First-episode Schizophrenic Patients Research Articles

First Episode Schizophrenia: Psychiatric and Cognitive Study for the Patients and Their First-degree Relatives

Background: severe and persistent mental condition Adults have a lifetime prevalence of schizophrenia that ranges from 0.4 to 1%. The purpose of this study was to compare the cognitive function of first-episode schizophrenic patients to that of multiple schizophrenic patients, as well as to examine cognitive function in patients with first-episode schizophrenia and the impact of treatment on first-degree relatives of the patient.
 Methods: The 200 participants in this cross-sectional case-control study were of both sexes and ranged in age from 18 to 50. There were five groups created for the subjects: Group I (n=50): Schizophrenia in its initial episode. Group II (n=50): Relatives of schizophrenia patients experiencing their first episode. Group III (n=50): Schizophrenia with multiple episodes. Healthy volunteers make up Group IV (n=50). Group V (n=36): Group I was followed up with one year following therapy.
 Results: Total IQ, attention, executive function, memory function, and social cognition were significantly different between patients and controls. First-degree relatives and the control group showed substantial differences in attention, executive function, and memory function. The Wisconsin Card Sorting Test (WCST) categories that were completed and the number of preservation errors, as well as the Trail Making Test (TMT) A and B, Mayer-Salovey-Caruso Perception and experiencing areas of emotional intelligence (MESCIT), mental control, logical memory, total number of digits, association learning, and visual reproduction are all measured by the Wechsler Memory Scale (WMS). Other than the perception branch and experiential region (social cognition), there was no statistically significant change in the overall IQ, WCST, Benton Visual Retention Test (BVRT), or MESCIT.
 Conclusions: In terms of general intelligence, attention, executive function, memory function, and social cognition, first episode patients outperformed many episode patients.

Association of serum brain-derived neurotrophic factor level and early response to antipsychotic drug in first-episode patients with schizophrenia.

To investigate the role of Brain derived neurotrophic factor (BDNF) in the psychotic symptoms in first-episode patients with schizophrenia and whether BDNF levels were associated with the improvement of psychotic symptoms after risperidone treatment. 89 schizophrenia patients and 90 healthy controls were recruited, the schizophrenia patients were assigned into early response or early non-response groups at 2weeks based on improvement in the positive and negative symptoms scale (PANSS) total score. All patients were treated with risperidone for 2weeks, their serum BDNF levels were compared at baseline and after 2weeks treatment. We found that patients had lower BDNF levels, compared to controls at baseline. After 2weeks of treatment of risperidone, BDNF levels were significantly increased and psychotic symptoms were decreased in early response group. Correlation analysis showed that the change of BDNF levels after treatment was correlated with the change of PANSS total score. Further regression analysis showed that the change in BDNF levels was an independent predictor for the improvement in psychotic symptoms. Our findings reveal that the level of BDNF was lower in first-episode schizophrenic patients, moreover, the changes in serum BDNF levels may have a predictive effect on the early improvement in psychotic symptoms in the first 2weeks.

Exploring the link between cognitive deficit, self-esteem, alexithymia, and depressive symptom of schizophrenia.

ObjectiveTo the best of our knowledge, studies have been rarely conducted to assess the correlation between cognitive deficit, self‐esteem, and alexithymia in the depressive symptoms of schizophrenia (SCZ). Therefore, this study aims to explore the risk factors associated with impairment of cognitive function, alexithymia, and self‐esteem among a representative sample of first‐episode schizophrenic patients.MethodWe recruited 107 first‐episode schizophrenic patients (48.6% male, 51.4% female, 36.94 ± 10.73 years) into the research group, according to the Diagnostic and Statistical Manual of Mental Disorders (5th edition). A total of 45 healthy people (51.1% male, 48.9% female, 32.47 ± 10.94 years) were enlisted in the healthy control group. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Cognitive functions were estimated using the Montreal Cognitive Assessment Scale (MoCA). The feelings of respect and self‐acceptance were tested using the Rosenberg Self‐Esteem Scale (RSES). Emotion of identifying and describing were measured by self‐report scale of Toronto Alexithymia Scale‐20 (TAS‐20).ResultsOverall cognitive impairment and alexithymia were found more serious in the patients of SCZ than the healthy group (p < .001, respectively). The patients of SCZ have higher self‐esteem than the healthy group (p = .013). Total score of MoCA, ability of visual space and executive function, and delayed recall were explored had negatively correlation with alexithymia (r = −.319, p = .001; r = −.248, p = .010; r = −0.263, p = .006). Total score of RSES and depressive symptoms of PANSS had a positive correlation with alexithymia (r = .394, p = .001; r = .208, p = .032). Stepwise regression analyses have shown a positive relationship between difficulty describing feelings and depression subscale of PANSS (β = .188, t = −2.007, p = .047) while a negative relationship between externally oriented thinking and depression subscale of PANSS (β = −.244, t = −2.603, p = .011). A positive link correlation also was found between the total scores of TAS and RSES (β = .372, t = 4.144, p = .001). A negative relevance was found between the total scores of TAS and scores of MoCA (β = −.305, t = −3.348, p = .001).ConclusionOverall impairment of cognitive function and alexithymia are commonly encountered in SCZ patients. Poor cognitive function, alexithymia, and high level self‐esteem may be specific detective risk factors for the depressive symptoms of SCZ.

PCSK9 mediates dyslipidemia induced by olanzapine treatment in schizophrenia patients.

It is controversial whether dyslipidemia induced by antipsychotics in schizophrenia patients is due to weight gain or direct effects of drug treatment. However, recent evidence showed that olanzapine can cause acute dyslipidemia independent of weight change, and the underlying mechanism remains unclear. To study the role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in olanzapine-induced dyslipidemia, we analyzed in schizophrenic patients and in experimental models involving mice and cells to understand the mechanism. Disturbances in lipid homeostasis caused by 8-week olanzapine treatment were prospectively evaluated in first-episode schizophrenic patients. Additionally, mice were administered olanzapine for 5 or 8 weeks to delineate liver actions for PCSK9 contributing to olanzapine-induced dyslipidemia. Olanzapine directly affected lipid metabolism, suggesting dyslipidemia is independent of weight gain in schizophrenia patients. Olanzapine administration significantly increased plasma PCSK9, which was positively correlated with the increment in low-density lipoprotein cholesterol (LDL-C) (r=0.77, p<0.001). Increased expression of PCSK9 in liver tissue of olanzapine-treated mice occurred prior to olanzapine-induced LDL-C abnormality. Hepatic sterol regulatory element binding protein-2 (SREBP-2) protein levels increased in mice treated with olanzapine but largely declined in olanzapine (10μM) treated HepG2 cells, which suggested high concentration of olanzapine-induced PCSK9 increase was not SREBP-2-dependent. However, expressions of sterol regulatory element binding protein-1c (SREBP-1c) significantly increased in the higher dose treated groups, which was consistent with PCSK9 increases. Activation of SREBP-1c after high-dose olanzapine treatment promotes PSCK9 expression, and consequently the degradation of low-density lipoprotein receptors results in LDL-C increase. Lipid disturbances caused by olanzapine are independent of weight gain. The study explored the relationship between SREBP-1c and PCSK9 in regulating lipoprotein metabolism after olanzapine treatment in vitro and in vivo. Further exploration of olanzapine-induced PCSK9 regulatory mechanisms may help identify control points for inhibition of olanzapine-mediated dyslipidemia.

Impaired Emotional Self-Referential Processing in First-Episode Schizophrenia.

Impairments in self-representation are relevant to the expression of psychosis. To date, the characteristics and neural mechanisms of self-impairment in schizophrenia remain unclear. To this end, we used event-related potentials (ERPs) to measure brain activity in 56 first-episode patients with schizophrenia and 56 healthy controls. Participants judged personal trait adjectives regarding themselves, their mothers, or a public person, followed by an unexpected old/new recognition test. The recognition score for mother-reference adjectives was lower than that for self-reference adjectives in patients, while the control group showed comparatively high recognition scores for both self- and mother-referential adjectives. In addition, control subjects recognized more negative words, while patients remembered more positive words. ERP data revealed that controls exhibited typical task effects (self-reference = mother-reference > other-reference) during both automatic attention and effortful encoding periods [indexed by P2 and the late positive potential (LPP), respectively]. In contrast, patients only exhibited the task effect in the P2 amplitude. Moreover, controls exhibited larger P2 amplitudes during encoding negative than positive words, whereas patients had enhanced LPP amplitudes during memory retrieval of positive compared to negative words. These findings demonstrated self-representation dysfunction in first-episode schizophrenic patients in mother (the intimate other) referential processing and the absence of a negative memory bias.

Optimizing and Individualizing the Pharmacological Treatment of First-Episode Schizophrenic Patients: Study Protocol for a Multicenter Clinical Trial.

Introduction: Affecting ~1% of the world population, schizophrenia is known as one of the costliest and most burdensome diseases worldwide. Antipsychotic medications are the main treatment for schizophrenia to control psychotic symptoms and efficiently prevent new crises. However, due to poor compliance, 74% of patients with schizophrenia discontinue medication within 1.5 years, which severely affects recovery and prognosis. Through research on intra and interindividual variability based on a psychopathology–neuropsychology–neuroimage–genetics–physiology-biochemistry model, our main objective is to investigate an optimized and individualized antipsychotic-treatment regimen and precision treatment for first-episode schizophrenic patients.Methods and Analysis: The study is performed in 20 representative hospitals in China. Three subprojects are included. In subproject 1, 1,800 first-episode patients with schizophrenia are randomized into six different antipsychotic monotherapy groups (olanzapine, risperidone, aripiprazole, ziprasidone, amisulpride, and haloperidol) for an 8-week treatment. By identifying a set of potential biomarkers associated with antipsychotic treatment response, we intend to build a prediction model, which includes neuroimaging, epigenetics, environmental stress, neurocognition, eye movement, electrophysiology, and neurological biochemistry indexes. In subproject 2, apart from verifying the prediction model established in subproject 1 based on an independent cohort of 1,800 first-episode patients with schizophrenia, we recruit patients from a verification cohort who did not get an effective response after an 8-week antipsychotic treatment into a randomized double-blind controlled trial with minocycline (200 mg per day) and sulforaphane (3 tables per day) to explore add-on treatment for patients with schizophrenia. Two hundred forty participants are anticipated to be enrolled for each group. In subproject 3, we tend to carry out one trial to construct an intervention strategy for metabolic syndrome induced by antipsychotic treatment and another one to build a prevention strategy for patients at a high risk of metabolic syndrome, which combines metformin and lifestyle intervention. Two hundred participants are anticipated to be enrolled for each group.Ethics and Dissemination: The study protocol has been approved by the Medical Ethics committee of the Second Xiangya Hospital of Central South University (No. 2017027). Results will be disseminated in peer-reviewed journals and at international conferences.Trial Registration: This trial has been registered on Clinicalrials.gov (NCT03451734). The protocol version is V.1.0 (April 23, 2017).

Altered default mode network activity and cortical thickness as vulnerability indicators for SCZ: a preliminary resting state MRI study.

Alterations in brain function in patients with schizophrenia (SCZ) and other neuropsychiatric disorders are evident not only during specific cognitive challenges, but also from functional MRI data obtained during a resting state. Patients with chronic SCZ have shown deficits in default mood network (DMN) and gray matter volume in resting-state functional magnetic resonance imaging (rs-fMRI). However, cortical thickness and surface area in first-episode schizophrenic patients have rarely been investigated. In the present study, we applied independent component analysis (ICA) to a series of rs-fMRIs of 15 SCZ patients and 15 matched healthy controls. The data were analyzed using MELODIC of FMRIB's Software Library (FSL version 5.9; www.fmrib.ox.ac.uk/fsl) to identify large-scale patterns of temporal signal-intensity coherence. Patients with SCZ showed significantly higher functional connectivity in the DMN, auditory network, and cerebellum network (p=0.049, p=0.05, and p=0.007, respectively) than matched healthy controls. The patients also exhibited significantly less cortical thickness, primarily in the bilateral prefrontal and parietal cortex, and higher thickness in the bilateral anterior temporal lobes, left medial orbitofrontal cortex, and left cuneus than the matched healthy controls. These results indicate that significantly abnormal DMN connectivity and cortical thickness contribute to local functional pathology in patients with SCZ.

Neurocognition and social cognition in remitted first-episode schizophrenia: correlation with VEGF serum levels

BackgroundAccumulating evidence suggests that serum vascular endothelial growth factor (VEGF) in many neurobiological processes potentially contributes to the pathophysiology of psychiatric disorders, particularly cognitive decline. The purpose of this study was to explore the differences in neurocognition, social cognition and VEGF among remitted first-episode schizophrenic patients, non-remitters and normal control subjects. Moreover, we investigated the association between serum VEGF levels and cognitive functions.Method65 remission (RS) and 45 nonremission patients (NRS) after first-episode schizophrenia, as well as 58 healthy controls (HC) were enrolled in this study. Social cognition was assessed using the Chinese Facial Emotion Test (CFET); neurocognition was measured with a test battery consisting of Hopkins Verbal Learning Test-Revised, Verbal Fluency Test, Trail Making Tests, Digit Span Tests (DST) and Stroop Tests. Blood samples were collected for VEGF measurements. Data was analyzed with SPSS 22.0 (Chicago, IL, USA).ResultsOn nearly all neurocognitive tests (except for DST), RS performed significantly worse than HC but better than NRS (P < 0.05). NRS, but not RS, exhibited markedly poorer social cognition than HC (except for Happiness and Surprise subscales of the CFET) (P < 0.05). VEGF levels showed a gradient change among three groups (HC > RS > NRS).ConclusionCompared to HC, RS demonstrated poorer neurocognitive but intact social cognition functioning. These results indicate that VEGF levels decreased gradually with the severity of cognitive impairment in schizophrenia. VEGF may be involved in the pathological mechanism of cognitive performance in RS.

The correlation between lipid level and cognitive function in first-episode schizophrenia patients with positive and negative symptoms

Objective To explore the characteristics of blood lipid level and cognitive impairment in first-episode schizophrenic patients with positive and negative symptoms, and their correlation. Methods Seventy inpatients with first-episode schizophrenia were enrolled in the hospital.Their psychiatric symptoms were assessed by positive and negative syndrome scale (PANSS). They were divided into two groups: positive symptoms group with 42 patients and negative symptoms group with 28 patients.All patients were assessed with the Chinese version of the measurement and treatment research to improve cognition in schizophrenia consensus cognitive battery (MCCB). The differences and characteristics of cognitive function between the two groups were compared.Body mass index (BMI), serum triglyceride, total cholesterol, low density lipoprotein and high density lipoprotein were recorded at admission, and the results were compared between the two groups.The correlation between cognitive assessment scores and metabolic indicators intra groups were analyzed using pearson correlation analysis. Results The scores of trail making test(TMT), brief assessment of cognition in schizophrenia-symbol encoding(BACS), Hopkins verbal learning test, maze and continuous performance test-identical pairs(CPT-IP) in positive group((27.13±6.89), (32.97±13.69), (35.70±7.52), (32.63±4.59), (33.35±11.10)) were higher than those in negative group ((12.90±14.72), (19.90±11.98), (25.80±5.44), (27.50±5.20), (19.89±11.29), all P<0.05). In terms of BMI and lipid metabolism indicators, the total cholesterol and low-density lipoprotein levels in the negative group ((5.03±1.42), (3.04±1.18)) were higher than those in the positive group ((4.18±0.78), (2.45±0.64)), and the difference was statistically significant (P<0.05). In negative group, total cholesterol and low density lipoprotein were negatively correlated with the scores of TMT(r=-0.469, -0.751), BACS(r=-0.517, -0.538) and CPT-IP(r=-0.495, -0.542) in cognitive function(all P<0.05). Conclusion First-episode schizophrenia patients with positive and negative symptoms have similar lesion dimensions in cognitive function, but patients with negative symptoms are more severely impaired.There are differences in lipid metabolism between first-episode schizophrenia patients with positive dominant symptoms and negative dominant symptoms, and the lipid metabolism of first-episode schizophrenia patients with negative dominant symptoms is related to cognitive function. Key words: First-episode schizophrenia; Negative symptom; Positive symptom; Cognitive function; Lipid metabolism

Serum high-sensitivity C-reactive protein levels are positively associated with cognitive impairments in patients with first-episode schizophrenia

BackgroundTo clarify the controversy regarding the relationship between serum high-sensitivity C-reactive protein (hs-CRP) levels and cognitive impairments in first-episode schizophrenic patients and examine whether hs-CRP is a potential objective biological indicator for evaluating cognitive impairment in first-episode schizophrenic patients. MethodsSerum hs-CRP levels were measured in 58 first-episode schizophrenic patients and 31 healthy controls using immunofluorescence. The Brief Psychiatric Rating Scale (BPRS) and the P300 event-related potential were assessed. The relationship between serum hs-CRP levels and both BPRS scores and P300 were analyzed. ResultsSerum hs-CRP levels and BPRS scores were significantly higher in the study group than in the control group. The incubation period of P3 was longer, and the amplitude of P3 was larger in the study group than in the control group. Correlation analysis showed that in the study group, serum hs-CRP levels were positively correlated with BPRS total scores. Serum hs-CRP levels were also positively correlated with the incubation period of P3 and negatively correlated with P3 amplitudes. ConclusionsSerum hs-CRP levels were positively associated with cognitive impairment in first-episode schizophrenic patients and potentially represent an objective biological indicator for the rapid evaluation of cognitive impairment in first-episode schizophrenic patients.

S72. PRO-SOCIAL PROSPECTIVE MEMORY PERFORMANCE IS ASSOCIATED WITH PLASMA OXYTOCIN LEVEL IN SEXUALLY DIMORPHIC WAY IN FIRST-DEGREE RELATIVES OF SCHIZOPHRENIA

BackgroundProspective memory (PM) in real world is mostly societal and it often involves activities in which the individual has to remember to do something for others, which is also called pro-social PM. The neuropeptide oxytocin has been implicated in social cognition and social interaction in a number of studies. The aim of the present study was to investigate the correlation between pro-social PM performance and plasma oxytocin level in first-episode schizophrenic patients (FES), first-degree relatives (FDRs) of schizophrenia, and healthy controls (HCs). In addition, we also tried to explore the sexually dimorphic feature in the interactions of above-mentioned factors.MethodsForty-six FES patients, 41 non-psychotic FDRs of patients with chronic schizophrenia (unrelated to the FES group) and 54 HCs were studied. Pro-social time-based prospective memory (TBPM) and event-based prospective memory (EBPM) performance were assessed with the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT). A serial of tests reflecting retrospective memory and executive functions were also administrated. Plasma oxytocin levels were determined by radioimmunoassay using a RIA kit.Results(1) There were significant differences in performance between FES, FDRs, and HCs with respect both TBPM and EBPM, even after controlling for age, sex and education level by analysis of covariance (ANCOVA). We found significant group*sex interaction only regarding TBPM (F(2, 133)=4.8, p=0.01). Female HCs performed significantly poorer than male HCs on TBPM (11.1 ± 5.5 vs 14.4 ± 4.8, t=-2.3, p=0.026). However, this sexually dimorphic trend was not seen in either FES (9.0 ± 5.1 vs 7.5 ± 5.1, t=1.0, p=0.34) or FDRs (12.3 ± 3.5 vs 11.1 ± 4.4, t=1.0, p=0.3). (2) A significant group*sex interaction was also revealed with regard to plasma oxytocin level (F(2, 134)=4.1, p=0.018). In HCs, females exhibited significantly higher plasma oxytocin level than males (62.2 ± 28.3 pg/ml vs 44.4 ± 20.9 pg/ml, t=2.5, p=0.015). But this sexually dimorphic feature did not appear in FES (58.3 ± 20.1pg/ml vs 59.6 ± 19.4 pg/ml, t=-0.2, p=0.822) or FDRs (60.4 ± 19.2 pg/ml vs 74.0 ± 46.0 pg/ml, t=-1.2, p=0.230). In addition, there was a significant difference in plasma oxytocin level between the three groups only in male. Post-hoc analyses suggest male FDRs exhibited significant higher plasma oxytocin level than male HCs. (3) After controlling age and education level, partial correlation analysis indicated higher plasma oxytocin levels to be significantly associated with higher TBPM scores in FDRs (r=0.39, p=0.015). In order to determine the origin of this correlation, we further conducted 2 separate partial correlation analyses in males and females, still with age and education level as controlled variables. The correlation between plasma oxytocin level and TBPM remained significant in male FDRs (r=0.5, p=0.021) but disappeared in female FDRs (r=0.2, p=0.434).DiscussionIn the present study, we found the pre-existing sex-specific patterns (as in HCs) of plasma oxytocin level and TBPM were substantially disrupted in FES and FDRs. Moreover, a significant association between plasma oxytocin levels and PM was only found in FDRs, and only male FDRs contribute to this significant association, suggesting oxytocin may play an important role regulating pro-social PM in FDRs in sexually dimorphic way.Longitudinal studies with larger sample size and measurement of oxytocin receptor function and genetic variations should be conducted in the future.

Association of white matter abnormality with facial emotion cognitive in the first-episode schizophrenic patients with never-medicated

Objective To explore the structure changes of white matter in the first-episode schizophrenic patients with never-medicated(FESZ) and the relationship between facial emotion perception and white matter (WM) integrity. Methods Sixty-three schizophrenic patients and thirty health control subjects underwent diffusion tensor imaging (DTI) scans.Voxel-based analysis was used to compared fractional anisotropy (FA) map between the two groups.Correlations were analyzed with pearson relative analysis between impaired facial emotion perception tested by facial emotion categorization (FEC) and severity of symptoms measured by the Positive and Negative Syndrome Scale (PANSS). Results (1)Compared with controls, FESZ patients showed overall decreased FA in WM of the body of left ventral frontal lobe ((MNI(x, y, z): -18, 26, -4; t=4.43)), right supramarginal gyrus ((MNI(x, y, z): 32, -50, 26; t=4.27)), left middle occipital gyral ((MNI(x, y, z): -26, -60, 0; t=4.89)), right middle occipital gyral ((MNI(x, y, z): 28, -70, 14; t=4.18)), left fusiform gyrus ((MNI(x, y, z): -40, -50, 0; t=3.92)), left cerebellum anterior lobe ((MNI(x, y, z): -32, -56, -28; t=4.57)), right parahippocampa gyrus1 ((MNI(x, y, z): 32, -10, -14; t=4.16)), right parahippocampa gyrus2 ((MNI(x, y, z): 16, -6, -14; t=4.56)), left anterior cingulate ((MNI(x, y, z): -2, 4, -6; t=4.41)), left extra-nuclear ((MNI(x, y, z): -2, -10, -6; t=4.44)), right thalamus ((MNI(x, y, z): 10, -10, 2; t=4.20)), left thalamus ((MNI(x, y, z): -22, -28, 12; t=4.01)), and right caudate ((MNI(x, y, z): 14, 12, 8; t=4.87)). (2)Compared with controls, the patients with schizophrenia showed a higher shift point and a steeper slope than control subjects in FEC.Correlational analysis revealed that the negative correlations were found between the slope and negative factor(r=-0.298, P=0.036), between positive factor and the FA value in WM of the right middle occipital gyral(r=-0.322, P=0.023) and the left middle occipital gyral(r=-0.288, P=0.043), and between the FA value in the left cerebellum anterior lobe and shift point(r=-0.393, P=0.005), but the positive correlation was found between disorganized/concrete factor and the FA value in the right parahippocampal gyrus(r=0.429, P=0.002). Conclusions There are extensive microstructural abnormalities in WM of patients with FESZ.Disrupted WM integrity in these regions may constitute a potential neural pathological basis for the facial emotion perception impairments in schizophrenia. Key words: Schizophrenia; Facial emotion perception; Diffusion tensor imaging; White matter

Arginine vasopressin improves the memory deficits in Han Chinese patients with first-episode schizophrenia

The memory impairment is a core deficit in the first-episode schizophrenia patients. Arginine vasopressin (AVP) in the brain can improve learning and memory. We performed multicentre, randomized, double-blind, placebo-controlled, parallel-group clinical trial to study the cognitive functioning in Han Chinese first-episode schizophrenic patients in a 12-week treatment regime with the intranasal administration of AVP (128 cases) or placebo (131 cases) in addition to the conventional treatment. The methods of positive and negative syndrome scale (PANSS), Wechsler memory scale-4th edition (WMS-IV) and event-related potential (ERP) were used to study the effects of AVP on the cognitive function. The results showed that (1) AVP concentration decreased in cerebrospinal fluid (CSF) of the right-handed Han Chinese first-episode schizophrenic patients comparing with that of the health volunteers (7.1±1.5pg/ml vs 13.3±1.9pg/ml, p<0.01), and did not change in plasma; (2) AVP significantly improved PANSS scores including total scores, positive symptoms, negative symptoms and general psychopathology comparing with those of the placebo group; (3) AVP elevated WMS-IV scores including the long-term memory (accumulation), short-term memory (recognition, comprehension), immediate memory (number recitation) and memory quotient 4, 8 and 12 weeks after treatment; and (4) AVP did not influence the latency and wave amplitude of target stimulus of P300 of right-handed Han Chinese first-episode schizophrenic patients. The data suggested that AVP might improve cognitive process, such as memorizing and extraction of the information although there were many changes of cognitive functions in the right-handed Han Chinese first-episode schizophrenic patients.

Association of Val66Met polymorphism of brain-derived neurotrophic factor gene with cognitive impairment and clinical symptoms in first episode schizophrenia

To assess the association of cognitive impairment and clinical symptoms in first-episode schizophrenia with the Val66Met (rs6265) polymorphism of brain-derived neurotrophic factor (BDNF) gene. For 87 patients with first-episode schizophrenia and 76 healthy controls, the Val66Met polymorphism was determined with a Taqman Assay-on-Demand method. Wechsler intelligence test was carried out for all participants. Correlation of cognitive impairment with clinical severity was also analyzed. The patients were significantly lower in total IQ, verbal IQ and performance IQ compared to the controls. The lower total IQ (F=4.59, P= 0.01) and verbal IQ (F=4.44, P=0.01) were influenced by genetic factors and diagnostic interaction. The vertal IQ of Val/Val patients was significantly lower than those of Val/Met and Met/Met carriers. For the control group, the verbal IQ of Met/Met carriers was lower than that of Val/Met carriers, and the total IQ of Met/Met carriers was lower than those of Val/Met and Val/Val carriers. For the patient group, the total IQ of Val/Val carriers was negatively correlated with positive symptoms (r=-0.65, P=0.03) and thought disorders (r=-0.61, P=0.02). Cognitive impairment in first-episode schizophrenic patients is associated with the Val66Met polymorphism of the BDNF gene, and has an important clinical relevance.

A Comparative Study on Fear Expression Recognition Characteristics in First-episode Schizophrenic Patients

Objective: To explore the characteristics of fear expression recognition in the patients with first-episode schizophrenia. Methods: Based on the case-control design, the Ekman facial expression database was used to research the subjects’ overall response rate of low / high fear facial expression, accuracy rate of low / high level fear and its response time in the control group (28 cases) and the first-episode schizophrenic patient group (27 cases) with matching gender (p = 0.696), age (p = 0.255) and education level (p = 0.895). Results: The high level fear accuracy rate (50.41 ± 6.18) of case group was lower than that of the control group (68.29 ± 4.27, p = 0.034). The response time (362.84 ± 25.23) of low-level fear of healthy control group was positively correlated with the accuracy rate (21.79 ± 2.28) (r = 0.494, p = 0.008); the negative symptom of case group (23.35 ± 10.56) was negatively correlated with the accuracy rate of high level fear (r = -0.428, p = 0.042). Conclusion: The patients with first-episode schizophrenia have the disorder of high-level fear recognition and the accuracy rate of fear facial expression recognition can reveal the negative symptoms of the patients.

Face-related visual search deficits in first-episode schizophrenia

Schizophrenia is considered a complex illness with multiple cognitive dysfunctions, including a deficit in visual processing. However, whether the deficiency of visual processing in schizophrenia is general across stimuli or stimulus-specific remains the subject of debate. In the current study, eighteen first-episode schizophrenic patients and eighteen healthy controls participated in three visual search tasks in which they were asked to search a specific target of a triangle, face identity or facial affect. The results showed that, compared to healthy controls, the accuracies for face identity and facial affect searches were significantly lower in schizophrenic patients, while the performance of the triangle search was the same. Furthermore, the accuracy of the facial affect search was negatively correlated to negative symptoms in schizophrenia. These results revealed a face-related deficit in schizophrenia and suggest that visual processing deficits in schizophrenia were stimuli-specific.

Association study on serum protein factors and cognitive function in first-episode schizophrenia characterized by positive and negative symptoms

Objective To investigate the relationship between the serum concentration of IL-6, S100β, NT-3 and the cognitive functions in first-episode schizophrenia characterized by positive or negative symptoms. Methods 44 first-episode schizophrenic patients characterized by positive symptoms (positive group), 36 first-episode schizophrenic patients characterized by negative symptoms (negative group) and 50 healthy controls (controls) were collected. The serum levels of IL-6, S100β and NT-3 were measured by enzyme-linked immunosorbent assay (ELISA). The systematic evaluation tool-MCCB was applied to assess cognitive function in patients and controls. Results NT-3 serum levels in positive or negative groups were lower than those in controls and the differences were significant((118.39±37.50) ng/L, (112.55±32.29) ng/L vs (141.18±29.67) ng/L) (P<0.01). IL-6 and S100β serum levels in positive or negative groups were higher than those in controls and the differences were statistically significant((5.74±1.00)ng/L, (5.07±1.17)ng/L vs (4.23±0.91)ng/L), ((132.98±46.71)ng/L, (124.99±43.14)ng/L vs (103.63±31.57)ng/L)(P<0.01). IL-6 serum levels in the positive group ((5.07±1.17)ng/L) were lower than those in the negative group ((5.74±0.99)ng/L) and the difference was statistically significant (P<0.05). In MCCB test, the TMT scores in patients characterize by positive symptoms or patients characterize by negative symptoms were higher than those in healthy control group (P<0.01). BACS SC, HVLT-R WMS-Ⅲ, SS, NAB, BVMT-R, CF in patients characterize by positive symptoms or by negative symptoms were lower than those in healthy control group(P<0.01). There were no statistical difference in the MCCB scores between the patients with positive symptoms and negative symptoms. In positive group, there was a positive correlation between the IL-6 serum concentration and the general symptom scores in PANSS (P<0.05). In positive group, NT-3 serum concentration was positively correlated with the general symptom scores or total scores of PANSS (P<0.05). BVMT-R scores in MCCB were also positively correlated with IL-6 or NT-3 serum concentration in positive group (P<0.05). Conclusion The impairment of part of cognitive functions for schizophrenic patients may be related to the serum protein factors. There may be different in pathophysiology between the first-episode schizophrenic patients characterized by positive symptoms and those characterized by negative symptoms. Key words: First-episode schizophrenia; Positive symptoms; Negative symptoms; Serum protein factor; Cognitive function

The effects of olanzapine treatment on brain regional glucose metabolism in neuroleptic-naive first-episode schizophrenic patients.

The current study examined metabolic alterations associated with a positive response to olanzapine and identified brain regions associated with treatment-related improvement of symptoms in neuroleptic-naive first-episode schizophrenic patients using [18 F]fluoro-deoxy-glucose positron emission tomography analysis. Neuroleptic-naive first-episode schizophrenic patients who showed good or poor clinical responses to olanzapine were assessed using the Positive and Negative Syndrome Scale. Data were analyzed using statistical nonparametric mapping. Before treatment, responders showed significantly increased metabolism in the superior temporal gyrus and cerebellum compared with healthy controls. Glucose metabolism in responders was significantly increased after treatment in the left precentral gyrus, left postcentral gyrus, and left paracentral lobule, and significantly decreased in the left hypothalamus. An analysis of the Positive and Negative Syndrome Scale symptoms associated with olanzapine treatment revealed that "suspiciousness/persecution" scores were positively correlated with metabolic changes in the right superior frontal gyrus. These findings provide evidence of the neural mechanisms underlying the effects of olanzapine on metabolism in the early stages of schizophrenia.

Dysregulated 14-3-3 Family in Peripheral Blood Leukocytes of Patients with Schizophrenia.

The 14-3-3 family, which is composed of seven distinct members in humans, plays important roles in the cell cycle, apoptosis, synaptic plasticity and neuronal differentiation and migration. Previous genetic and post-mortem gene expression studies have linked this family to schizophrenia. However, the direction of gene expression changes in these studies has been inconsistent, and reports of 14-3-3 gene expression in living schizophrenic patients are still lacking. Here, we assessed 14-3-3 gene and protein expression levels in peripheral blood leukocytes from drug-naïve first-episode schizophrenic patients and matched controls. mRNA and protein expression levels were quantified by qRT-PCR and UPLC-MRM/MS, respectively. Expression analysis revealed four downregulated and one upregulated mRNA transcripts as well as five downregulated protein levels of 14-3-3 isoforms in schizophrenia. Moreover, significant positive correlations between 14-3-3 mRNA and protein expression levels were found in schizophrenia, and we also identified negative correlations between ε, θ and ζ isoform expression levels and positive symptoms of schizophrenia. Our results suggest that gene and protein expression levels for the 14-3-3 family are dysregulated in schizophrenia, perhaps owing to specific regulatory mechanisms, and we also suggest that expression of the 14-3-3ε, θ and ζ isoform genes could be useful indicators of disease severity.

Decreased bilateral thalamic gray matter volume in first-episode schizophrenia with prominent hallucinatory symptoms: A volumetric MRI study.

Studies comparing gray matter (GM) volume of schizophrenic patients with or without auditory verbal hallucinations (AVHs) to that of normal controls remain controversial. This project aims to investigate changes of GM volumes of drug-naïve schizophrenic patients with and without AVHs. Eighteen first episode schizophrenic (FES) patients with AVHs, 18 FES patients without AVHs, and 18 healthy controls were scanned using structural MRI. Voxel-based morphometry (VBM) analysis was conducted to investigate changes of GM volume among the three groups. Patients with and without AVHs exhibited reduced GM volumes relative to normal controls in the left superior temporal gyrus, frontal regions, cerebellum and caudate. Further analysis of the GM of subcortical structures found that patients with AVHs had reduced thalamic volume than healthy controls. No significant difference was found between patients with and without AVHs. Significant correlation was found between the total scores of the Positive and Negative Syndrome Scale and bilateral thalamic volume. ROC analysis of thalamic volumes of the patients with AVHs and normal controls showed that the area under the curve was 0.698 (P = 0.043). The decreased thalamic volumes might serve as a biomarker for discriminating FES AVHs patients from normals.