背景:精神分裂症与显著的认知障碍相关。然而,精神分裂症认知功能障碍的病理生理机制尚不清楚.基于最新的认知概念,免疫炎症因子和脑的结构磁共振成像(sMRI)特征被认为是精神分裂症的标志物。本研究探讨原发性精神分裂症患者认知功能与免疫炎症因子及sMRI的相关性。
方法:进行非干预性横断面研究,包括21名原发性精神分裂症患者,根据诊断和统计手册确定的人,第五版(DSM-V)并分组下设不雅察组。30名健康志愿者随着年龄的增长,性别,手支配,将与原发性精神分裂症患者相匹配的受教育时间纳入对照组。所有受试者均行sMRI检查。MATRICS共识认知电池(MCCB)用于评估原发性精神分裂症患者的认知功能。血清淀粉样蛋白A(SAA)水平,单核细胞趋化蛋白1(MCP-1),用酶联免疫吸附试验(ELISA)测定几丁质酶-3样蛋白1(YKL-40)。采用Pearson相关分析,分析免疫炎症因子水平与认知功能及脑sMRI特征的相关性。
结果:观察组的所有MCCB项目得分和总分均明显低于对照组(p<0.001)。观察组YKL-40和SAA水平明显高于对照组(t=3.406,p<0.05;t=5.656,p<0.001)。与对照组相比,观察组左右岛叶体积减少,左右前扣带皮质,左右海马,右侧海马旁回,右杏仁核,左下枕叶,左颞叶上叶,左颞极,左颞叶中下叶(p<0.001)。YKL-40和SAA水平均与MCCB评分呈负相关(r=-0.3668,p=0.004;r=-0.8495,p<0.001)。右岛叶的体积,左右前扣带皮质,右侧海马旁回,右杏仁核,左颞叶中灰质与YKL-40、SAA水平均呈负相关(p<0.05)。
结论:原发性精神分裂症患者的认知功能障碍与血清SAA和YKL-40水平升高以及灰质体积减少有关。
BACKGROUND: Schizophrenia is associated with significant cognitive impairment. However, the pathophysiological mechanisms underlying cognitive dysfunction in schizophrenia remain unclear. Based on the latest concept of cognition, immunoinflammatory factors and structural magnetic resonance imaging (sMRI) features of the brain are considered markers of schizophrenia. This study explored the correlations between cognitive function and immunoinflammatory factors and sMRI in primary schizophrenia patients.
METHODS: Non-interventional cross-sectional study was conducted, including 21 patients with primary schizophrenia, who were identified based on the Diagnostic and Statistical Manual, Fifth Edition (DSM-V) and grouped under the observation group. Thirty healthy volunteers with age, gender, hand dominance, and education duration matched with those of the primary schizophrenia patients were recruited to the control group. All subjects underwent sMRI examination. MATRICS consensus cognitive battery (MCCB) was employed to assess the cognitive functions among patients with primary schizophrenia. The levels of serum amyloid A (SAA), monocyte chemoattractant protein 1 (MCP-1), and chitinase-3-like protein 1 (YKL-40) were measured by means of enzyme-linked immunosorbent assay (ELISA). Pearson\'s correlation analysis was carried out to analyze the correlation between immunoinflammatory factor levels and cognitive functions as well as brain sMRI features.
RESULTS: The scores for all MCCB items and the total score for the observation group were apparently lower than those for the control group (p < 0.001), while the YKL-40 and SAA levels were notably higher in the observation group (t = 3.406, p < 0.05; t = 5.656, p < 0.001). Compared to the control group, the observation group exhibited reduced volumes of left and right insular lobes, left and right anterior cingulate cortexes, left and right hippocampi, right parahippocampal gyrus, right amygdala, left inferior occipital lobe, left superior temporal lobe, left temporal pole, and left middle and inferior temporal lobes (p < 0.001). The levels of YKL-40 and SAA were both negatively correlated with MCCB score (r = -0.3668, p = 0.004; r = -0.8495, p < 0.001). The volumes of right insular lobe, left and right anterior cingulate cortexes, right parahippocampal gyrus, right amygdala, and gray matter in left middle temporal lobe were all negatively correlated with the levels of YKL-40 and SAA (p < 0.05).
CONCLUSIONS: Cognitive impairment in patients with primary schizophrenia is associated with increased serum SAA and YKL-40 levels and decreased gray matter volume.