Ju MingLiang, Long Bin, Wei YanYan, Tang XiaoChen, Xu LiHua, Gan RanPiao, Cui HuiRu, Tang YingYing, Yi ZhengHui, Liu HaiChun, Wang ZiXuan, Chen Tao, Gao Jin, Hu Qiang, Zeng LingYun, Li ChunBo, Wang JiJun, Liu HuanZhong, Zhang TianHong
Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China.
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China.
Schizophr Res Cogn. 2025 Jan 27;40:100346. doi: 10.1016/j.scog.2025.100346. eCollection 2025 Jun.
Psychosis is a complex brain disorder with diverse biological subtypes influenced by various pathogenic mechanisms, which can affect treatment efficacy. The ANR(Attenuated Niacin Response) subtype is characterized by pronounced negative symptoms and functional impairments, suggesting a distinct clinical profile. However, research on the cognitive characteristics associated with the ANR subtype in drug-naïve first-episode psychosis(FEP) patients remains limited.
This observational study involved 54 FEP patients and 52 healthy controls(HC). Clinical psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS), while cognitive performance was evaluated through the Chinese version of the MATRICS Consensus Cognitive Battery(MCCB). Additionally, niacin response was measured using aqueous methylnicotinate patches, with responses quantified to classify participants into ANR or normal niacin response (NNR) groups.
Among the FEP patients, 25.9 % were classified as having ANR, significantly higher than the 7.7 % in the HC group ( = 6.247, = 0.012). The ANR group exhibited more severe negative symptoms and higher total PANSS scores compared to the NNR group, with significant differences in cognitive performance on the Trail Making test and the Brief Visuospatial Memory Test-Revised. Correlation analyses revealed a significant positive relationship between overall symptom severity and niacin response, as well as between cognitive performance and niacin response, particularly for the Trail Making and Symbol coding tests.
This study demonstrates that the ANR subtype in first-episode psychosis is linked to more severe negative symptoms and cognitive impairments. Targeted assessments and interventions for patients with ANR may improve treatment outcomes and enhance understanding of cognitive dysfunction in psychotic disorders.
精神病是一种复杂的脑部疾病，具有受多种致病机制影响的不同生物学亚型，这可能会影响治疗效果。ANR（烟酸反应减弱）亚型的特征是明显的阴性症状和功能损害，提示有独特的临床特征。然而，关于首次发作未用药的精神病（FEP）患者中与ANR亚型相关的认知特征的研究仍然有限。
这项观察性研究纳入了54名FEP患者和52名健康对照（HC）。使用阳性和阴性症状量表（PANSS）评估临床精神病理学，同时通过中文版的MATRICS共识认知成套测验（MCCB）评估认知表现。此外，使用烟酸甲酯贴片测量烟酸反应，对反应进行量化以将参与者分为ANR或正常烟酸反应（NNR）组。
在FEP患者中，25.9%被分类为具有ANR，显著高于HC组中的7.7%（χ² = 6.247，P = 0.012）。与NNR组相比，ANR组表现出更严重的阴性症状和更高的PANSS总分，在连线测验和修订版简短视觉空间记忆测验中的认知表现存在显著差异。相关分析显示总体症状严重程度与烟酸反应之间以及认知表现与烟酸反应之间存在显著正相关关系, 特别是对于连线测验和符号编码测验。
本研究表明，首次发作精神病中的ANR亚型与更严重的阴性症状和认知障碍有关。对ANR患者进行针对性评估和干预可能会改善治疗结果，并增进对精神障碍中认知功能障碍的理解。
