Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Oct 19, 2023; 13(10): 724-731
Published online Oct 19, 2023. doi: 10.5498/wjp.v13.i10.724
Correlation between cognitive impairment and metabolic imbalance of gut microbiota in patients with schizophrenia
Jing Ma, Xue-Qin Song
Jing Ma, First Department of Mood Disorders, The Second Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, Henan Province, China
Xue-Qin Song, Department of Psychiatry, The First Affiliated of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Ma J and Song XQ designed the study; Ma J wrote the manuscript; Ma J and Song XQ collected and analyzed the data; Ma J and Song XQ revised and reviewed the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of The First Affiliated of Zhengzhou University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Qin Song, PhD, Chief Physician, Department of Psychiatry, The First Affiliated of Zhengzhou University, No. 1 Jian Dong Road, Zhengzhou 450052, Henan Province, China. sxq907907@163.com
Received: June 6, 2023
Peer-review started: June 6, 2023
First decision: June 21, 2023
Revised: August 8, 2023
Accepted: August 15, 2023
Article in press: August 15, 2023
Published online: October 19, 2023
Processing time: 127 Days and 18 Hours
Abstract
BACKGROUND

The gut microbiome interacts with the central nervous system through the gut-brain axis, and this interaction involves neuronal, endocrine, and immune mechanisms, among others, which allow the microbiota to influence and respond to a variety of behavioral and mental conditions.

AIM

To explore the correlation between cognitive impairment and gut microbiota imbalance in patients with schizophrenia.

METHODS

A total of 498 untreated patients with schizophrenia admitted to our hospital from July 2020 to July 2022 were selected as the case group, while 498 healthy volunteers who underwent physical examinations at our hospital during the same period were selected as a control group. Fluorescence in situ hybridization was employed to determine the total number of bacteria in the feces of the two groups. The cognitive function test package was used to assess the score of cognitive function in each dimension. Then, the relationship between gut microbiota and cognitive function was analyzed.

RESULTS

There were statistically significant differences in the relative abundance of gut microbiota at both phylum and class levels between the case group and the control group. In addition, the scores of cognitive function, such as atten-tion/alertness and learning ability, were significantly lower in the case group than in the control group (all P < 0.05). The cognitive function was positively correlated with Actinomycetota, Bacteroidota, Euryarchaeota, Fusobacteria, Pseudomonadota, and Saccharibacteria, while negatively correlated with Bacillota, Tenericutes, and Verrucomicrobia at the phylum level. While at the class level, the cognitive function was positively correlated with Class Actinobacteria, Bacteroidia, Betaproteobacteria, Proteobacteria, Blastomycetes, and Gammaproteobacteria, while negatively correlated with Bacilli, Clostridia, Coriobacteriia, and Verrucomicrobiae.

CONCLUSION

There is a relationship between the metabolic results of gut microbiota and cognitive function in patients with schizophrenia. When imbalances occur in the gut microbiota of patients, it leads to more severe cognitive impairment.

Keywords: Schizophrenia, Cognitive function, Gut microbiota, Metabolic imbalance, Bacteria

Core Tip: The highlights of this study are as follows. First, individuals with schizophrenia have imbalanced intestinal microbiota compared to healthy individuals. Second, patients with schizophrenia exhibit cognitive impairments in various areas such as attention, memory, social cognition, and executive function. Additionally, specific microbial groups such as Actinomycetes, Bacteroides, and Proteobacteria have shown a positive correlation with cognitive function in patients with schizophrenia. Furthermore, there is a close relationship between metabolic imbalance of intestinal flora and cognitive impairment in individuals with schizophrenia. Lastly, further clinical trials are necessary to gather more data and insights for the development of effective treatments for schizophrenia.