Reliability and validity of the Repeatable Battery for the Assessment of Neuropsychological Status in community-dwelling elderly

Interactive effects of ARRB2 and CHRNA5 genetic polymorphisms on cognitive function in Chinese male methamphetamine use disorder patients

BACKGROUND AND OBJECTIVES

Both β-arrestin2 and nicotinic acetylcholine receptor (nAChR) have been implicated in cognitive processes, particularly in relation to psychiatric disorders, including addiction. Previous studies have suggested that nAChR may be regulated by β-arrestin2. However, no study has investigated the interaction of β-arrestin2 and nAChR on cognition. We aimed to examine the main and interactive effects of their respective encoding genes, ARRB2 and CHRNA5, on cognitive function in MUD patients.

METHODS

We recruited 559 patients with methamphetamine use disorder (MUD) and 459 healthy controls, assessed their cognitive functioning using the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and genotyped ARRB2 rs1045280 and CHRNA5 rs3829787 polymorphisms in MUD patients.

RESULTS

Compared to healthy controls, MUD patients scored significantly lower on all RBANS indexes. Neither ARRB2 rs1045280 nor CHRNA5 rs3829787 had main effects on cognitive function in MUD patients, but there were significant interactive effects between the two single nucleotide polymorphisms (SNPs) on multiple RBANS indexes, including immediate memory, visuospatial/constructional, delayed memory, and total score. In detail, among carriers of CHRNA5 rs3829787 T allele, ARRB2 rs1045280 TT carriers had higher RBANS scores than the C allele carriers, whereas among carriers of CHRNA5 rs3829787 CC genotype, ARRB2 rs1045280 TT carriers performed worse in RBANS.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

Our study identified for the first time an interactive effect between ARRB2 and CHRNA5 on cognitive function in MUD patients, which would enlarge our knowledge of genetic interaction on cognitive function.

Immediate memory is associated with alexithymia in Chinese Han first-episode, drug-naïve major depressive disorder

Background

Alexithymia is defined as a difficulty in identifying and describing one's own emotions. It represents a risk factor for cognitive deficits and is frequently observed in individuals with depressive disorders. However, the relationship between alexithymia and neurocognitive function in major depressive disorder (MDD) is still unknown. This study aimed to explore the association between alexithymia and neurocognition in patients with MDD.

Methods

A total of 134 Chinese Han first-episode drug-naïve patients with MDD were recruited. The 20-item Toronto Alexithymia scale (TAS-20), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the 9-item Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder-7 items (GAD-7) was used to assess alexithymia, neurocognitive functioning, and emotion. Multivariable liner regression models were used to estimate the association between alexithymia and neurocognition. Interaction and stratified analyses were conducted according to age, gender, marital and education status.

Results

Among the 134 patients with MDD, 55 participants (41%) had alexithymia. In the fully adjusted model, TAS total score (TAS-T) (β: -0.34, 95% CI: -0.61~ -0.07) and difficulty identifying feelings (DIF) (β: -0.8, 95% CI: -1.3~-0.31) were statistically significantly associated with immediate memory.

Conclusions

Higher level of alexithymia, particularly the difficulty identifying feelings facet, is associated with lower scores of immediate memory in patients with MDD.

Smartphone video games for cognitive functions and negative symptoms in male with chronic schizophrenia: A randomized controlled trial

Background

Video games have been extensively examined as a promising and innovative approach for addressing various psychiatric disorders. The primary objective of this study is to evaluate the effect of smartphone video games on cognitive functions, psychiatric symptoms and overall functioning in male with chronic schizophrenia.

Methods

We conducted a 6-week randomized controlled trial to compare the cognitive function, psychotic symptoms, overall functioning, and other outcomes of schizophrenic patients who engaged in smartphone video games (game group) with those who watched television programs (control group). We recruited schizophrenic patients who met the eligibility criteria from July 2021 to February 2022. The primary outcomes were the comparisons of various clinical scores between the two groups at baseline before interventions, the third and sixth weeks of the interventions, and the third and sixth weeks following the completion of interventions.

Results

Comparing the scores of the RBANS, PANSS, and GAF scales between the two groups, smartphone video games improved cognitive function, negative symptoms, and overall functioning. However, GSE and PHQ-9 scores did not reveal significant differences between the two groups. While there was a significant difference in PMGQ scores between the two groups, neither group reached the threshold for game addiction.

Conclusions

In this study, we emphasize the improvements of cognitive functions, psychiatric symptoms and overall functioning that brought by smartphone video games in male with chronic schizophrenia. Our findings indicate the need for more extensive research, future research should address what mechanisms of action underlie these effects of video games.

Trial registration

This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100044113) and registered on 11/3/21.

Sex-specific differences in the relationship between thyroid hormones and neurocognition in schizophrenia: A large-scale cross-sectional study

BACKGROUND

Sex differences in thyroid hormones, cognitive function, and psychiatric symptoms in schizophrenia remain underexplored. The study aimed to investigate the cross-sectional relationships between thyroid hormone levels, cognitive impairments, and clinical symptoms in people with chronic schizophrenia, with a focus on sex differences.

METHODS

We included 1007 people with schizophrenia (602 males and 405 females), and 326 healthy controls (193 males and 133 females). Cognitive function and psychiatric symptoms were assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Positive and Negative Syndrome Scale (PANSS), respectively. Blood samples were collected to measure serum total thyroxine (TT4), total triiodothyronine (TT3), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Analysis of variance (ANOVA) and two-way ANOVA were used to compare clinical characteristics and sex differences. Pearson correlation and hierarchical linear regression were conducted to assess the relationships between thyroid hormone levels, cognitive impairments, and clinical symptoms.

RESULTS

People with schizophrenia exhibited lower levels of thyroid hormones compared to the healthy control group (both P < 0.01). Male patients had higher TT3 and FT3 levels than female patients (both P < 0.01). The cognitive scores of the healthy controls were generally higher than those of people with schizophrenia (P < 0.001). Additionally, there were significant sex differences in visuospatial/constructive abilities and language (both P < 0.01) among people with schizophrenia, with males scoring higher than females. The linear regression found that in the cognitive domain, TT4 was negatively associated with Visuospatial/Constructive abilities and RBANS total scores in male patients (both P < 0.05), whereas TT4 was positively associated with these abilities and attention in female patients (all P < 0.05). Additionally, in male patients, TT3 was negatively associated with most of PANSS scale (all P < 0.05). In female, TT3 was only negatively associated with the PANSS Negative scale (P < 0.05).

CONCLUSION

Sex differences exist in thyroid hormone T3 levels in people with schizophrenia. The association between thyroid hormones and cognitive performance varies by sex in chronic schizophrenia.

Medial orbitofrontal cortex structure, function, and cognition associates with weight loss for laparoscopic sleeve gastrectomy

OBJECTIVE

The objective of this study was to investigate underlying mechanisms of long-term effective weight loss after laparoscopic sleeve gastrectomy (LSG) and effects on the medial orbitofrontal cortex (mOFC) and cognition.

METHODS

A total of 18 individuals with obesity (BMI ≥ 30 kg/m2) underwent LSG. Clinical data, cognitive scores, and brain magnetic resonance imaging scans were evaluated before LSG and 12 months after LSG. We employed voxel-based morphometry analysis and seed-based resting-state functional connectivity (RSFC) analysis to assess LSG-induced structural and functional changes in mOFC. Partial correlation analysis and univariate and multivariate linear regression models were used to explore associations among biochemical indexes, neuroimaging, cognition, and weight loss.

RESULTS

No significant improvement in general cognition was found after LSG. Decreases in gray matter volume of the bilateral mOFC and increases in RSFC of the right mOFC were observed 12 months after LSG. Weight loss was associated with RSFC, general cognitive scores, and triglyceride changes. Multivariate linear regression model revealed gray matter volume of the left mOFC and working memory scores at baseline explained 55.2% of the variation in weight loss.

CONCLUSIONS

These findings suggest that mOFC imaging and cognitive scores could serve as biomarkers for predicting persistent weight loss after LSG, which provides a solid foundation for a potential target for neuromodulation research.

Differences in cognitive impairment and its correlation with circulating cell-free mitochondrial DNA in medication-free depression and bipolar depression patients

OBJECTIVE

This study aimed to investigate whether there are differences in cognitive impairment between medication-free patients with bipolar depression (BD) and major depressive disorder (MDD) and whether these differences are related to circulating cell-free mtDNA (ccf-mtDNA).

METHODS

For this cross-sectional study, 76 outpatients with BD, 86 outpatients with MDD and 70 healthy controls (HCs) were enrolled. Sociodemographic and clinical data were collected. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test were used to assess cognitive function. Plasma ccf-mtDNA levels were measured via qPCR.

RESULTS

BD and MDD patients had similar scores for immediate memory, language, attention, delayed memory, the RBANS total score, Stroop color, Stroop word, and Stroop total score, which were significantly lower than the HCs. The visuospatial/constructive scores of the BD patients were significantly lower than those of the HCs (p < 0.001) and MDD patients (p = 0.008), but there was no difference between the HCs and MDD patients. The ccf-mtDNA levels in the BD and MDD patient groups were significantly higher than those in the HC group, and those in the MDD group were higher than those in the BD group (p = 0.016). Multiple stepwise regression analysis showed that ccf-mtDNA was negatively correlated with language in patients with depression (t = -2.11, p = 0.039).

CONCLUSION

There were differences in specific cognitive dimensions between patients with BD and MDD. Increased ccf-mtDNA levels were found in BD and MDD patients, suggesting ccf-mtDNA may be involved in the pathophysiology of MDD and BD.

Variations in inflammatory regulators in male patients with chronic schizophrenia associated with psychopathology and cognitive deficits

BACKGROUND

Immune dysregulation has been identified as a contributing factor in the pathophysiology of schizophrenia. This study aimed to investigate variations in specific immune regulators and their correlation with psychopathology and cognitive functions in male patients with chronic schizophrenia.

METHODS

Employing a cross-sectional design, this study included 72 male patients with chronic schizophrenia. The Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status were utilized to assess psychopathology and cognitive functions, respectively.

RESULTS

Serum levels of interleukin (IL)-4, IL-10, IL-12p40, IL-13, and monocyte chemoattractant protein-1 (MCP-1) were measured. There were significantly increased levels of IL-4, IL-13, and MCP-1, alongside decreased levels of IL-10 in patients compared to controls (all P < 0.05). IL-4 levels showed a significant negative association with PANSS positive symptoms (beta=-0.222, P = 0.042). After controlling for antipsychotic medication, BMI, and smoking, this correlation was no longer significant (r=-0.232, P = 0.055). Additionally, positive correlations of IL-4 (beta = 0.297, P = 0.008), IL-13 (beta = 0.371, P = 0.001), and MCP-1 (beta = 0.280, P = 0.013) with language scores were observed. Increased levels of IL-4 (P = 0.044, OR = 1.994), IL-13 (P = 0.019, OR = 2.245), as well as IL-4 and MCP-1 interactions (P = 0.043, OR = 2.000) were positively associated with the risk of chronic schizophrenia, while lower levels of IL-10 (P = 0.003, OR = 0.2.867) were also linked to an increased risk.

CONCLUSION

The identified associations between specific immune markers and the clinical and cognitive features of chronic schizophrenia in males underscored the potential immune-mediated mechanisms underlying schizophrenia.

Prolactin deficiency drives diabetes-associated cognitive dysfunction by inducing microglia-mediated synaptic loss

BACKGROUND

Diabetes-associated cognitive dysfunction, characterized by hippocampal synaptic loss as an early pathological feature, seriously threatens patients' quality of life. Synapses are dynamic structures, and hormones play important roles in modulating the formation and elimination of synapses. The pituitary, the master gland of the body, releases several hormones with multiple roles in hippocampal synaptic regulation. In this study, we aimed to explore the relationship between pituitary hormones and cognitive decline in diabetes.

METHODS

A total of 744 patients with type 2 diabetes (T2DM) (445 men and 299 postmenopausal women) who underwent serum pituitary hormone level assessments, comprehensive cognitive evaluations and MRI scans were enrolled. Dynamic diet interventions were applied in both chow diet-fed mice and high-fat diet (HFD)-fed diabetic mice. The cognitive performance and hippocampal pathology of prolactin (PRL)-knockout mice, neuronal prolactin receptor (PRLR)-specific knockout mice and microglial PRLR-specific knockout mice were assessed. Microglial PRLR-specific knockout mice were fed an HFD to model diabetes. Diabetic mice received an intracerebroventricular infusion of recombinant PRL protein or vehicle.

RESULTS

This clinical study revealed that decreased PRL levels were associated with cognitive impairment and hippocampal damage in T2DM patients. In diabetic mice, PRL levels diminished before hippocampal synaptic loss and cognitive decline occurred. PRL loss could directly cause cognitive dysfunction and decreased hippocampal synaptic density. Knockout of PRLR in microglia, rather than neurons, induced hippocampal synaptic loss and cognitive impairment. Furthermore, blockade of PRL/PRLR signaling in microglia exacerbated abnormal microglial phagocytosis of synapses, further aggravating hippocampal synaptic loss and cognitive impairment in diabetic mice. Moreover, PRL infusion reduced microglia-mediated synaptic loss, thereby alleviating cognitive impairment in diabetic mice.

CONCLUSION

PRL is associated with cognitive dysfunction and hippocampal damage in T2DM patients. In diabetes, a decrease in PRL level drives hippocampal synaptic loss and cognitive impairment by increasing microglia-mediated synapse engulfment. Restoration of PRL levels ameliorates cognitive dysfunction and hippocampal synaptic loss in diabetic mice.

Association of EEG and cognitive impairment in overweight and non-overweight patients with schizophrenia

OBJECTIVE

Schizophrenia (SCZ) is a globally prevalent, severe chronic mental disorder, with cognitive dysfunction being one of its core symptoms. Notably, overweight is exceedingly common among individuals with SCZ, and overweight can also impact cognitive function. Therefore, the relationship between overweight and cognition in SCZ is a clinical issue that is in need of research attention.

METHODS

This study enrolled 77 patients with SCZ, including 36 overweight and 41 non-overweight patients. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity, while cognitive functions were evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Electroencephalography (EEG) testing was performed, with power spectral analysis conducted across various frequency bands (δ, θ, α, β, low γ, and high γ).

RESULTS

Compared to non-overweight SCZ patients, those overweight exhibited significantly lower RBANS total and index scores in immediate memory, visuospatial/constructional abilities, and delayed memory. EEG spectral analysis revealed that overweight SCZ patients demonstrated significantly lower oscillation power ratios in the β, low γ, and high γ frequency bands compared to their non-overweight counterparts. Correlation analyses indicated a significant positive relationship between β wave activity and RBANS total scores among overweight SCZ patients, suggesting that reduced β power correlates with more severe cognitive dysfunction.

CONCLUSION

Our findings indicate that overweight SCZ patients experience more severe cognitive impairments in a resting state than those who are not overweight, with significant differences in EEG spectrum observed in the β and γ frequency bands. Additionally, our study establishes a correlation between various EEG spectrum dimensions and cognition. This research highlights the effects of overweight on cognition in individuals with SCZ. Additionally, employing EEG technology to study cognitive function in overweight SCZ patients can offer valuable electrophysiological insights.

Association of empathy with clinical symptoms and cognitive function in chronic schizophrenia patients with and without suicide attempts

Cognitive impairment is recognized as a risk factor for suicide in schizophrenia (SZ) patients. Despite empathy being an important aspect of social cognition, the association between suicidal behavior and empathy has received little attention. We aimed to compare empathy and neurocognition in SZ patients with and without suicide attempts (SAs), and to explore the relationship between empathy, neurocognition, and clinical symptoms in SZ patients with and without SAs. Data on SAs and socio-demographic characteristics were collected from 628 chronic SZ patients. The patients' symptomatology was measured by the Positive and Negative Syndrome Scale (PANSS). Empathy and neurocognition were assessed with the Interpersonal Reactivity Index (IRI) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), respectively. Patients with SAs performed better on all IRI domains (except for Perspective Taking) and total scores. Regression results showed that negative symptoms, positive symptoms, and duration of illness were independently associated with IRI total score in patients without SAs (adjusted R2 = 0.048). In patients without SAs, negative symptoms, general psychopathology, education, age, and sex were independently associated with RBANS total score (adjusted R2 = 0.265), while in patients with SAs, education, PANSS total score, and age at onset were independently associated with RBANS total score (adjusted R2 = 0.456). Our results show that SZ patients with SAs may have better empathic performance than patients without SAs. In chronic SZ patients, negative and positive symptoms may have different effects on cognition in the SAs and non-SAs groups.

Dysfunction of large-scale brain networks underlying cognitive impairments in shift work disorder

It has been demonstrated that shift work can affect cognitive functions. Several neuroimaging studies have revealed altered brain function and structure for patients with shift work disorder (SWD). However, knowledge on the dysfunction of large-scale brain networks underlying cognitive impairments in shift work disorder is limited. This study aims to identify altered functional networks associated with cognitive declines in shift work disorder, and to assess their potential diagnostic value. Thirty-four patients with shift work disorder and 36 healthy controls (HCs) were recruited to perform the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and resting-state functional scans. After surface-based preprocessing, we calculated within- and between-network functional connectivity (FC) using the Dosenbach atlas. Moreover, correlation analysis was done between altered functional connectivity of large-scale brain networks and scores of cognitive assessments in patients with shift work disorder. Finally, we established a classification model to provide features for patients with shift work disorder concerning the disrupted large-scale networks. Compared with healthy controls, increased functional connectivity within-networks across the seven brain networks, and between-networks involving ventral attention network (VAN)-subcortical network (SCN), SCN-frontoparietal network (FPN), and somatosensory network (SMN)-SCN were observed in shift work disorder. Decreased functional connectivity between brain networks was found in shift work disorder compared with healthy controls, including visual network (VN)-FPN, VN-default mode network (DMN), SMN-DMN, dorsal attention network (DAN)-DMN, VAN-DMN, and FPN-DMN. Furthermore, the altered functional connectivity of large-scale brain networks was significantly correlated with scores of immediate memory, visuospatial, and delayed memory in patients with shift work disorder, respectively. Abnormal functional connectivity of large-scale brain networks may play critical roles in cognitive dysfunction in shift work disorder. Our findings provide new evidence to interpret the underlying neural mechanisms of cognitive impairments in shift work disorder.

The identification of novel schizophrenia-related metabolites using untargeted lipidomics

Human lipidome still remains largely unexplored among Chinese schizophrenia patients. We aimed to identify novel lipid molecules associated with schizophrenia and cognition among schizophrenia patients. The current study included 96 male schizophrenia patients and 96 gender-matched healthy controls. Untargeted lipidomics profiling was conducted among all participants. Logistic regression models were used to assess metabolite associations with schizophrenia. We further assessed the incremental predictive value of identified metabolites beyond conventional risk factors on schizophrenia status. In addition, identified metabolites were tested for association with cognitive function among schizophrenia patients using linear regression models. A total of 34 metabolites were associated with schizophrenia. Addition of these identified metabolites to age, body mass index, smoking, and education significantly increased the risk reclassification of schizophrenia. Among the schizophrenia-related metabolites, 10 were further associated with cognition in schizophrenia patients, including four metabolites associated with immediate memory, two metabolites associated with delayed memory, three metabolites associated with visuospatial, four metabolites associated with language, one metabolite associated with attention, and two metabolites associated with the total score. Our findings provide novel insights into the biological mechanisms of schizophrenia, suggesting that lipid metabolites may serve as potential diagnostic or therapeutic targets of schizophrenia.

Associations between complexity of glucose time series and cognitive function in adults with type 2 diabetes

AIMS

To characterize the comparative contributions of different glycaemic indicators to cognitive dysfunction, and further investigate the associations between the most significant indicator and cognitive function, along with related cerebral alterations.

MATERIALS AND METHODS

We performed a cross-sectional study in 449 subjects with type 2 diabetes who completed continuous glucose monitoring and cognitive assessments. Of these, 139 underwent functional magnetic resonance imaging to evaluate cerebral structure and olfactory neural circuit alterations. Relative weight and Sobol's sensitivity analyses were employed to characterize the comparative contributions of different glycaemic indicators to cognitive dysfunction.

RESULTS

Complexity of glucose time series index (CGI) was found to have a more pronounced association with mild cognitive impairment (MCI) compared to glycated haemoglobin, time in range, and standard deviation. The proportion and multivariable-adjusted odds ratios (ORs) for MCI increased with descending CGI tertile (Tertile 1: reference group [≥4.0]; Tertile 2 [3.6-4.0] OR 1.23, 95% confidence interval [CI] 0.68-2.24; Tertile 3 [<3.6] OR 2.27, 95% CI 1.29-4.00). Decreased CGI was associated with cognitive decline in executive function and attention. Furthermore, individuals with decreased CGI displayed reduced olfactory activation in the left orbitofrontal cortex (OFC) and disrupted functional connectivity between the left OFC and right posterior cingulate gyrus. Mediation analysis demonstrated that the left OFC activation partially mediated the associations between CGI and executive function.

CONCLUSION

Decreased glucose complexity closely relates to cognitive dysfunction and olfactory brain activation abnormalities in diabetes.

Sex-Specific Association of Body Mass Index with Hippocampal Subfield Volume and Cognitive Function in Non-Demented Chinese Older Adults

Recent research suggests a possible association between midlife obesity and an increased risk of dementia in later life. However, the underlying mechanisms remain unclear. Little is known about the relationship between body mass index (BMI) and hippocampal subfield atrophy. In this study, we aimed to explore the associations between BMI and hippocampal subfield volumes and cognitive function in non-demented Chinese older adults. Hippocampal volumes were assessed using structural magnetic resonance imaging. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A total of 66 participants were included in the final analysis, with 35 females and 31 males. We observed a significant correlation between BMI and the hippocampal fissure volume in older females. In addition, there was a negative association between BMI and the RBANS total scale score, the coding score, and the story recall score, whereas no significant correlations were observed in older males. In conclusion, our findings revealed sex-specific associations between BMI and hippocampal subfield volumes and cognitive performance, providing valuable insights into the development of effective interventions for the early prevention of cognitive decline.

Robotic assessment of sensorimotor and cognitive deficits in patients with temporal lobe epilepsy

OBJECTIVE

Individuals with temporal lobe epilepsy (TLE) frequently demonstrate impairments in executive function, working memory, and/or declarative memory. It is recommended that screening for cognitive impairment is undertaken in all people newly diagnosed with epilepsy. However, standard neuropsychological assessments are a limited resource and thus not available to all. Our study investigated the use of robotic technology (the Kinarm robot) for cognitive screening.

METHODS

27 participants with TLE (17 left) underwent both a brief neuropsychological screening and a robotic (Kinarm) assessment. The degree of impairments and correlations between standardized scores from both approaches to assessments were analysed across different neurocognitive domains. Performance was compared between people with left and right TLE to look for laterality effects. Finally, the association between the duration of epilepsy and performance was assessed.

RESULTS

Across the 6 neurocognitive domains (attention, executive function, language, memory, motor and visuospatial) assessed by our neuropsychological screening, all showed scores that significantly correlated with Kinarm tasks assessing the same cognitive domains except language and memory that were not adequately assessed with Kinarm. Participants with right TLE performed worse on most tasks than those with left TLE, including both visuospatial (typically considered right hemisphere), and verbal memory and language tasks (typically considered left hemisphere). No correlations were found between the duration of epilepsy and either the neuropsychological screening or Kinarm assessment.

SIGNIFICANCE

Our findings suggest that Kinarm may be a useful tool in screening for neurocognitive impairment in people with TLE. Further development may facilitate an easier and more rapid screening of cognition in people with epilepsy and distinguishing patterns of cognitive impairment.

Association between serum insulin-like growth factor 1 levels and the improvements of cognitive impairments in a subgroup of schizophrenia: Preliminary findings

BACKGROUND

Numerous studies have implicated abnormal insulin-like growth factor 1 (IGF-1) in the pathophysiology of schizophrenia, but findings have been inconsistent.

METHODS

We conducted a meta-analysis to compare IGF-1 levels in schizophrenia patients with healthy controls and explored factors contributing to variability between estimates. In an independent sample (58 chronic schizophrenia patients and 30 healthy controls), we investigated differences in IGF-1 levels among schizophrenia subgroups with distinct cognitive profiles, identified using k-means clustering based on five cognitive domains from The Repeatable Battery for the Assessment of Neuropsychological Status. Associations between serum IGF-1 levels and clinical and neurocognitive improvements were also examined.

RESULTS

The meta-analysis revealed significantly lower serum IGF-1 levels in schizophrenia patients compared to healthy controls, albeit with high heterogeneity. Medication status, BMI, and severity of negative symptoms were identified as potential contributors to this heterogeneity. In our independent study, antipsychotic treatment led to a significant increase in IGF-1 levels, and lower pre-treatment serum IGF-1 levels correlated with greater improvement in cognitive deficits, particularly in a subgroup with more severe cognitive symptoms.

CONCLUSIONS

Our findings support the "IGF-1 deficiency hypothesis" in the pathogenesis of schizophrenia. Further research is crucial to elucidate the role of IGF-1 in the cognitive impairments associated with schizophrenia.

Relationship between cognitive function and brain activation in major depressive disorder patients with and without insomnia: A functional near-infrared spectroscopy (fNIRS) study

BACKGROUND

Patients with major depressive disorder (MDD) frequently present with sleep disturbances and cognitive impairment. The purpose of this study was to investigate whether cognitive impairment is more severe in MDD patients with insomnia, and the underlying neural mechanisms.

METHODS

A total of 41 MDD patients with insomnia and 43 MDD patients without insomnia were recruited. We used functional near-infrared spectroscopy (fNIRS) to assess changes in oxyhemoglobin (Oxy-Hb) concentrations in the brain of patients while performing a verbal fluency task (VFT). Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI), cognitive function by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and severity of depression by the Hamilton Depression Scale (HAMD).

RESULTS

Compared to MDD patients without insomnia, those with insomnia had lower scores on the RBANS total and immediate memory, visuospatial/constructional, and delayed memory subscales, as well as lower oxy-Hb concentrations in the bilateral dorsolateral prefrontal cortex (DLPFC) and bilateral medial prefrontal cortex (mPFC).Further correlation analysis showed that there was a significant correlation between the RBANS total score in all brain regions except left mPFC in MDD patients with insomnia(all p < 0.05). Further multiple linear regression showed that Oxy-Hb concentrations of left DLPFC were independently associated with RBANS total score.

CONCLUSION

Our study suggests that MDD patients with insomnia have more cognitive impairment, which is associated with impaired frontal brain activity. Our findings may provide new insights to understand the underlying neural mechanisms of both disorders MDD patients and provide potential clinical value for developing treatment strategies for insomnia in MDD patients.

Effect of 12-week shen-based qigong exercise on the residual symptoms of schizophrenia: Study protocol for a single-centre randomised controlled trial

Introduction

Negative symptoms and cognitive impairment are common residual symptoms of schizophrenia that seriously affect the quality of life and social function of patients. The intervention of residual symptoms is an important part of schizophrenia rehabilitation. Traditional Chinese exercise has been applied as a supplementary rehabilitation method for schizophrenia. However, research on its use and pertinence in the rehabilitation of residual symptoms remains lacking. In this study, we will verify the intervention effect of a new method, namely, shen-based qigong exercise, on the residual symptoms of schizophrenia, in the hopes of finding a safe and effective rehabilitation method for the residual symptoms of schizophrenia.

Methods

This is a single-centre randomised controlled trial. A total of 60 schizophrenics who meet the criteria will be randomly divided into the control and intervention groups in accordance with the ratio of 1:1. Conventional drug treatment will remain unchanged in both groups. In this case, the control group will be given daily rehabilitation, whereas the intervention group will be given daily rehabilitation and shen-based qigong exercise intervention. The intervention period will be 12 weeks. The primary outcome will be negative symptoms assessed by the Scale for the Assessment of Negative Symptoms. The secondary outcome will be the global cognitive function assessed by the Repeatable Battery for the Assessment of Neuropsychological Status and event-related potential P300. Other outcomes will include specific cognitive domain (i.e. working memory), quality of life and social function. The results will be measured within 1 week before and after the intervention.

Discussion

The results of this study will likely help find an economical and convenient rehabilitation method for the residual symptoms of schizophrenia and, at the same time, may promote the popularisation and application of traditional Chinese exercises and traditional Chinese medicine theories in the treatment of mental diseases.

Trial registration

ClinicalTrials.gov registry number: NCT05310955.

Association of bone turnover markers and cognitive function in Chinese chronic schizophrenia patients with or without vitamin D insufficiency

BACKGROUND

Increasing evidence shows that bone turnover markers (BTMs) and vitamin D can affect human cognitive function. However, there are few studies that have investigated the association between BTMs and cognitive function in chronic schizophrenia patients. The aim of this study was to investigate the relationship between BTMs and cognitive function in chronic schizophrenia patients with or without vitamin D insufficiency (VDI).

METHODS

In all, 118 chronic schizophrenia patients were enrolled in this cross-sectional study. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was applied to evaluate the cognitive function of the subjects. Blood analysis included bone turnover markers, vitamin D levels, and glycolipid levels.

RESULTS

Relative to 72 vitamin D-sufficient (VDS) patients, 46 VDI patients had higher bone resorption markers levels and lower bone formation markers levels. Regression analysis showed that, in the total sample, CTX and language function exhibited independent positive correlation (p = 0.027, R2 change = 0.042), and in the VDS group, procollagen type I N-terminal propeptide (PINP) was independently negatively correlated with language function (p = 0.031, R2 change = 0.065), while the positive correlation between osteopontin (OPN) and delayed memory remained in the VDI group (p = 0.036, R2 change = 0.083).

CONCLUSION

Our study showed an association between the levels of BTMs and cognitive function among chronic schizophrenia patients. This correlation may have different mechanisms of action at different vitamin D levels.

The Presence and Severity of NAFLD are Associated With Cognitive Impairment and Hippocampal Damage

CONTEXT

Although cognitive impairment in nonalcoholic fatty liver disease (NAFLD) has received attention in recent years, little is known about detailed cognitive functions in histologically diagnosed individuals.

OBJECTIVE

This study aimed to investigate the association of liver pathological changes with cognitive features and further explore the underlying brain manifestations.

METHODS AND PATIENTS

We performed a cross-sectional study in 320 subjects who underwent liver biopsy. Among the enrolled participants, 225 underwent assessments of global cognition and cognitive subdomains. Furthermore, 70 individuals received functional magnetic resonance imaging scans for neuroimaging evaluations. The associations among liver histological features, brain alterations, and cognitive functions were evaluated using structural equation model.

RESULTS

Compared with controls, patients with NAFLD had poorer immediate memory and delayed memory. Severe liver steatosis (odds ratio, 2.189; 95% CI, 1.020-4.699) and ballooning (OR, 3.655; 95% CI, 1.419-9.414) were related to a higher proportion of memory impairment. Structural magnetic resonance imaging showed that patients with nonalcoholic steatohepatitis exhibited volume loss in left hippocampus and its subregions of subiculum and presubiculum. Task-based magnetic resonance imaging showed that patients with nonalcoholic steatohepatitis had decreased left hippocampal activation. Path analysis demonstrated that higher NAFLD activity scores were associated with lower subiculum volume and reduced hippocampal activation, and such hippocampal damage contributed to lower delayed memory scores.

CONCLUSIONS

We are the first to report the presence and severity of NAFLD to be associated with an increased risk of memory impairment and hippocampal structural and functional abnormalities. These findings stress the significance of early cognitive evaluation in patients with NAFLD.

Altered White Matter Structural Network Connectivity Associated with Cognitive Declines in Psychogenic Erectile Dysfunction

It has been reported that individuals with psychogenic erectile dysfunction (pED) potentially suffer from cognitive declines. Despite that increasing neuroimaging studies have demonstrated abnormalities of cerebral structural changes in pED, the association between altered white matter (WM) structural network and cognitive impairments remains unclear. Hence, this study aimed to explore the relationship between WM structural network connectivity and cognitive performance in patients with pED. Forty pED patients and 33 healthy controls (HCs) were recruited to perform cognitive assessments, and diffusion tensor imaging scans. We firstly constructed the WM structural network and applied the machine learning method to identify the important features. Then, we examined group differences in cognitive assessments, WM structural network connectivity within the identified features, and associations between altered WM structural network connectivity and cognitive scores in pED patients. From 26,896 features of DTI data, 24 important features were identified by K-Nearest Neighbor classification with a satisfactory accuracy (78%). Compared with HCs, we found that pED patients showed higher fractional anisotropy (FA) values between left transverse temporal sulcus and left supramarginal gyrus, and lower FA values between left suborbital sulcus and left para-hippocampal part of the medial occipito-temporal gyrus in pED patients. Furthermore, the increased FA between left transverse temporal sulcus and left supramarginal gyrus was observed to be negatively associated with impaired delayed memory. Overall, our findings provide new insights into WM network alterations associated with impaired cognitive functions in pED, which may unravel the potential neural mechanisms underlying the cognitive impairments of pED patients.

Association between cognitive impairment and olfactory deficits in systemic lupus erythematosus without major neuropsychiatric syndromes

OBJECTIVE

The aim of the study was to investigate the utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), evaluate cognitive deficits in systemic lupus erythematosus (SLE) patients and examine the relationship between cognitive and olfactory functions.

METHODS

55 SLE patients and 50 healthy controls were administered by RBANS including five indexes: immediate memory (IMME), visuospatial/constructional (Vis/Con), language (LANG), attention (ATT), and delayed memory (DEME). Olfactory functions were evaluated by computerized testing including three stages of smell: threshold (THR), identification (ID), and memory (ME) of different odors. The disease activity and cumulative damage were assessed by the SLE Disease Activity Index 2000 (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI).

RESULTS

SLE patients exhibited significant lower total RBANS scores, IMME, Vis/Con, ATT, and DEME index scores than healthy controls (p < 0.01 for all and p = 0.027 for attention). Reduced RBANS scores were associated with several organ involvement and autoantibodies. SLE patients with higher SLEDAI-2K scores or with accumulated damage (SDI≥1) showed decreased RBANS scores. All the olfactory scores in SLE patients were significantly decreased than controls (p = 0.001). Patients had higher proportion of anosmia (8.57% vs 0%) and hyposmia (28.58% vs 5.72%) than controls (χ2 = 10.533, p = 0.015). Multivariable regression analysis revealed that olfactory functions had a positive effect on RBANS index scores. Olfactory memory and total scores were significantly correlated with the DEME (r = 0.393, p = 0.021) and total scores (r = 0.429, p = 0.011).

CONCLUSION

This study indicates that significantly cognitive and olfactory functions are impaired in SLE patients. The RBANS is a potentially useful instrument for evaluating neuropsychological status in SLE. Physicians are encouraged to perform routine screening in SLE patients to detect subtle cognitive dysfunction.

Altered auditory processes pattern predicts cognitive decline in older adults: different modalities with aging

Background

Cohort studies have shown that older adults with hearing impairment as assessed by self-report or behavioral measures are at higher risk of developing dementia many years later. A fine-grained examination of auditory processing holds promise for more effective screening of older adults at risk of cognitive decline. The auditory mismatch negativity (MMN) measure enables one to gain insights into the neurobiological substrate of central auditory processing. We hypothesized that older adults showing compromised indexes of MMN at baseline would exhibit cognitive decline at the one-year follow-up.

Methods

We performed cognitive evaluations with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Form A and Form B) in 108 community-dwelling older adults and acquired EEG via the classic passive auditory oddball paradigm at baseline and 12-month follow-up.

Results

The results showed that young-old adults with future cognitive decline showed a decrease in MMN peak amplitude, accompanied by a forward-shifting latency, whereas in older adults it showed a delay in MMN latency, and unchanged MMN peak amplitude at midline electrodes (Fz, FCz and Cz). Furthermore, the peak amplitude of the MMN decreases with age in older adults aged 70-80 years rather than 60-70 years or > 80 years.

Conclusion

The altered MMN model exists in different aging stages and it's a promising electrophysiological predictor of cognitive decline in older adults. In addition, further research is needed to determine the neural mechanisms and potential implications of the accelerated decline in MMN in older adults.

Altered Functional Connectivity of Large-Scale Brain Networks in Psychogenic Erectile Dysfunction Associated with Cognitive Impairments

Purpose

Several studies have demonstrated that psychogenic erectile dysfunction (pED) patients potentially suffer from cognitive dysfunction. Despite that previous neuroimaging studies have reported abnormal functional connections of brain areas associated with cognitive function in pED, the underlying mechanisms of cognitive dysfunction in pED remain elusive. This study aims to investigate the underlying mechanisms of cognitive dysfunction by analyzing large-scale brain networks.

Patients and Methods

A total of 30 patients with pED and 30 matched healthy controls (HCs) were recruited in this study and scanned by resting-state functional magnetic resonance imaging. The Dosenbach Atlas was used to define large-scale networks across the brain. The resting-state functional connectivity (FC) within and between large-scale brain networks was calculated to compare pED patients with HCs. The relationship among cognitive performances and altered FC of large-scale brain networks was further explored in pED patients.

Results

Our results showed that the decreased FC within visual network, and between visual network and default mode network, visual network and frontoparietal network, and ventral attention and default mode network were found in pED patients. Furthermore, there was a positive correlation between immediate memory score and FC within visual network. The visuospatial score was negatively correlated with decreased FC between ventral attention network and default mode network.

Conclusion

Taken together, our findings revealed the relationship between cognitive impairments and altered FC between large-scale brain networks in pED patients, providing the new evidence about the neural mechanisms of cognitive dysfunction in pED patients.

Serum total cholesterol levels associated with immediate memory performance in patients with chronic schizophrenia

Cognitive impairments are common in patients with schizophrenia. Changes in total cholesterol (TC) may be involved in the development of schizophrenia and associated with cognitive function. This study aimed to investigate differences in serum TC level and cognitive function between schizophrenia patients and healthy controls and explore the relationship between serum TC level and cognitive function in patients with schizophrenia. A total of 105 schizophrenia patients and 105 healthy controls were recruited. Results showed that patients with schizophrenia had significantly lower scores on the overall RBANS scale and subscales (i.e., immediate memory, language, attention, and delayed memory) than those of healthy controls. Pearson's correlation analyses showed that in patients with schizophrenia, serum TC levels were positively associated with RBANS subscale scores of immediate memory and language. Furthermore, multivariate regression analyses showed that serum TC level was positively associated with the immediate memory index in patients with schizophrenia. However, no significant association was found between serum TC level and RBANS score in the healthy control group. Our results suggest that elevated serum TC level may be related to improved cognitive function in patients with schizophrenia, especially that of immediate memory.

Self-perception of cognitive functions in patients with neurological impairments as measured against a translated Cognitive Change Index

The primary purpose of the study was to compare the results of neuropsychological assessments with results obtained using a translated Cognitive Change Index (CCI) on patients with diagnosed brain pathology. Our study included 54 patients diagnosed with neurologic pathology (stroke, TBI, or brain tumor) at the University Rehabilitation Institute Soca (average age = 51 years, SD = 15 years). The results of neuropsychological evaluations and anamnestic data were also obtained for the clinical subsample. Confirmatory factor analysis of the translated CCI performed on responses of 151 normative elderly participants supported a one-factor structure of the questionnaire. Cronbach's α was 0.77 in the clinical sample. A significant correlation was found between lower scores for attention and visual abilities using objective measurement tools and a person's self-assessment of impairment in their own cognitive functions (score on CCI). Individuals can perceive that their attention and visual abilities are impaired when those abilities also score low in diagnostic tests.

Altered Functional Connectivity and Topological Organization of Brain Networks Correlate to Cognitive Impairments After Sleep Deprivation

Introduction

Sleep deprivation (SD) has a detrimental effect on cognitive functions. Numerous studies have indicated the mechanisms underlying cognitive impairments after SD in brain networks. However, the findings based on the functional connectivity (FC) and topological architecture of brain networks are inconsistent.

Methods

In this study, we recruited 30 healthy participants with regular sleep (aged 25.20 ± 2.20 years). All participants performed the repeatable battery for the assessment of neuropsychological status and resting-state fMRI scans twice, during the rested wakefulness (RW) state and after 24 h of total SD. Using the Dosenbach atlas, both large-scale FC and topological features of brain networks (ie nodal, global and local efficiency) were calculated for the RW and SD states. Furthermore, the correlation analysis was conducted to explore the relationship between the changes in FC and topological features of brain networks and cognitive performances.

Results

Compared to the RW state, the large-scale brain network results showed decreased between-network FC in somatomotor network (SMN)-default mode network (DMN), SMN-frontoparietal network (FPN), and SMN-ventral attention network (VAN), and increased between-network FC in the dorsal attention network (DAN)-VAN, DAN-SMN after SD. The clustering coefficient, characteristic path length and local efficiency decreased after SD. Moreover, the decreased attention score positively correlated with the decreased topological measures and negatively correlated with the FC of DAN-SMN.

Conclusion

Our results suggested that the increased FC of DAN-SMN and decreased topological features of brain networks may act as neural indicators for the decrease in attention after SD.

Clinical Trial Registration

The study was registered at the Chinese Clinical Trial Registry, registration ID: ChiCTR2000039858, China.

Differences in cognitive deficits in patients with methamphetamine and heroin use disorder compared with healthy controls in a Chinese Han population

BACKGROUND AND AIMS

To date, the pattern of heroin- and methamphetamine-induced cognitive impairment is unclear, especially in the Chinese population. The aim of this study was to compare the similarity and heterogeneity of cognitive impairment between heroin and methamphetamine-dependent patients and to link cognitive impairment to drug-related variables.

METHODS

567 pure methamphetamine patients, 78 pure heroin patients and 201 healthy volunteers participated in this study. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function including immediate memory, visuospatial/constructional index, language, attention, delayed memory, and total scores.

RESULTS

Methamphetamine-dependent and heroin-dependent patients performed significantly worse on all RBANS subtest and total scores (all p < 0.05). Moreover, methamphetamine-dependent patients had more delayed memory impairment than heroin-dependent patients (p = 0.02). In addition, some drug-related variables, such as duration of abstinence, age at first drug use, and duration of drug use, were independently associated with memory and visuospatial/constructional index in methamphetamine patients (all p < 0.05). In contrast, none of the drug-related variables were associated with cognitive performance in heroin patients (all p > 0.05).

CONCLUSIONS

Chronic heroin and methamphetamine patients may exhibit different patterns of cognitive deficits.

Normative Data for Adult Mandarin-Speaking Populations: A Systematic Review of Performance-Based Neuropsychological Instruments

OBJECTIVES

Normative data are essential for neuropsychological evaluations, but they are scarce for Mandarin-speaking populations, despite Mandarin being the language with the most native speakers. Several normative data studies have been reported in recent years for Mandarin speakers, who reside in different countries/regions (e.g., mainland China, Taiwan, and Singapore, etc.). This review aims to serve as a reference guide to appropriate norms when working with a Mandarin-speaking patient and to guide future endeavors in test validation and development in areas where studies to date fall short.

METHOD

We conducted a systematic review utilizing the PsycInfo, PubMed, and China Knowledge Resource Integrated databases as well as additional literature search through citations. We performed evaluations of the existing norms based on their test selection, cognitive domains covered, sample size, language, regions of participant recruitment, stratification by age/gender/education levels, and reporting of other psychometric properties. We focused on articles that included performance-based tests for adults but excluded those with purely clinical norms or from commercial publishers.

RESULTS

We reviewed 1155 articles found through literature search and identified 43 articles reporting normative data for this population that met our inclusion criteria. Sixty-five distinctive tests and 127 versions were covered. The results are presented within two detailed tables organized by articles and tests, respectively.

CONCLUSIONS

We discussed the strengths and limitations of these normative reports. Practitioners are recommended to utilize normative data that most closely approximate a test-taker's cultural and demographic backgrounds. Limitations of the current review are also discussed.

Intervention for a Digital, Cognitive, Multi-Domain Alzheimer Risk Velocity Study: Protocol for a Randomized Controlled Trial

BACKGROUND

In the United States, more than 6 million adults live with Alzheimer disease (AD) that affects 1 out of every 3 older adults. Although there is no cure for AD currently, lifestyle-based interventions aimed at slowing the rate of cognitive decline or delaying the onset of AD have shown promising results. However, most studies primarily focus on older adults (>55 years) and use in-person interventions.

OBJECTIVE

The aim of this study is to determine the effects of a 2-year digital lifestyle intervention on AD risk among at-risk middle-aged and older adults (45-75 years) compared with a health education control.

METHODS

The lifestyle intervention consists of a digitally delivered, personalized health coaching program that directly targets the modifiable risk factors for AD. The primary outcome measure is AD risk as determined by the Australian National University-Alzheimer Disease Risk Index; secondary outcome measures are functional fitness, blood biomarkers (inflammation, glucose, cholesterol, and triglycerides), and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status and Neurotrack Cognitive Battery). Screening commenced in January 2021 and was completed in June 2021.

RESULTS

Baseline characteristics indicate no difference between the intervention and control groups for AD risk (mean -1.68, SD 7.31; P=.90).

CONCLUSIONS

The intervention in the Digital, Cognitive, Multi-domain Alzheimer Risk Velocity is uniquely designed to reduce the risk of AD through a web-based health coaching experience that addresses the modifiable lifestyle-based risk factors.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04559789; https://clinicaltrials.gov/show/NCT04559789.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/31841.

Status and Factors of Cognitive Function Among Older Adults in Urban China

The present study aimed to examine the current status and influencing mechanisms of different demographic factors associated with cognitive function in urban Chinese older adults. A total of 644 older adults from 14 communities in urban China (e.g., Shanghai, Beijing, and Wuxi) were investigated by using the Mini-Mental State Examination and the Repeatable Battery for the Assessment of Neuropsychological Status. The results indicated that the overall cognitive function of older adults in urban China was normal. We found an aging effect on cognitive level, and cognitive function declined more rapidly after age 80. Older age, unmarried status, and lower occupational cognitive requirements increased the likelihood of cognitive risk. Higher educational levels and active engagement in exercise may contribute to cognitive reserve and have a protective effect on cognitive decline in late life. Further study is needed to develop appropriate interventions to improve the mental health of older people.

Factor Structure of the Repeatable Battery for the Assessment of Neuropsychological Status in Huntington's Disease

OBJECTIVE

The Repeatable Battery for the Assessment of Neuropsychological Status is a commonly used neuropsychological screening tool that is useful in a Huntington's disease (HD) population given its relatively brief administration time and assessment of multiple cognitive domains. Although 5 index scores are calculated, this structure has not been universally supported in clinical samples, which have often found a two- and three-factor structure to be better fitting. This study explored the Repeatable Battery for the Assessment of Neuropsychological Status factor structure in a large HD sample, which has not been done to date.

METHOD

In total, 147 individuals with HD completed the Repeatable Battery for the Assessment of Neuropsychological Status. An exploratory factor analysis was conducted to explore the Repeatable Battery for the Assessment of Neuropsychological Status factor structure.

RESULTS

Consistent with the findings from a majority of other clinical samples investigated, our results revealed a better fitting two-factor structure (verbal and visual).

CONCLUSION

The traditional Repeatable Battery for the Assessment of Neuropsychological Status index structure may not be valid in HD, which yields important clinical and research implications.

Association between cognitive impairment and apolipoprotein A1 or apolipoprotein B levels is regulated by apolipoprotein E variant rs429358 in patients with chronic schizophrenia

ApoE gene polymorphism may be involved in the change in blood lipid profile and cognitive impairment of the general population. However, few studies explored the effects of ApoE gene polymorphism on blood lipid levels and cognition in schizophrenia. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was employed to evaluate the cognition and the SNPStats was used to investigate the association of ApoE rs429358 with schizophrenia. The models of analysis of covariance and multivariate analysis were conducted to investigate the effect of ApoE rs429358 on cognition in schizophrenia. Altogether, 637 patients with schizophrenia and 467 healthy controls were recruited in this study. The findings in the case group found that both the ApoA1 and ApoB levels were predictors for RBANS total score (p < 0.001 vs. p = 0.011), immediate memory (p < 0.001 vs. p = 0.019), language (p < 0.001 vs. p = 0.013), attention (p < 0.001 vs. p < 0.001), except ApoA1 level only was a predictor for visuospatial/constructional (p = 0.014) and delayed memory (p < 0.001). When the association was examined in different ApoE rs429358 genotype subgroups, the association between ApoA1 level and RBANS scores (except for the language score) or between ApoB level and RBANS scores (except for the attention score) was regulated by ApoE rs429358. Our results suggest that patients with schizophrenia have broad cognitive impairment compared with healthy controls. For patients with schizophrenia, both ApoA1 and ApoB levels were positively associated with cognition. There was a significant association between ApoA1 or ApoB levels and cognition in schizophrenia, which was regulated by the ApoE rs429358.

Different Modulatory Effects of Cognitive Training and Aerobic Exercise on Resting State Functional Connectivity of Entorhinal Cortex in Community-Dwelling Older Adults

The entorhinal cortex (EC) plays an essential role in age-related cognitive decline. However, the effect of functional connectivity (FC) changes between EC and other cerebral cortices on cognitive function remains unclear. The aim of this study was to explore the modulation of two interventions (cognitive training and aerobic exercise) on EC-FC in community-dwelling older adults. In total, 94 healthy older adults aged between 65 and 75 years were assigned to either the cognitive training or aerobic exercise group to receive 24 sessions over 12 weeks, or to a control group. Resting-state functional magnetic resonance imaging was performed at both baseline and 12-month follow-up. Compared to the cognitive training group, the aerobic exercise group showed greater EC-FC in the bilateral middle temporal gyrus, right supramarginal gyrus, left angular gyrus, and right postcentral gyrus. Compared to the control group, the cognitive training group had a decreased EC-FC in the right hippocampus, right middle temporal gyrus, left angular gyrus, and right postcentral gyrus and an increased EC-FC in the bilateral pallidum, while the aerobic exercise group showed increased EC-FC between the right medial prefrontal cortex(mPFC), bilateral pallidum, and right precuneus. Baseline EC-FC in the mPFC was positively correlated with the visuospatial/constructional index score of the Repeatable Battery for the Assessment of Neuropsychological Status. In the cognitive training group, EC-FC value changes in the right hippocampus were negatively correlated with changes in the RBANS delayed memory index score, while in the aerobic exercise group, EC-FC value changes in the left angular gyrus were positively correlated with changes in the RBANS attention index score. These findings support the hypothesis that both cognitive training and aerobic exercise can modulate EC-FC in aging populations but through different neural pathways.

The relationship between cognitive function and performance in instrumental activities of daily living in older adults

Introduction

Deficits in cognition have been found to be associated with problems in performing daily activities; however, it is unknown what specific domains of cognition are related to each daily activity.

Method

Thirty-six occupational therapists identified the 20 most important instrumental activities of daily living for older adults and the cognitive demands required. Thirty-two older adults rated the perceived mental effort when performing these activities. They were assessed on their cognitive functions. Descriptive statistics were used to report the results. The Pearson correlation coefficient was used to identify relationships between cognitive functions and perceived mental effort.

Results

Activities relating to ‘communication’, ‘financial management’, ‘health management’ and ‘safety and emergency management’ require more cognitive demands. Results from the older adults showed the highest significant correlations in immediate memory and ‘paying bills’ ( r = 0.54), delayed memory and ‘following emergency procedures’ and ‘paying bills’ ( rs = 0.52), and executive functioning and ‘making and keeping medical appointments’ ( r = −0.49).

Conclusion

Findings contribute to the emerging understanding of specific cognitive domains related to the instrumental activities of daily living. The results can be used to reframe and improve intervention strategies for individuals with cognitive decline to maintain or improve performance in daily activities.

Relationship between afternoon napping and cognitive function in the ageing Chinese population

BACKGROUND

Several studies have shown that afternoon napping promotes cognitive function in the elderly; on the other hand, some studies have shown opposite results. This current study further examined the relationship between afternoon napping and cognitive function in the ageing Chinese population.

METHODS

A total of 2214 elderly were included (napping group: n=1534; non-napping group: n=680). They all received cognitive evaluations by the Beijing version of the Montreal Cognitive Assessment, the Mini-Mental State Examination, and the Chinese version of the Neuropsychological Test Battery. Among all the subjects, 739 elderly volunteered to take blood lipid tests.

RESULTS

Significant differences in cognitive function and blood lipids were observed between the napping and the non-napping groups. Afternoon napping was associated with better cognitive function including orientation, language, and memory in the present study. Subjects with the habit of afternoon napping also showed a higher level of triglyceride than the non-napping subjects.

CONCLUSION

The results demonstrated that afternoon napping was related to better cognitive function in the Chinese ageing population.

Effect of 1 Year of Qigong Exercise on Cognitive Function Among Older Chinese Adults at Risk of Cognitive Decline: A Cluster Randomized Controlled Trial

Background: The rapidly aging Chinese population is showing an increase in age-related illnesses, including mild cognitive impairment and Alzheimer disease. The best types of physical activity for the improvement of cognition remain unknown. This study aimed to compare the effectiveness of a tailored qigong exercise with that of stretching exercise in the maintenance of cognitive abilities in Chinese elders at risk of cognitive decline. Methods: Seventy-four community-dwelling adults aged ≥60 years were screened for eligibility. Using a randomized control group design, participants with scores ≥19 on the Chinese version of the Montreal Cognitive Assessment-Basic (MoCA) were allocated to a 1-year qigong intervention (n = 33) and a stretching control exercise group (n = 33). The primary outcome was the MoCA score, as a measure of global cognitive function, and secondary outcomes were globe cognition and five domain scores on the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The MoCA and RBANS were administered at baseline and 1 year after intervention to assess the effect of the exercises on cognitive decline. Results: Twenty-five of 33 (75.8%) participants in the qigong group and 26 of 33 (78.8%) participants in the control group completed the 1-year exercise programs. A bivariate test revealed strong correlation between MoCA and RBANS total scores after the intervention (r = 0.517, p < 0.01). Generalized estimating equations revealed a lower risk of progression of cognitive decline at 1 year in the qigong group than in the control group (odds ratio, 0.314; 95% confidence interval, 0.103-0.961; p = 0.04). Two-way repeated-measures ANOVA followed by post hoc t tests with Bonferroni corrections indicated that MoCA and RBANS scores were significantly higher in the qigong group than in the control group (MoCA and RBANS global cognition, memory, visuospatial/constructional ability, and language, all p < 0.01), with the exception of RBANS attention score (p > 0.05). Conclusions: One year of qigong practice was significantly superior to stretching exercise not only for the prevention of cognitive decline progression, but also for the improvement of several cognitive functions, among older Chinese adults at risk of cognitive decline.

The Korean Repeatable Battery for the Assessment of Neuropsychological Status-Update : Psychiatric and Neurosurgery Patient Sample Validity

Objective

This study aimed to validate the Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status Update (K-RBANS).

Methods

We performed a retrospective analysis of 283 psychiatric and neurosurgery patients. To investigate the convergent validity of the K-RBANS, correlation analyses were performed for other intelligence and neuropsychological test results. Confirmatory factor analysis was used to test a series of alternative plausible models of the K-RBANS. To analyze the various capabilities of the K-RBANS, we compared the area under the receiver operating characteristic (ROC) curves (AUC).

Results

Significant correlations were observed, confirming the convergent validity of the K-RBANS among the Total Scale Index (TSI) and indices of the K-RBANS and indices of intelligence (r=0.47–0.81; p<0.001) and other neuropsychological tests at moderate and above significance (r=0.41–0.63; p<0.001). Additionally, the results testing the construct validity of the K-RBANS showed that the second-order factor structure model (model 2, similar to an original factor structure of RBANS), which includes a first-order factor comprising five index scores (immediate memory, visuospatial capacity, language, attention, delayed memory) and one higher-order factor (TSI), was statistically acceptable. The comparative fit index (CFI) (CFI, 0.949) values and the goodness of fit index (GFI) (GFI, 0.942) values higher than 0.90 indicated an excellent fit. The root mean squared error of approximation (RMSEA) (RMSEA, 0.082) was considered an acceptable fit. Additionally, the factor structure of model 2 was found to be better and more valid than the other model in χ² values (Δχ²=7.69, p<0.05). In the ROC analysis, the AUCs of the TSI and five indices were 0.716–0.837, and the AUC of TSI (AUC, 0.837; 95% confidence interval, 0.760–0.896) was higher than the AUCs of the other indices. The sensitivity and specificity of TSI were 77.66% and 78.12%, respectively.

Conclusion

The overall results of this study suggest that the K-RBANS may be used as a valid tool for the brief screening of neuropsychological patients in Korea.

Genetic impact of ZNF804A on cognitive function in patients with bipolar I disorder

Our previous genetic study identified a variant rs1344706 in the zinc finger protein 804A (ZNF804A) gene conferring susceptibility to bipolar disorder subtype I (BD-I) in Han Chinese. Literature documented that this variant may affect brain structure and function. As such, we attempted to identify whether the rs1344706 polymorphism influences cognitive function in patients with bipolar disorder I. We recruited 177 patients with bipolar disorder in remission period. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The single nucleotide polymorphisms (SNP) rs1344706 was genotyped using TaqMan assays. Analysis of covariance (ANCOVA) analysis showed a significant genotypic effect on RBANS immediate memory (P = 0.002) and total score (P = 0.001). Post hoc analysis showed that the patients with T/T genotype have lower RBANS immediate memory and total scores than those with T/G or G/G genotypes. When the patients were stratified by sex, such significances are only seen in male patients, but not female patients. Our findings suggested a sex-specific effect of ZNF804A rs1344706 polymorphism on cognitive function in patients with bipolar disorder-I.

The fMRI study for acupuncture on shift work sleep disorder: Study protocol for a randomized controlled neuroimaging trial

INTRODUCTION

Nearly 20% of night shift nurses will cause shift work disorder (SWD) due to the disruption of sleep-wake cycle, which not only affects the daily work efficiency, but also brings a huge burden on physical and mental health. Acupuncture is a safe and effective intervention on SWD. This trial will combine with functional magnetic resonance imaging (fMRI) to study the clinical effects and potential mechanism of acupuncture in the treatment of SWD.

METHODS AND ANALYSIS

This is a randomized controlled neuroimaging trial, with enrolled participants, outcome assessors, and data statisticians blinded. 60 patients with SWD and 30 healthy controls who sleep regularly will be recruited and divided into divided into a control group, a true acupoints treatment group (TATG) and a sham acupoints treatment group (SATG) by the ratio of 1:1:1. The TATG and SATG will receive 8 sessions of acupuncture treatment in 4 weeks. Cognitive function scales and MRI scanning will be performed before and after 4-week acupuncture treatment. The control group will receive no intervention. Functional connectivity of intra-network and inter-network will be the primary outcome and effect indicator. The secondary outcomes included Repeatable Battery for the Assessment of Neuropsychological Status, Attentional Network Test, Pittsburgh Sleep Quality Index scale and needle sensation assessment scale. Neuroimage indicators will be correlated with clinical data and scores of cognitive function assessment to explore the possible mechanisms underlying the changes of brain activity caused by acupuncture treatment.

DISCUSSION

The results of this study will enable us to verify the therapeutic effect of acupuncture on SWD and explore the potential central mechanism of acupuncture on SWD from the change of brain activity.

Associations between small and middle molecules clearance and the change of cognitive function in peritoneal dialysis

BACKGROUND

Uremic toxins have been suspected as potential contributors for cognitive impairment in peritoneal dialysis (PD) patients. However, associations between the clearance of serum small and middle molecules and the change of cognitive function were not fully explored and then we explored this issue in the present study.

METHOD

A total of clinically-stable 222 patients on PD were enrolled and then followed up for 2 years in this single-center prospective cohort study. Small and middle molecules clearances were examined by urea clearance (Kt/V), creatinine clearance (Ccr) and beta-2 microglobulin (B2M) clearance via dialysate and urine at baseline and after 2 years. Global and specific cognitive impairment were measured at baseline and after 2 years. Modified Mini-Mental State Examination (3MS) was assessed for global cognitive function, trail-making tests A and B for executive function and subtests of the battery for the assessment of neuropsychological status for immediate and delayed memory, visuospatial skills and language ability.

RESULTS

The median of total Kt/V, Ccr and B2M clearance were 1.89, 53.2 l/w/1.73 m2 and 17.5 l/w/1.73 m2, respectively at baseline. The prevalence of global cognitive impairment was 12.3% for 222 patients and 15.4% for the remained 130 patients after 2 years. At baseline, total Kt/V was independently positively associated with delayed memory function. Total and dialysate beta-2 microglobulin clearance was positively associated with 3MS scores and negatively with completion time on trail A after multivariate adjustment. At 2 years, we observed a significant difference in the changing trend of 3MS scores between groups divided by total B2M clearance (P = 0.033), which still maintained to be meaningful after multivariate adjustment (P = 0.024). Patients with total B2M clearance > 19.0 l/w/1.73 m2 got significant improvement on their 3MS scores (P = 0.005). Patients divided by total Kt/V or Ccr were not significantly different in the trends of general and any specific cognitive function during the follow up.

CONCLUSION

The higher middle molecules clearance independently correlated to better performance on general cognitive and executive function in PD patients, which also predict an improvement in general cognitive function during the follow up.

Omega-3 fatty acids ameliorate cognitive dysfunction in schizophrenia patients with metabolic syndrome

Our previous study showed that metabolic abnormalities reduced the levels of brain-derived neurotrophic factor (BDNF) and deteriorated cognitive performance in patients with schizophrenia. Inflammation may play a key role in this process. Omega-3 fatty acids have been documented to ameliorate inflammation. Therefore, we hypothesized that omega-3 fatty acids may be of value in enhancing BDNF levels and improving cognitive function in patients with schizophrenia with metabolic syndrome (MetS). We recruited 80 patients with both schizophrenia and MetS who received long-term olanzapine monotherapy. The enzyme-linked immunosorbent assay was used to measure the plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). The patients were randomly assigned to the OMG-3 group (n = 40) or the placebo group (n = 40). Of the 80 patients who consented to the study, 72 completed this 12-week RCT. The primary outcome was the changes from baseline to 12 weeks in clinical characteristics and the levels of BDNF, CRP, IL-6 and TNF-α. There was a significant correlation between omega-3 fatty acid treatment and enhanced delayed memory factor in the RBANS assessment (F_group×time = 6.82; df = 1, 66; P = 0.01) when the patients completed this study. Along with cognitive improvement, omega-3 fatty acids enhanced BDNF (F_group×time = 4.93; df = 1, 66; P = 0.03) and reduced CRP (F_group×time = 17.11; df = 1, 66; P < 0.01), IL-6 (F_group×time = 9.71; df = 1, 66; P < 0.004) and TNF-α (F_group×time = 6.71; df = 1, 66; P = 0.012) levels after 12 weeks of treatment. The changes in BDNF levels are negatively correlated with the changes in TNF-α levels (r = -0.37, P = 0.03) but not with the changes in CRP and IL-6 levels. Our findings provide suggestive evidence that omega-3 fatty acids have beneficial effects on cognitive function in patients with MetS, which is paralleled by enhanced BDNF levels.

Reconsidering the RBANS Factor Structure: a Systematic Literature Review and Meta-Analytic Factor Analysis

The primary aim was to perform a systematic literature review and extract data necessary for a meta-analytic factor analysis of the RBANS. Secondary aims were to examine the potential validity and utility of the resulting factor structure. Literature was identified through a review of PsycINFO, PubMed, MEDLINE, Academic Search Complete, Psychology & Behavioral Sciences Collection, CINAHL Complete, Health Source: Nursing/Academic Edition, and SocINDEX. A two-stage meta-analytic structural equation modeling method was implemented to pool correlation matrices from primary studies and perform confirmatory factor analyses. Following model selection, factor scores were computed for two datasets and subjected to correlation and diagnostic accuracy analyses. A pooled correlation matrix was computed from 24 sample correlation matrices (N = 5299). Confirmatory factor analysis revealed that the theoretical five-factor model produced the best fit but only when error terms between Story Memory and Story Recall as well as between Figure Copy and Figure Recall were included. Regression-based factor scores showed mixed relationships with the manual-defined indices, and the overall diagnostic accuracy of the factor scores was adequate in both samples examined (AUC = 0.71 and 0.87). The five-factor model was an unexpected result given the failure of multiple previous studies to find support for that model. The five-factor model demonstrates several areas of potential improvement, including better representation of the factors by the indicators. The factor scores implied by this model also require further validation.

One-day tropisetron treatment improves cognitive deficits and P50 inhibition deficits in schizophrenia

The core features of schizophrenia (SCZ) include cognitive deficits and impaired sensory gating represented by P50 inhibition deficits, which appear to be related to the α7 nicotinic acetylcholine receptor (nAChR). An agonist of nAChR receptor may improve these defects. This study aimed to investigate how administering multiple doses of tropisetron, a partial agonist of nAChR, for 1 day would affect cognitive deficits and P50 inhibition deficits in SCZ patients. We randomized 40 SCZ non-smokers into a double-blind clinical trial with four groups: placebo, 5 mg/d, 10 mg/d, and 20 mg/d of oral tropisetron. Their P50 ratios were all more than 0.5 and they took risperidone at 3-6 mg/day for at least a month before participating in the experiment. We measured the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and P50 inhibition before and one day after treatment. After one day of treatment, the total RBANS scores of the 20 mg and 5 mg tropisetron groups, and the immediate memory of the 10 mg group were significantly higher than placebo group. The P50 ratio was smaller in the 5 mg and 10 mg groups than in the placebo group (both p < 0.05) after treatment. Furthermore, the improvement in RBANS total score was correlated with increased S1 latency (p < 0.05), and the increase in immediate memory score was correlated with decreased S2 amplitude. One day of treatment with tropisetron improved both cognitive and P50 inhibition deficits, suggesting that longer term treatment with α7 nAChR agonists for these deficits in SCZ may be promising.

Retinal nerve fiber layer thickness is associated with hippocampus and lingual gyrus volumes in nondemented older adults

OBJECTIVES

Abnormal retina structures, such as thinner retinal nerve fiber layer (RNFL), have been frequently reported in patients with Alzheimer's disease (AD). However, the association between RNFL and brain structures in cognitively normal adults remains unknown. We therefore set out to conduct a cross-sectional investigation to determine whether RNFL thickness is associated with brain structure volumes in nondemented older adults.

METHODS

We measured RNFL thickness by optical coherence tomography and brain structure volumes by 3 T magnetic resonance imaging. Cognitive function was assessed using the Chinese version of Repeatable Battery for the Assessment of Neurological Status. Pearson correlation was initially employed to screen for the potential associations among RNFL thickness, brain structure volumes and cognitive function. And then, multivariable linear regression models were conducted to further examine such associations adjusting for possible confounding factors, including age, sex, years of education and the estimated total intracranial volume (eTIV).

RESULTS

113 participants (≥ 65 years old) were screened and 80 of them (mean age: 68 ± 5.3 years; 48% male) were included in the final analysis. RNFL thickness in temporal quadrant was associated with medial temporal lobes volumes [unadjusted: r = 0.155, P = 0.175; adjusted: β = 0.205 (0.014, 0.383), P = 0.035], and especially associated with the hippocampus volume [unadjusted: r = 0.213, P = 0.062; adjusted: β = 0.251 (0.060, 0.435), P = 0.011] after adjusted for age, sex, years of education and eTIV. Moreover, it showed that RNFL thickness in inferior quadrant [unadjusted: r = 0.221, P = 0.052; adjusted: β = 0.226 (0.010. 0.446), P = 0.041] was significantly associated with occipital lobes volumes after the adjustment of age, sex, years of education and eTIV, and selectively associated with the substructure of lingual gyrus volume [unadjusted: r = 0.223, P = 0.050; adjusted: β = 0.278 (0.058, 0.487), P = 0.014]. In addition, average RNFL thickness was associated with the cognitive domain of visuospatial/constructional [unadjusted: r = 0.114, P = 0.322; adjusted: β = 0.216 (0.006, 0.426), P = 0.044] after the adjustment in these nondemented older adults.

CONCLUSIONS

Quadrant-specific associations exist between RNFL thickness and brain regions vulnerable to aging or neurodegeneration in older adults with normal cognition. These findings would promote further investigations into using RNFL as a noninvasive and less expensive biomarker of neurocognitive aging and AD-related neurodegeneration.

Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Normative Data for Older Adults

OBJECTIVE

Provide updated older adult (ages 60+) normative data for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Form A, using regression techniques, and corrected for education, age, and gender.

METHOD

Participants (aged 60-93 years; N = 415) were recruited through the Healthy Ageing Research Program (HARP), University of Western Australia, and completed Form A of the RBANS as part of a wider neuropsychological test battery. Regression-based techniques were used to generate normative data rather than means-based methods. This methodology allows for the control of demographic variables using continuous data. To develop norms, the data were assessed for: (1) normality; (2) associations between each subtest score and age, education, and gender; (3) the effect of age, education, and gender on subtest scores; and (4) residual scores which were converted to percentile distributions.

RESULTS

Differences were noted between the three samples, some of which were small and may not represent a clinically meaningful difference. Younger age, more years of education, and female gender were associated with better scores on most subtests. Frequency distributions, means, and standard deviations were produced using unstandardized residual scores to remove the effects of age, education, and gender.

CONCLUSIONS

These normative data expand upon past work by using regression-based techniques to generate norms, presenting percentiles, as well as means and standard deviations, correcting for the effect of gender, and providing a free-to-use Excel macro to calculate percentiles.

Role of endothelium-independent vasodilation in the relationship between visceral adiposity and reduced cognitive performance in older adults with type 2 diabetes

OBJECTIVE

In this cross-sectional analysis, we sought to assess the relationship of adiposity and forearm microvascular reactivity with cognitive dysfunction among older Asians with type 2 diabetes (T2D).

METHODS

Subjects with T2D aged ≥ 55 years were analyzed (N = 907). Cognitive performance was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Mini-Mental State Exam (MMSE). Visceral fat area (VFA) was estimated by tetrapolar multi-frequency bioimpedance. Forearm microvascular endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) were assessed by laser Doppler imaging with iontophoresis.

RESULTS

RBANS total score was correlated with VFA, EDV, and EIV (all P < .05). However, VFA was correlated with EIV, but not with EDV. Multivariable linear regression showed significant association between VFA and RBANS total score (B = -0.02, 95% CI= -0.03 to -0.01) or memory (immediate and delayed) index scores. These associations were attenuated after adjustment for EIV. Mediation analysis showed that EIV partially mediated the relationship between visceral adiposity and RBANS scores (all Sobel tests P < .05). EIV also mediated the relationship between VFA and MMSE score.

CONCLUSIONS

Impaired endothelium-independent vascular smooth muscle reactivity may exert a mediatory effect on the association between increased visceral adiposity and decreased cognitive performance in older adults with T2D.

Association Between SIRT1, Cytokines, and Metabolic Syndrome in Schizophrenia Patients With Olanzapine or Clozapine Monotherapy

Objective: Previous studies consistently showed the interaction between Sirtuin 1 (SIRT1) and immune inflammation is significantly related to metabolic abnormalities, but their role in the pathogenesis of metabolic syndrome caused by second-generation antipsychotics (SGAs) in schizophrenia patients largely remains unknown. Hence, the present study aimed to fill this gap. Methods: A total of 54 schizophrenia patients with olanzapine or clozapine monotherapy [metabolic syndrome (MetS)/non-MetS patients, 27/27] and 67 healthy subjects were recruited in the present study. The Positive and Negative Syndrome Scale was used, and the plasma levels of SIRT1, interleukin 6 (IL-6), IL-8, IL-10, and tumor necrosis factor α (TNF-α) were measured. Results: The results showed that schizophrenia patients treated with olanzapine or clozapine (both MetS and non-MetS groups) had significantly higher plasma levels of IL-6, IL-10, and TNF-α compared to normal controls (all P < 0.05). Moreover, the MetS patients exhibited markedly lower plasma levels of SIRT1 and higher plasma levels of IL-6 than non-MetS patients and normal controls (all P < 0.05). However, there were no significant differences in IL-8 levels between groups. Our correlation analysis showed that SIRT1 was significantly correlated with diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol in schizophrenia patients. The stepwise logistic regression analysis further identified the IL-6 × SIRT1 (β = -0.463, t = 10.040, P = 0.002) as the influencing factor for the MetS in the patients. Conclusion: Our preliminary findings suggest that SIRT1 interacted with inflammatory cytokines associated with MetS in schizophrenia patients treated with SGA monotherapy.