Impaired verbal memory function is related to anterior cingulate glutamate levels in schizophrenia: findings from the STRATA study.
Impaired verbal memory function is related to anterior cingulate glutamate levels in schizophrenia: findings from the STRATA study.
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精神分裂症患者言语记忆功能受损与前扣带谷氨酸水平有关：STRATA研究结果。
DOI：
10.1038/s41537-022-00265-5
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发表时间：
2022-07-12
期刊：
影响因子：
--
通讯作者：
MacCabe, James H.
中科院分区：
文献类型：
--
作者：
Griffiths, Kira;Egerton, Alice;Millgate, Edward;Anton, Adriana;Barker, Gareth J.;Deakin, Bill;Drake, Richard;Eliasson, Emma;Gregory, Catherine J.;Howes, Oliver D.;Kravariti, Eugenia;Lawrie, Stephen M.;Lewis, Shon;Lythgoe, David J.;Murphy, Anna;McGuire, Philip;Semple, Scott;Stockton-Powdrell, Charlotte;Walters, James T. R.;Williams, Stephen R.;MacCabe, James H.
认知障碍与精神分裂症患者的生活质量下降和预后不良有关。大脑谷氨酸可能对临床结果和认知都有贡献，但这些关系还没有被很好地理解。我们用质子磁共振波谱对85名非情感性精神病患者的多中心队列进行了研究。在前扣带回皮质(ACC)检测谷氨酸神经代谢产物。认知功能评定采用简明精神分裂症认知评定量表(BACS)。根据治疗史和当前症状严重程度，患者被归类为抗精神病药物反应或无反应。用回归分析检验谷氨酸或谷氨酰胺(Glu， + )与BACS量表和总分之间的倒U型相关关系。然后，我们测试了抗精神病药物反应组对谷氨酸和认知之间的关系的交互作用。在调整了年龄、性别和氯丙嗪当量剂量后，谷氨酸和谷氨酸与言语记忆呈正相关(谷氨酸，β = 3.73，95%CI = 1.26~6.20，P = 0.004；Glx，β = 3.38，95%CI = 0.84~5.91，P = 0.01)。这种联系在抗精神病药物反应好和差的组之间没有区别。Ac谷氨酸与BACs评分呈正相关(β = 3.12，95%CI = 0.0 1~6.2 3，P = 0.0 1~6.2 3，P<0.0 5)，但在控制抗精神病药物剂量后，这种相关性不显著。ACC中谷氨酸能代谢物的降低与较差的言语记忆有关，并且这种关系与抗精神病药物反应无关。对抗精神病药物反应性和非反应性疾病中谷氨酸和认知之间的关系的进一步研究可能有助于对患者群体进行有针对性的治疗干预。
Impaired cognition is associated with lower quality of life and poor outcomes in schizophrenia. Brain glutamate may contribute to both clinical outcomes and cognition, but these relationships are not well-understood. We studied a multicentre cohort of 85 participants with non-affective psychosis using proton magnetic resonance spectroscopy. Glutamate neurometabolites were measured in the anterior cingulate cortex (ACC). Cognition was assessed using the Brief Assessment for Cognition in Schizophrenia (BACS). Patients were categorised as antipsychotic responders or non-responders based on treatment history and current symptom severity. Inverted U-shaped associations between glutamate or Glx (glutamate + glutamine) with BACS subscale and total scores were examined with regression analyses. We then tested for an interaction effect of the antipsychotic response group on the relationship between glutamate and cognition. ACC glutamate and Glx had a positive linear association with verbal memory after adjusting for age, sex and chlorpromazine equivalent dose (glutamate, β = 3.73, 95% CI = 1.26–6.20, P = 0.004; Glx, β = 3.38, 95% CI = 0.84–5.91, P = 0.01). This association did not differ between good and poor antipsychotic response groups. ACC glutamate was also positively associated with total BACS score (β = 3.12, 95% CI = 0.01–6.23, P = 0.046), but this was not significant after controlling for antipsychotic dose. Lower glutamatergic metabolites in the ACC were associated with worse verbal memory, and this relationship was independent of antipsychotic response. Further research on relationships between glutamate and cognition in antipsychotic responsive and non-responsive illness could aid the stratification of patient groups for targeted treatment interventions.
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