Relapse of first-episode schizophrenia patients and neurocognitive impairment: The role of dopaminergic and anticholinergic burden.

Autor: Cuesta MJ; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain. Electronic address: mcuestaz@cfnavarra.es., Ballesteros A; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain., Sánchez-Torres AM; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain., Amoretti S; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain., López-Ilundain JM; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain., Merchán-Naranjo J; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain., González-Ortega I; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, i, Vitoria, Spain., Salgado P; Hospital del Mar Medical Research Institute, Spain., Rodriguez-Jimenez R; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Av. Córdoba s/n, 28041 Madrid, Spain; Universidad Complutense de Madrid (UCM), Plaza Ramón y Cajal, s/n, 28040 Madrid, Spain., Roldán-Bejarano A; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Psychiatry Department, Institut d'Investigació Biomèdica-SantPau (IIB-SANTPAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain., Sarró S; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain., Ibáñez Á; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain., Usall J; Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Barcelona, Spain., Escartí MJ; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Fundación Investigación Hospital Clínico de Valencia, Valencia, Spain., Moreno-Izco L; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain., Mezquida G; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Basic Clinal Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain., Parellada M; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain., González-Pinto A; BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, i, Vitoria, Spain., Berrocoso E; Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain., Bernardo M; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2022 Oct; Vol. 248, pp. 331-340. Date of Electronic Publication: 2022 Sep 22.
DOI: 10.1016/j.schres.2022.09.014
Abstrakt: Background: The prevention of relapse may be a key factor to diminish the cognitive impairment of first-episode schizophrenia (FES) patients. We aimed to ascertain the effects of relapse, and dopaminergic and anticholinergic treatment burdens on cognitive functioning in the follow-up.
Methods: Ninety-nine FES patients participated in this study. Cognitive assessments were performed at baseline and after 3 years of follow-up or, in those patients who relapsed, after >2 months of stabilization of the new acute psychotic episode. The primary outcomes were final cognitive dimensions.
Results: Repeated measures MANOVA analyses showed improvements in the whole sample on the end-point assessments in processing speed and social cognition. However, only impairment in social cognition showed a significant interaction with relapse by time in this sample. Relapse in FES patients was significantly associated with poor performance on end-point assessments of working memory, social cognition and global cognitive score. Anticholinergic burden, but not dopaminergic burden, was associated with verbal memory impairment. These significant associations resulted after controlling for baseline cognitive functioning, relapse and dopaminergic burden.
Conclusions: The relationship between relapse and cognitive impairment in recovered FES patients seems to be particularly complex at the short-term follow-up of these patients. While relapse was associated with working memory, social cognition impairments and global cognitive score, anticholinergic burden might play an additional worsening effect on verbal memory. Thus, tailoring or changing antipsychotics and other drugs to reduce their anticholinergic burden may be a potential modifiable factor to diminish cognitive impairment at this stage of the illness.
Competing Interests: Declaration of competing interest Dr. R. Rodriguez-Jimenez has been a consultant for, spoken in activities of, or received grants from: Instituto de Salud Carlos III, Fondo de Investigación Sanitaria (FIS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid Regional Government (S2010/ BMD-2422 AGES; S2017/BMD-3740), JanssenCilag, Lundbeck, Otsuka, Pfizer, Ferrer, Juste, Takeda, Exeltis, Casen-Recordati, Angelini. A. Ibáñez has received research support from or served as speaker or advisor for Janssen-Cilag, Lundbeck and Otsuka. C. De-la-Camara received financial support to attend scientific meetings from Janssen, Almirall, Lilly, Lundbeck, Rovi, Esteve, Novartis, Astrazeneca, Pfizer and Casen Recordati. Dr. A. Gonzalez-Pinto has received grants and served as consultant, advisor or CME speaker for the following entities: Almirall, AstraZeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Glaxo-Smith-Kline, Janssen-Cilag, Ferrer, Johnson & Johnson, Lundbeck, Merck, Otsuka, Pfizer, Sanofi-Aventis, Servier, Shering-Plough, Solvay, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), the Basque Government, the Stanley Medical Research Institute, Wyeth, Angelini, Exeltis, Casen and Servier. Dr. Bernardo has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of ABBiotics, Adamed, Angelini, Casen Recordati, Janssen-Cilag, Menarini, Rovi and Takeda.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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