Abnormal glucose metabolism is associated with clinical symptoms of adolescent-onset patients with first-episode drug-naive schizophrenia

Unraveling the prevalence and key influencers of metabolic syndrome in Drug-Naïve, first-episode major depressive disorder patients with psychotic symptoms: A decision tree modeling approach

BACKGROUND

Investigating the relationship between metabolic syndrome (MetS) and first-episode, drug-naïve psychotic major depressive disorders (FEDN-PMD), this study employed decision tree modeling to identify key factors.

METHODS

A cross-sectional study was conducted with 1718 FEDN-PMD patients. Sociodemographic, clinical, and blood biochemical parameters were collected, and the prevalence of MetS was assessed.

RESULTS

MetS was more prevalent in the PMD group (16.96 %) compared to non-PMD (5.95 %) and whole MDD groups (7.04 %). Utilizing decision tree modeling, four key variables were identified: TSH, duration of disease, A-TPO, and age. Specifically, when TSH was less than 6.9 IU/mL, MetS incidence was 2.67 %. Higher TSH levels, in conjunction with other factors, substantially influenced MetS incidence, especially when age was 51.5 years or older, and A-TPO was greater or equal to 763.025 IU/mL.

CONCLUSIONS

MetS is prevalent in FEDN-PMD patients. The decision tree model highlighted the importance of TSH, duration of disease, A-TPO, and age in predicting MetS risk. These insights could lead to personalized interventions, potentially mitigating the risk of MetS and enhancing patient outcomes.

Body mass index-specific metabolic profiles in schizophrenia: implications for cognitive dysfunction and psychopathology

While metabolic dysfunction is linked to schizophrenia, the relationship between metabolic parameters, cognitive function, and psychopathological symptoms across different body mass index (BMI) categories remains inadequately understood. This study aimed to explore the distinct metabolic predictors of cognitive and psychopathological outcomes in schizophrenia patients stratified by BMI. A total of 1034 patients with schizophrenia were recruited and categorized into underweight, normal weight, overweight and obesity groups. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status, and psychopathological symptoms were evaluated using the Positive and Negative Syndrome Scale. Metabolic profiles and anthropometric measures were obtained via standard tests. Significant metabolic differences were found across BMI groups, except for low-density lipoprotein. Underweight patients performed worse in language compared to obese patients, which had higher positive symptom but lower negative symptom scores. Multivariate linear regression analysis revealed that in obese patients, elevated triglyceride was independently associated with better cognitive performance (p < 0.05). In overweight patients, waist-hip ratio was significantly correlated with cognitive outcomes, which specifically predicting the severity of positive symptoms (all p < 0.05). In underweight patients, fasting blood glucose (β = 0.77, p < 0.05) and triglyceride (β = 1.28, p < 0.01) were associated with immediate memory deficits, while attention was negatively influenced by high-density lipoprotein levels (β = -0.10, p < 0.05). Schizophrenia patients exhibit distinct BMI-specific metabolic patterns that differentially predict cognitive and psychopathological outcomes, highlighting the importance of tailored metabolic interventions based on BMI stratification.

Mechanisms of Neuronal Reactivation in Memory Consolidation: A Perspective from Pathological Conditions

Memory consolidation refers to a process by which labile newly formed memory traces are progressively strengthened into long term memories and become more resistant to interference. Recent work has revealed that spontaneous hippocampal activity during rest, commonly referred to as "offline" activity, plays a critical role in the process of memory consolidation. Hippocampal reactivation occurs during sharp-wave ripples (SWRs), which are events associated with highly synchronous neural firing in the hippocampus and modulation of neural activity in distributed brain regions. Memory consolidation occurs primarily through a coordinated communication between hippocampus and neocortex. Cortical slow oscillations drive the repeated reactivation of hippocampal memory representations together with SWRs and thalamo-cortical spindles, inducing long-lasting cellular and network modifications responsible for memory stabilization.In this review, we aim to comprehensively cover the field of "reactivation and memory consolidation" research by detailing the physiological mechanisms of neuronal reactivation and firing patterns during SWRs and providing a discussion of more recent key findings. Several mechanistic explanations of neuropsychiatric diseases propose that impaired neural replay may underlie some of the symptoms of the disorders. Abnormalities in neuronal reactivation are a common phenomenon and cause pathological impairment in several diseases, such as Alzheimer's disease (AD), epilepsy and schizophrenia. However, the specific pathological changes and mechanisms of reactivation in each disease are different. Recent work has also enlightened some of the underlying pathological mechanisms of neuronal reactivation in these diseases. In this review, we further describe how SWRs, ripples and slow oscillations are affected in Alzheimer's disease, epilepsy, and schizophrenia. We then compare the differences of neuronal reactivation and discuss how different reactivation abnormalities cause pathological changes in these diseases. Aberrant neural reactivation provides insights into disease pathogenesis and may even serve as biomarkers for early disease progression and treatment response.

Prefrontal cortical dopamine deficit may cause impaired glucose metabolism in schizophrenia

The brain neurotramsmitter dopamine may play an important role in modulating systemic glucose homeostasis. In seven hundred and four drug- naïve patients with first-episode schizophrenia, we provide robust evidence of positive associations between negative symptoms of schizophrenia and high fasting blood glucose. We then show that glucose metabolism and negative symptoms are improved when intermittent theta burst stimulation (iTBS) on prefrontal cortex (PFC) is performed in patients with predominantly negative symptoms of schizophrenia. These findings led us to hypothesize that the prefrontal cortical dopamine deficit, which is known to be associated with negative symptoms, may be responsible for abnormal glucose metabolism in schizophrenia. To explore this, we optogenetically and chemogenetically inhibited the ventral tegmental area (VTA)-medial prefrontal cortex (mPFC) dopamine projection in mice and found both procedures caused glucose intolerance. Moreover, microinjection of dopamine two receptor (D2R) neuron antagonists into mPFC in mice significantly impaired glucose tolerance. Finally, a transgenic mouse model of psychosis named Disc1tr exhibited depressive-like symptoms, impaired glucose homeostasis, and compared to wild type littermates reduced D2R expression in prefrontal cortex.

Prevalence and clinical profile of abnormal glucose in first-episode and drug-naïve patients with major depressive disorder with comorbid abnormal thyroid function: a large-scale cross-sectional study

BACKGROUND

The associated factors of abnormal glucose in patients with major depressive disorder (MDD) with comorbid abnormal thyroid function (ATF) remain unclear. To the best of our knowledge, this is the first study with a large sample size that examines the risk factors of abnormal glucose in first-episode drug-naïve (FEDN) MDD patients comorbid with ATF and includes clinical correlates and thyroid hormone levels.

METHODS

A total of 1718 FEDN MDD patients were recruited. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale were used to evaluate the symptoms of patients. Fasting blood glucose concentration and thyroid hormone levels were measured.

RESULTS

The prevalence of abnormal glucose in MDD patients with comorbid ATF was 47.3%, which was 4.25 times higher than that in MDD patients without ATF (17.4%). Compared to those ATF patients without abnormal glucose, ATF patients with abnormal glucose scored higher on HAMD, HAMA and PANSS positive subscale, had a higher rate of suicide attempts, severe anxiety and psychotic symptoms, and had higher levels of thyroid-stimulating hormone (TSH), and thyroid peroxidases antibody (TPOAb) which were also correlated with abnormal glucose in MDD patients comorbid ATF (all P < 0.05). The combination of HAMD score and TSH could differentiate abnormal glucose from ATF. Further, TSH was independence-related with the concentration of fasting blood glucose in MDD patients with comorbid ATF.

CONCLUSION

Our results demonstrate a high prevalence of abnormal glucose in MDD patients with comorbid ATF. Some clinical and thyroid function-related variables may be associated with abnormal glucose in MDD patients with comorbid ATF.

Effect of Running Exercise on Brain Functional Magnetic Resonance Characteristics of College Students with Depression

In order to effectively reduce the incidence of depression in college students, the author proposes a method to influence brain functional magnetic resonance through running exercise. Aiming at the effect of running exercise on the brain functional magnetic resonance characteristics of depression in college students, through the comparison experiment between the MDD group and the HC group and the retrospective analysis of the sugar water preference experiment in rats, explore it in depth. Experimental results show that under the running exercise for six consecutive weeks, the average body weight of the rats in the depression model group was significantly lower than that in the blank control group, and the health status was significantly better than that in the blank group. Running exercise can effectively affect and reduce the incidence of depression in college students.

Influencing factors of obesity in community patients with deficit schizophrenia: a cross-sectional study

Background

Obesity is very common in patients with schizophrenia. We aimed to evaluate the influencing factors of obesity in community patients with deficit schizophrenia, to provide implication for schizophrenia management in community.

Methods

We selected patients with deficit schizophrenia who lived in 10 communities in our city from March 1 to June 30, 2021. The characteristics of included schizophrenia patients were evaluated and analyzed. Pearson correlation analysis was conducted to evaluate the obesity and related characteristics. Logistic regression analyses were conducted to assess the risk factors of obesity in patients with schizophrenia.

Results

A total of 284 patients with schizophrenia were included, the incidence of obesity in patients with schizophrenia was 56.70%. gender (r = 0.619), waist circumference (r = 0.644), BMI (r = 0.891), diabetes (r = 0.698), FG (r = 0.582), triglyceride (r = 0.618), HDL-C (r = −0.644), LDL-C (r = 0.583), apolipoprotein B (r = 0.595), and PANSS score (r = 0.813) were all correlated with the obesity in patients with schizophrenia (all p < 0.05). Logistic regression analysis indicated that female (OR 2.129, 95% CI 1.615–3.022), waist circumference ≥ 90 cm (OR 3.814, 95% CI 2.778 ~ 4.312), diabetes (OR 2.856, 95% CI 1.905 ~ 3.448), FG ≥ 88 mg/dL (OR 1.551, 95% CI 1.284 ~ 2.183), triglyceride ≥ 160 mg/dL (OR 1.804, 95% CI 1.236–2.845), HDL-C ≤ 0.8 mmol/L (OR 2.032, 95% CI 1.614–3.079), LDL-C ≥ 2.0 mmol/L (OR 1.926, 95% CI 1.442–2.041) and apolipoprotein B ≥ 0.70 g/L (OR 2.119, 95% CI 1.658–2.873) were the risk factors of obesity in patients with schizophrenia (all p < 0.05).

Conclusions

The obesity rate of patients with deficit schizophrenia in the community is high, and there are many associated risk factors. Early intervention targeted on those risk factors are warranted to reduce the obesity in schizophrenia patients.