Abstract
Elevated C-reactive protein (CRP), a non-specific biomarker of systemic bodily inflammation, has been associated with more pronounced cognitive impairments in adults with psychiatric disorders, particularly in the domains of memory and executive function. Whether this association is present in early life (i.e., the time at which the cognitive impairments that characterise these disorders become evident), and is specific to those with emerging psychiatric disorders, has yet to be investigated. To this end, we examined the association between salivary CRP and cognitive function in children aged 11–14years and explored the moderating effect of psychopathology. The study utilised data from an established longitudinal investigation of children recruited from the community (N=107) that had purposively over-sampled individuals experiencing psychopathology (determined using questionnaires). CRP was measured in saliva samples and participants completed assessments of cognition (memory and executive function) and psychopathology (internalising and externalising symptoms and psychotic-like experiences). Linear regression models indicated that higher salivary CRP was associated with poorer letter fluency (β=−0.24, p=0.006) and scores on the inhibition (β=−0.28, p=0.004) and inhibition/switching (β=−0.36, p<0.001) subtests of the colour-word interference test, but not with performance on any of the memory tasks (working, visual, and verbal memory tasks). Results were largely unchanged after adjustment for psychopathology and no significant interactions between CRP and psychopathology were observed on any cognitive measure. Our findings provide preliminary evidence that elevated salivary CRP is associated with poorer cognitive function in early life, but that this association is not moderated by concurrent psychopathology. These findings have implications for early intervention strategies that attempt to ameliorate cognitive deficits associated with emerging psychiatric disorders. Further research is needed to determine whether salivary CRP levels can be used as a valid marker of peripheral inflammation among healthy adolescents.
Highlights
Over the past decade, there have been increased efforts to elucidate the role of inflammatory processes in both the pathogenesis and symptomology of psychiatric disorders (Haroon et al, 2012)
Such findings lend support to the notion that chronic inflammation may contribute to the cognitive impairments that typically characterise these disorders; two major questions remain unanswered: Firstly, to what extent is the association between C-reactive protein (CRP) and cognition specific to those with psychiatric disorders? Secondly, is this association present during early life? The latter is pertinent given that the cognitive impairments observed among individuals with these disorders emerge during childhood, many years before disorder onset (Dickson et al, 2012; Koenen et al, 2009; Laurens et al, 2015)
CRP data for this participant were not outliers within the current sample and the results of the main analyses examining the relationship between salivary CRP and cognition were unchanged after excluding this participant. In this sample of children aged 11–14 years, enriched for those presenting with psychopathology, we examined the association between salivary CRP and cognitive performance, and, for the first time, the extent to which this relationship was modified by concurrent psychopathology
Summary
There have been increased efforts to elucidate the role of inflammatory processes in both the pathogenesis and symptomology of psychiatric disorders (Haroon et al, 2012) These efforts have demonstrated that a number of psychiatric disorders, including schizophrenia, bipolar disorder, and depression, A.E. Cullen et al / Brain, Behavior, and Immunity 66 (2017) 221–229 are characterised by elevated concentrations of C-reactive protein (CRP), a non-specific biomarker of systemic bodily inflammation (Fernandes et al, 2016a; Fernandes et al, 2016b; Howren et al, 2009). Such findings lend support to the notion that chronic inflammation may contribute to the cognitive impairments that typically characterise these disorders; two major questions remain unanswered: Firstly, to what extent is the association between CRP and cognition specific to those with psychiatric disorders? Secondly, is this association present during early life? The latter is pertinent given that the cognitive impairments observed among individuals with these disorders emerge during childhood, many years before disorder onset (Dickson et al, 2012; Koenen et al, 2009; Laurens et al, 2015)
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