The relationship between blood-brain barrier dysfunction and neurocognitive impairments in first-episode psychosis: findings from a retrospective chart analysis.
Schizophrenia
cerebrospinal fluid
cognition
working memory
working speed
Journal
BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931
Informations de publication
Date de publication:
11 Apr 2023
11 Apr 2023
Historique:
medline:
12
4
2023
entrez:
11
4
2023
pubmed:
12
4
2023
Statut:
epublish
Résumé
Even before the onset of psychotic symptoms, individuals with schizophrenia display cognitive impairments. Simultaneously, increasing amounts of individuals exhibit dysfunction of the blood-brain barrier (BBB). However, the impact of BBB dysfunction on neurocognitive impairment in people with first-episode psychosis has not yet been investigated. To advance understanding of said relationship, we considered one of the largest first-episode psychosis cohorts with cerebrospinal fluid parameters available, and investigated whether BBB dysfunction is related to working memory, working speed and attention. We conducted a retrospective chart review of 121 in-patients diagnosed with a first episode of a schizophrenia spectrum disorder. Patients underwent neurocognitive testing and a lumbar puncture within routine clinical care. To define BBB dysfunction, albumin cerebrospinal fluid/serum quotients, immunoglobulin G ratios and oligoclonal band types were evaluated, and gender-specific differences investigated. Neurocognitive functioning was assessed by the Wechsler Adult Intelligence Scale, Test of Attentional Performance and Repeatable Battery for the Assessment of Neuropsychological Status. We performed simple and multiple linear regression analyses to interpret associations of interest. Of those tested, 16% showed an alteration in albumin quotients and 12% had an oligoclonal band type indicating BBB dysfunction. Notably, male patients were more likely to have an increased albumin quotient and a higher immunoglobulin G ratio than female patients. We found no significant association between BBB dysfunction and neurocognitive assessments. The hypothesised relationship between BBB and neurocognitive impairments was not detectable in our retrospective cohort. Further cerebrospinal fluid-based studies with a longitudinal assessment of cognitive functioning and disease trajectory are urgently needed.
Sections du résumé
BACKGROUND
BACKGROUND
Even before the onset of psychotic symptoms, individuals with schizophrenia display cognitive impairments. Simultaneously, increasing amounts of individuals exhibit dysfunction of the blood-brain barrier (BBB). However, the impact of BBB dysfunction on neurocognitive impairment in people with first-episode psychosis has not yet been investigated.
AIMS
OBJECTIVE
To advance understanding of said relationship, we considered one of the largest first-episode psychosis cohorts with cerebrospinal fluid parameters available, and investigated whether BBB dysfunction is related to working memory, working speed and attention.
METHOD
METHODS
We conducted a retrospective chart review of 121 in-patients diagnosed with a first episode of a schizophrenia spectrum disorder. Patients underwent neurocognitive testing and a lumbar puncture within routine clinical care. To define BBB dysfunction, albumin cerebrospinal fluid/serum quotients, immunoglobulin G ratios and oligoclonal band types were evaluated, and gender-specific differences investigated. Neurocognitive functioning was assessed by the Wechsler Adult Intelligence Scale, Test of Attentional Performance and Repeatable Battery for the Assessment of Neuropsychological Status. We performed simple and multiple linear regression analyses to interpret associations of interest.
RESULTS
RESULTS
Of those tested, 16% showed an alteration in albumin quotients and 12% had an oligoclonal band type indicating BBB dysfunction. Notably, male patients were more likely to have an increased albumin quotient and a higher immunoglobulin G ratio than female patients. We found no significant association between BBB dysfunction and neurocognitive assessments.
CONCLUSIONS
CONCLUSIONS
The hypothesised relationship between BBB and neurocognitive impairments was not detectable in our retrospective cohort. Further cerebrospinal fluid-based studies with a longitudinal assessment of cognitive functioning and disease trajectory are urgently needed.
Identifiants
pubmed: 37038760
doi: 10.1192/bjo.2023.22
pii: S2056472423000224
pmc: PMC10134348
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e60Subventions
Organisme : Studienstiftung des Deutschen Volkes
ID : N/A
Références
Schizophr Res Cogn. 2021 Feb 13;24:100194
pubmed: 33659191
Schizophr Bull. 2014 Jul;40(4):744-55
pubmed: 23770934
Psychol Med. 2009 Jun;39(6):889-905
pubmed: 18945379
Nat Med. 2019 Feb;25(2):270-276
pubmed: 30643288
Am J Psychiatry. 2008 Feb;165(2):203-13
pubmed: 18172019
J Neural Transm Gen Sect. 1992;89(3):219-32
pubmed: 1389005
Mol Psychiatry. 2019 Jun;24(6):869-887
pubmed: 30116031
Neurosci Biobehav Rev. 2019 Oct;105:212-219
pubmed: 31415864
World Psychiatry. 2019 Jun;18(2):146-161
pubmed: 31059632
Science. 2016 Aug 19;353(6301):777-83
pubmed: 27540165
Arch Neurol. 2005 Jun;62(6):865-70
pubmed: 15956157
Schizophr Res. 2013 Dec;151(1-3):43-7
pubmed: 24200418
J Neurol Neurosurg Psychiatry. 1994 Aug;57(8):897-902
pubmed: 8057110
Neuro Endocrinol Lett. 2018 Mar;39(1):33-42
pubmed: 29803205
Neuron. 2015 Jan 21;85(2):296-302
pubmed: 25611508
Neurosci Lett. 2020 May 1;726:133664
pubmed: 29966749
Eur Arch Psychiatry Clin Neurosci. 2016 Oct;266(7):619-28
pubmed: 26769121
Early Interv Psychiatry. 2017 Dec;11(6):453-460
pubmed: 28449199
Psychiatr Q. 2022 Mar;93(1):137-149
pubmed: 33751356
Transl Psychiatry. 2021 Dec 8;11(1):621
pubmed: 34880213
Schizophr Bull. 2022 Jan 21;48(1):47-55
pubmed: 34480476
Neuropsychology. 2009 May;23(3):315-36
pubmed: 19413446
Nat Rev Immunol. 2009 Jun;9(6):449-56
pubmed: 19424277
Nat Med. 2013 Dec;19(12):1584-96
pubmed: 24309662
Front Psychiatry. 2014 Jan 08;4:182
pubmed: 24409157
Prog Neuropsychopharmacol Biol Psychiatry. 2022 Jan 10;112:110424
pubmed: 34363867
Lancet Psychiatry. 2018 Jan;5(1):79-92
pubmed: 28781208
Transl Psychiatry. 2020 Aug 12;10(1):279
pubmed: 32782247
Brain Behav Immun Health. 2020 Jun 30;6:100102
pubmed: 34589864
EBioMedicine. 2017 Apr;18:320-326
pubmed: 28427946