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Cognition and psychopathology in first-episode psychosis: are they related to inflammation?

Published online by Cambridge University Press:  08 April 2016

B. Cabrera ,
M. Bioque ,
R. Penadés ,
A. González-Pinto ,
M. Parellada ,
J. Bobes ,
A. Lobo ,
B. García-Bueno ,
J. C. Leza  and
M. Bernardo
B. Cabrera
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
M. Bioque
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
R. Penadés
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
A. González-Pinto
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Hospital Universitario de Álava (sede Santiago), BIOARABA, Universidad del País Vasco, Vitoria, Spain
M. Parellada
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Child and Adolescent Psychiatry Department, IIS Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
J. Bobes
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Psychiatry Department, University of Oviedo, Spain
A. Lobo
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
B. García-Bueno
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Department of Pharmacology, School of Medicine, Complutense University, Instituto de Investigación Hospital 12 de Octubre (I+12), Madrid, Spain
J. C. Leza
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Department of Pharmacology, School of Medicine, Complutense University, Instituto de Investigación Hospital 12 de Octubre (I+12), Madrid, Spain
M. Bernardo*
Affiliation:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
*
*Address for correspondence: Dr M. Bernardo, Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Spain. (Email: bernardo@clinic.ub.es)
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Abstract

Background

Cognitive deficits are present from the onset of psychosis and are considered a core feature of the disorder. Increasing evidence suggests that cognitive function is associated with inflammatory processes. This study evaluated the association between cognition and inflammatory biomarkers in first-episode psychosis (FEP), in order to identify cognitive phenotypes from inflammatory expression profiles.

Method

A case-control study of 92 FEP patients and 80 matched controls was used. Neurocognitive assessment, including verbal ability, sustained attention, verbal memory, working memory and executive function, was performed. The expression of pro- and anti-inflammatory mediators of the main intracellular inflammatory pathway was measured in peripheral blood mononuclear cells and plasma.

Results

FEP patients performed worse in all cognitive domains compared to controls and had higher expression of pro-inflammatory mediators and lower expression of anti-inflammatory mediators. In the FEP group, cognition and psychopathology were associated with inflammation. Hierarchical regression analysis showed that association between the anti-inflammatory prostaglandin 15d-PGJ2 and sustained attention on one hand, and COX-2 expression and executive function on the other, were statistically significant.

Conclusions

Our study provides evidence for an association between anti-inflammatory biomarkers and cognition in FEP. The identification of a subgroup of patients based on these measures could be useful to guide treatment programmes by providing tools to select a personalized treatment approach, but longitudinal studies are needed before. In the future, establishment of biomarkers linked to cognition would be useful to monitor the course of cognitive impairment, but substantially more data will be required. Determination of IκBα, the inhibitory protein of the pro-inflammatory transcription factor NFκB, could be useful in early phases to assess clinical severity.

Keywords

Biomarkerscognitionfirst-episode psychosis (FEP)inflammationprostaglandinschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 10 , July 2016 , pp. 2133 - 2144
Copyright
Copyright © Cambridge University Press 2016 

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