Abstract：
The contribution of anticholinergic burden to cognitive function in patients with treatment resistant schizophrenia (TRS) is uncertain. This case-control study aims to comprehensively examine the association between treatment resistance and cognitive functions and the contribution of anticholinergic burden in patients with schizophrenia. Anticholinergic burden of all patients was calculated using the Anticholinergic Cognitive Burden scale. Exploratory Factor Analysis of 11 cognitive assessments identified four cognitive domains: verbal memory, attention and general cognitive functions, visual memory and processing speed, and executive function. Two structural equation models (SEM) examined the relationship of TRS and these cognitive functions with, and without considering anticholinergic burden. A total of 288 participants were included (TRS N=111, non-TRS N=177). Patients with TRS performed poorer than the non-TRS group only in the executive function domain. Anticholinergic burden contributed significantly to the attention and general cognitive functions, visual memory and processing speed, and executive function. The impact of TRS on executive function was no longer significant after adding anticholinergic burden to the SEM. Results suggested that anticholinergic burden contributes to a wide range of cognitive function impairment in patients with schizophrenia and is likely to be part of the apparent differences of cognitive function between TRS and non-TRS.
摘要：
抗胆碱能负担对难治性精神分裂症（TRS）患者认知功能的贡献尚不确定。这项病例对照研究旨在全面检查精神分裂症患者的治疗抵抗与认知功能之间的关系以及抗胆碱能负担的作用。使用抗胆碱能认知负担量表计算所有患者的抗胆碱能负担。11项认知评估的探索性因素分析确定了四个认知领域：言语记忆，注意力和一般认知功能，视觉记忆和处理速度，和执行功能。两个结构方程模型(SEM)检验了TRS与这些认知功能的关系，而不考虑抗胆碱能负担。共有288名参与者参加（TRSN=111，非TRSN=177）。TRS患者仅在执行功能域中表现比非TRS组差。抗胆碱能负担对注意力和一般认知功能有显著贡献，视觉记忆和处理速度，和执行功能。在SEM中添加抗胆碱能负荷后，TRS对执行功能的影响不再显着。结果表明，抗胆碱能负担导致精神分裂症患者广泛的认知功能障碍，并且可能是TRS和非TRS之间认知功能明显差异的一部分。
