A vagal influence on schizophrenia? A nationwide retrospective cohort of vagotomized individuals.
A vagal influence on schizophrenia? A nationwide retrospective cohort of vagotomized individuals.
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迷走神经对精神分裂症的影响？
DOI：
10.1101/2024.01.30.24301418
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Krieger,Jean-Philippe
中科院分区：
文献类型：
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作者：
Richter,CorneliaF;Skibicka,KarolinaP;Meyer,Urs;Rohrmann,Sabine;Krieger,Jean-Philippe
背景和目的临床前证据表明迷走神经信号参与了精神分裂症相关的脑和行为异常的发展。然而，迷走神经通信是否是人类精神分裂症的一个危险因素，特别是它的损伤，仍然不清楚。迷走神经切断术，迷走神经的外科损伤，在现代治疗方法可用之前，常规作为消化性溃疡的治疗方法。因此，本研究的主要目的是调查迷走神经切断术是否调节随后发生精神分裂症的风险。此外，鉴于存在多种迷走神经切断术技术（即，“truncal”或“selective”），我们的次要目标是测试是否程度的去神经调节精神分裂症的风险schizophrenia.MethodsUsing一个全国性的回顾性匹配的队列设计，我们确定了8,315迷走神经切断的个人从瑞典国家患者登记在1970年至2020年期间和40,855 non-vagotomized个人匹配的年龄，性别和类型的消化性溃疡。被诊断为精神分裂症和相关精神病（ICD 10代码F20-29）的风险进行了分析，使用考克斯比例风险回归模型，包括死亡竞争risk.ResultsWhen考虑所有类型的迷走神经切断术在一起，迷走神经切断术与精神分裂症没有显着相关性（HR：0.91 [0.72; 1.16]）。然而，迷走神经干切断术（使所有脑下器官失去神经支配）显著增加了69%的患精神分裂症的风险（HR：1.69 [1.08; 2.64]），而选择性迷走神经切断术（仅使胃失去神经支配）没有显示出显著的关联。（HR：0.80 [0.61; 1.04]）.讨论我们的研究结果为迷走神经功能障碍可增加精神分裂症风险的假设提供了流行病学支持。值得注意的是，发现干，而不是选择性迷走神经切断术与精神分裂症的风险增加，提出了一种可能性，即活动的subjummatic非胃迷走神经分支可能是特别相关的精神分裂症的发展。
Background and ObjectivesEmerging preclinical evidence suggests that vagal signals contribute to the development of schizophrenia-related abnormalities in brain and behavior. Whether vagal communication in general, and its impairment in particular, is a risk factor for schizophrenia in humans remains, however, unclear. Vagotomy, the surgical lesion of the vagus nerve, was routinely performed as a treatment for peptic ulcer before modern treatment options were available. Hence, the primary aim of this study was to investigate whether vagotomy modulates the subsequent risk of developing schizophrenia. Moreover, given the existence of diverse vagotomy techniques (i.e., “truncal” or “selective”), our secondary goal was to test whether the extent of denervation modulates the risk of schizophrenia.MethodsUsing a nationwide retrospective matched cohort design, we identified 8,315 vagotomized individuals from the Swedish National Patient Register during the period 1970–2020 and 40,855 non-vagotomized individuals matching for age, sex and type of peptic ulcer. The risk of being diagnosed with schizophrenia and associated psychoses (ICD10 codes F20–29) was analyzed using Cox proportional hazards regression models, including death as competing risk.ResultsWhen considering all types of vagotomy together, vagotomy was not significantly associated with schizophrenia (HR: 0.91 [0.72; 1.16]). However, truncal vagotomy (which denervates all subdiaphragmatic organs) significantly increased the risk of developing schizophrenia by 69% (HR: 1.69 [1.08; 2.64]), whereas selective vagotomy (which only denervates the stomach) showed no significant association (HR: 0.80 [0.61; 1.04]).DiscussionOur results provide epidemiological support for the hypothesis that impairments in vagal functions could increase the risk of schizophrenia. Notably, the finding that truncal but not selective vagotomy is associated with an increased risk of schizophrenia raises the possibility that the activity of subdiaphragmatic non-gastric vagal branches may be of particular relevance for the development of schizophrenia.