C-Reactive Protein as a Possible Predictor of Trail-Making Performance in Individuals with Psychiatric Disorders

Nina Dalkner,René Pilz,Susanne A Bengesser,Valerie S Falzberger,Karin Schwalsberger,Melanie Lenger,Bernd Reininghaus,Eva Reininghaus,Roger S Mcintyre,Harald Mangge,Robert Queissner,Alexandra Rieger,Armin Birner,Carlo Hamm,Frederike T Fellendorf,Martina Platzer,Elisabeth M Weiss

doi:10.3390/nu12103019

Abstract

Cognitive dysfunction is a prominent feature of psychiatric disorders. Studies have shown that systemic low-grade inflammation is crucial in the development of cognitive deficits across psychiatric disorders. The aim of this study was to further examine the role of inflammation and inflammatory mediators in cognitive function in psychiatric disorders. This study included 364 inpatients (53% females) with International Classification of Diseases (ICD)-10 F3 (affective disorders) and F4 (neurotic, stress-related, and somatoform disorders) diagnoses. The mean age was 52 years (22 to 69 years) and the median body mass index was 27.6. Cognitive function was assessed with the Color–Word Interference Test after Stroop and the Trail-Making Test A/B. Multiple linear regression models were calculated to assess the predictive value of C-reactive protein and the kynurenine/tryptophan ratio on cognitive function controlling for age, sex, education, premorbid verbal intelligence quotient, illness duration, depressive symptoms, and obesity-related parameters (e.g., body mass index, high-density lipoprotein). Our data confirm that in patients with psychiatric disorders, C-reactive protein serum concentration is a relevant and important predictor of Trail-Making Test B performance, measuring cognitive flexibility. The effect size of this association did not change much after adding clinical and metabolic variables into the regression model. The kynurenine/tryptophan ratio was not related to cognitive test scores. The involvement of C-reactive protein as a peripheral inflammatory marker in cognitive flexibility and psychomotor processing speed in psychiatric illness can be concluded.

Highlights

Cognitive impairment, which is a prominent core feature across psychiatric disorders [1,2,3,4,5,6]includes deficits in attention, short- and long-term memory, understanding, creativity, knowledge, word meaning, verbal fluency, receptive vocabulary, psychomotor speed, problem solving, planning, reasoning, and judgment
Regression models were adjusted for age, sex, verbal intelligence quotient (IQ), illness duration, and Beck Depression Inventory-2 (BDI-2) (Model 2), and for relevant obesity-related variables and biomarkers including body mass index (BMI), diastolic blood pressure, triglycerides, high-density lipoprotein (HDL) cholesterol, history of diabetes (Model 3)
This study underscores the relevance of high-sensitive c-reactive protein (hsCRP), an important inflammatory marker, in predicting cognitive function in patients with mood- and anxiety-related disorders

Summary

Introduction

Cognitive impairment, which is a prominent core feature across psychiatric disorders [1,2,3,4,5,6]. Includes deficits in attention, short- and long-term memory, understanding, creativity, knowledge, word meaning, verbal fluency, receptive vocabulary, psychomotor speed, problem solving, planning, reasoning, and judgment. The latter are known as executive functions. Cognitive deficits decrease psychosocial functioning, aggravate the course of psychiatric disorders, and are strongly related to patients’ quality of life and well-being [8,9]. The biological mechanisms underlying cognitive deficits in psychiatric disorders are not fully understood

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