CSF N-CAM in neuroleptic-naı̈ve first-episode patients with schizophrenia

Abstract

An increased concentration of neural cell adhesion molecule (N-CAM) 105–115 kDa has been reported in patients with schizophrenia in both CSF and in post-mortem brain samples. To determine whether increased N-CAM is integral to the disease process or, alternatively, results from early treatment, CSF N-CAM was measured in a blind study of first episode (FE) patients, who were either neuroleptic-naı̈ve (NN) or neuroleptic-treated (NT, <100 mg Haldol equivalents), multi-episode (ME) patients, and controls. Overall, the FE patients displayed lower N-CAM concentrations as compared to controls ( p=0.043). This decrease in N-CAM in FE patients was seen only in the FE–NT group as compared to both controls ( p=0.0006). The FE–NT group also showed a lower CSF N-CAM compared to that in the FE–NN ( p=0.025) group. No difference in CSF N-CAM between the FE–NN and control group was found. ME patients showed an increased N-CAM as compared with FE patients ( p=0.018), but not as compared to controls ( p=0.93). Neuroleptic-naı̈ve first-episode patients do not display a phenotypic increase in N-CAM. Thus, N-CAM is altered in first-episode patients following acute neuroleptic treatment and withdrawal, as compared to neuroleptic-naı̈ve first-episode patients.