Özönder Ünal Ipek, Pirincci Aytac Miray, Adalı Aker Derya, Duymaz Tomris, Berkol Tonguc Demir
Department of Psychiatry, Tuzla State Hospital, Içmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla, Istanbul, Turkey.
Department of Psychiatry, Sancaktepe Şehit Prof.Dr. İlhan Varank Training And Research Hospital, Sancaktepe, Istanbul, Turkey.
BMC Psychiatry. 2025 May 26;25(1):542. doi: 10.1186/s12888-025-06970-6.
Cognitive impairments-especially in executive function and attention-are core features of schizophrenia and major barriers to functional recovery. Although systemic physiological factors such as blood viscosity and serum osmolarity have been implicated in schizophrenia, their association with cognitive deficits remains largely unexplored. This study aimed to investigate these relationships in male patients with schizophrenia in remission.
A total of 247 male patients diagnosed with schizophrenia in remission were recruited. Cognitive performance was assessed using the Frontal Assessment Battery (FAB), Stroop Test, and Trail Making Test (TMT). Hemorheological parameters, including whole blood viscosity (WBV) at low and high shear rates (LSR and HSR), and serum osmolarity were calculated. Regression analyses were conducted to determine predictors of cognitive outcomes.
In the multivariate analysis, higher WBV at HSR (β = 0.122, β = 0.037) was positively associated with executive function (FAB scores) and inversely associated with Stroop 5 time (β = -0.134, p = 0.025), TMT-A (β = -0.134, p = 0.032), and TMT-B (β = -0.137, p = 0.028) completion times, reflecting better cognitive performance. While higher serum osmolarity showed a positive correlation with FAB scores in univariate analysis, it did not remain an independent predictor in the multivariate model. The multivariate regression identified WBV at HSR, depressive symptoms, negative symptoms, use of long-acting injectable antipsychotics (LAI), and living arrangements as significant predictors of FAB scores, collectively explaining 16.9% of the variance (F(8,238) = 7.252, p < 0.001).
This study highlights the potential contribution of systemic physiological factors to cognitive function in schizophrenia. Higher WBV, within a physiological range, may support cerebral perfusion and be associated with better executive performance. Although serum osmolarity showed a positive association with executive function in univariate analysis, it was not an independent predictor in multivariate models, and its cognitive relevance remains to be clarified. These findings point to a possible role of physiological parameters in cognitive variability, but further studies are needed before drawing firm clinical implications.
Not applicable.
认知障碍——尤其是执行功能和注意力方面的障碍——是精神分裂症的核心特征，也是功能恢复的主要障碍。尽管血液粘度和血清渗透压等全身生理因素与精神分裂症有关，但其与认知缺陷的关联在很大程度上仍未得到探索。本研究旨在调查处于缓解期的男性精神分裂症患者中的这些关系。
共招募了247名被诊断为处于缓解期的男性精神分裂症患者。使用额叶评估量表（FAB）、斯特鲁普测验和连线测验（TMT）评估认知表现。计算血液流变学参数，包括低切变率和高切变率下的全血粘度（WBV）以及血清渗透压。进行回归分析以确定认知结果的预测因素。
在多变量分析中，高切变率下较高的WBV（β = 0.122，β = 0.037）与执行功能（FAB评分）呈正相关，与斯特鲁普5时间（β = -0.134，p = 0.025）、TMT-A（β = -0.134，p = 0.032）和TMT-B（β = -0.137，p = 0.028）完成时间呈负相关，反映出更好的认知表现。虽然在单变量分析中较高的血清渗透压与FAB评分呈正相关，但在多变量模型中它并非独立预测因素。多变量回归确定高切变率下的WBV、抑郁症状、阴性症状、长效注射用抗精神病药物（LAI）的使用以及生活安排是FAB评分的重要预测因素，共同解释了16.9%的方差（F(8,238) = 7.252，p < 0.001）。
本研究强调了全身生理因素对精神分裂症认知功能的潜在贡献。在生理范围内较高的WBV可能支持脑灌注并与更好的执行表现相关。尽管血清渗透压在单变量分析中与执行功能呈正相关，但在多变量模型中它并非独立预测因素，其认知相关性仍有待阐明。这些发现指出了生理参数在认知变异性中的可能作用，但在得出确切的临床意义之前还需要进一步研究。
不适用。
