelin系统功能障碍参与包括精神分裂症在内的精神疾病的病因发病机制。鉴于Reelin在脑 cytoarchitectonics中的作用以及在精神分裂症病例中前额叶区域其活性经常观察到的降低，Reelin通路功能障碍符合精神分裂症的神经发育假说，既作为生化易感性和/或精神病的最终触发因素，又作为决定临床病程的生物社会因素，最后，作为疾病监测和治疗的潜在靶点。本研究的目的是在对精神分裂症患者进行强化、结构化神经反馈治疗期间，检查Reelin血液水平与临床和神经认知参数之间的关联。37名男性偏执型精神分裂症患者被随机分为两组：一组接受为期3个月的神经反馈治疗，作为正在进行的抗精神病治疗的附加治疗（NF组，n = 18），另一组为接受标准社会支持和抗精神病治疗的对照组（CON组，n = 19）。比较两组之间的Reelin血清浓度、临床和神经认知测试结果。在为期3个月的试验（T2）后，NF组的Reelin血清水平相对于CON组有所升高。在T2时，NF组中PANSS（阳性和阴性症状量表）的阴性和一般症状显著降低更多，并且d2（d2持续注意力测试）和BCIS（贝克认知洞察力量表）评分仅在NF组中有所改善。NF组的AIS评分改善更为显著，但在T2时不足以将其与CON组区分开来。在为期3个月的NF附加治疗试验中，临床和神经认知改善与精神分裂症患者Reelin血清水平的显著升高相关。
