Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Dec 19, 2023; 13(12): 995-1004
Published online Dec 19, 2023. doi: 10.5498/wjp.v13.i12.995
Brain-derived neurotrophic factor, sex hormones and cognitive decline in male patients with schizophrenia receiving continuous antipsychotic therapy
Jin Li, Wen-Huan Xiao, Fei Ye, Xiao-Wei Tang, Qiu-Fang Jia, Xiao-Bin Zhang
Jin Li, Qiu-Fang Jia, Xiao-Bin Zhang, Department of Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
Wen-Huan Xiao, Fei Ye, Xiao-Wei Tang, Department of Psychiatry, Affiliated Wutaishan Hospital of Medical College of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
Co-corresponding authors: Qiu-Fang Jia and Xiao-Bin Zhang.
Author contributions: Li J and Zhang XB designed the study and manuscript preparation; Li J and Xiao WH recruited subjects, collected clinical data, laboratory samples, and cognitive assessment and did preliminary data analysis; Ye F and Tang XW assisted in the symptoms of schizophrenia assessment and data analysis; Jia QF did literature search, final analysis of the data, and prepared the final manuscript; All authors contributed to manuscript preparation and approved its final version. Qiu-Fang Jia and Xiao-Bin Zhang contributed equally to this work as co-corresponding authors. The reasons for designating Qiu-Fang Jia and Xiao-Bin Zhang as co-corresponding authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-corresponding authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Qiu-Fang Jia and Xiao-Bin Zhang contributed efforts of equal substance throughout the research process. The choice of these researchers as co-corresponding authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Qiu-Fang Jia and Xiao-Bin Zhang as co-corresponding authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by This study was supported by the Suzhou Municipal Sci-Tech Bureau Program, No. SS202070; Scientific and Technological Program of Suzhou, No. SS202069; Suzhou clinical Medical Center for mood disorders, No. Szlcyxzx202109; Suzhou Clinical Key Disciplines for Geriatric Psychiatry, No. SZXK202116; Suzhou Key Technologies Program, No. SKY2021063; Jiangsu Province social development project, No. BE2020764; Research Project of Jiangsu Commission of Health, No. M2020031; Elderly Health Research Project of Jiangsu Commission of Health, No. LR2022015 and No. LKZ2023020.
Institutional review board statement: The WuTaiShan Hospital Ethics Committee approved the study (approval No. 2018-011).
Informed consent statement: The written informed consent was provided by each participant.
Conflict-of-interest statement: The authors declare no conflicts of interest.
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: Xiao-Bin Zhang, MD, PhD, Chief Physician, Department of Psychiatry, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou 215137, Jiangsu Province, China. zhangxiaobim@163.com
Received: August 26, 2023
Peer-review started: August 26, 2023
First decision: September 5, 2023
Revised: October 4, 2023
Accepted: November 9, 2023
Article in press: November 9, 2023
Published online: December 19, 2023
Processing time: 115 Days and 4.7 Hours
Abstract
BACKGROUND

There are systematic differences in clinical features between women and men with schizophrenia (SCZ). The regulation of sex hormones may play a potential role in abnormal neurodevelopment in SCZ. Brain-derived neurotrophic factor (BDNF) and sex hormones have complex interacting actions that contribute to the etiology of SCZ.

AIM

To investigate the influence of BDNF and sex hormones on cognition and clinical symptomatology in chronic antipsychotic-treated male SCZ patients.

METHODS

The serum levels of follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), progesterone, testosterone (T), prolactin (PRL) and BDNF were compared between chronic antipsychotic-treated male (CATM) patients with SCZ (n = 120) and healthy controls (n = 120). The Positive and Negative Syndrome Scale was used to quantify SCZ symptoms, while neuropsychological tests were used to assess cognition. Neuropsychological tests, such as the Digit Cancellation Test (DCT), Semantic Verbal Fluency (SVF), Spatial Span Test (SS), Paced Auditory Serial Addition Test (PASAT), Trail Making Task (TMT-A), and Block Design Test (BDT), were used to assess executive functions (BDT), attention (DCT, TMT-A), memory (SS, PASAT), and verbal proficiency (SVF).

RESULTS

Although E2 levels were significantly lower in the patient group compared to the healthy controls, T, PRL, and LH levels were all significantly higher. Additionally, the analysis revealed that across the entire sample, there were positive correlations between E2 Levels and BDNF levels as well as BDNF levels and the digital cancellation time. In CATM patients with SCZ, a significant correlation between the negative symptoms score and PRL levels was observed.

CONCLUSION

Sex hormones and BDNF levels may also be linked to cognitive function in patients with chronic SCZ.

Keywords: Brain-derived neurotrophic factor; Clinical symptoms; Cognitive function; Schizophrenia; Sex hormones

Core Tip: Brain-derived neurotrophic factor (BDNF) and sex hormones are known to be involved to the psychopathology of schizophrenia (SCZ). However, the influence of BDNF and sex hormones on cognition and symptoms in chronic antipsychotic-treated male (CATM) SCZ patients have yet to be investigated. Testosterone, prolactin (PRL) and luteinizing hormone were significantly higher in the patient group than in the healthy controls while estradiol (E2) levels were significantly lower. Analysis also identified positive correlations between E2 levels and BDNF levels, and BDNF levels and the digital cancellation time, in the whole sample. we found significant correlations between PRL levels and negative symptoms score in CATM patients with SCZ.