Prolactin levels influenced by antipsychotic drugs in schizophrenia: A systematic review and network meta-analysis.

Prolactin increase is a common side effect in antipsychotic treatment of schizophrenia, which crucially impacts drug choice and treatment compliance. As previous reviews by our group on this topic have included only few Chinese studies, we aimed to compare and rank antipsychotics based on broader evidence. This systematic review pooled data of 92 included studies from previous systematic review by Huhn et al. and 38 newly-added studies from Chinese-database search, including Chinese databases of China National Knowledge Infrastructure (CNKI), WANFANG DATA, WEIPU Journal Net (VIP) and Sino Biomedicine Service System (SinoMed) up to 20 May 2020. We conducted both network meta-analysis (NMA) and pairwise meta-analysis. The primary outcome was prolactin increase (continuous data). We calculated mean differences (MDs) for prolactin level with 95% confidence intervals (CIs) using random-effects model as primary analysis. 130 RCTs with 25,610 participants were included. Newer antipsychotics (risperidone, amisulpride and paliperidone) and older antipsychotics (chlorpromazine, haloperidol and sulpride) increase prolactin levels with large effect sizes. The SMD results were not identical to the MD results because consistency and heterogeneity assumption was tested to be different in calculations. Sensitivity analyses removing two studies with massive baseline imbalance or removing Chinese studies with high risk of bias did not affect the result. In contrast to a previous review clozapine and zotepine were no longer associated with decreased prolactin levels compared to placebo. Risperidone's ranking has more implications supported by CINeMA. This NMA draws the conclusion with larger sample size and extends evidence to more literature in this field.

Resting-state functional connectivity changes within the default mode network and the salience network after antipsychotic treatment in early-phase schizophrenia.

OBJECTIVE: Abnormal resting-state functional connectivity (FC), particularly in the default mode network (DMN) and the salience network (SN), has been reported in schizophrenia, but little is known about the effects of antipsychotics on these networks. The purpose of this study was to examine the effects of atypical antipsychotics on DMN and SN and the relationship between these effects and symptom improvement in patients with schizophrenia. METHODS: This was a prospective study of 33 patients diagnosed with schizophrenia and treated with antipsychotics at Shanghai Mental Health Center. Thirty-three healthy controls matched for age and gender were recruited. All subjects underwent functional magnetic resonance imaging (fMRI). Healthy controls were scanned only once; patients were scanned before and after 6-8 weeks of treatment. RESULTS: In the DMN, the patients exhibited increased FC after treatment in the right superior temporal gyrus, right medial frontal gyrus, and left superior frontal gyrus and decreased FC in the right posterior cingulate/precuneus (P<0.005). In the SN, the patients exhibited decreased FC in the right cerebellum anterior lobe and left insula (P<0.005). The FC in the right posterior cingulate/precuneus in the DMN negatively correlated with the difference between the Clinical Global Impression (CGI) score pre/post-treatment (r=-0.564, P=0.023) and negative trends with the difference in the Positive and Negative Syndrome Scale (PANSS) total score pre/post-treatment (r=-0.475, P=0.063) and the difference in PANSS-positive symptom scores (r=-0.481, P=0.060). CONCLUSION: These findings suggest that atypical antipsychotics could regulate the FC of certain key brain regions within the DMN in early-phase schizophrenia, which might be related to symptom improvement. However, the effects of atypical antipsychotics on SN are less clear.

Impaired cue identification and intention retrieval underlie prospective memory deficits in patients with first-episode schizophrenia.

OBJECTIVE: Schizophrenia is associated with impairment in prospective memory, the ability to remember to carry out an intended action in the future. It has been established that cue identification (detection of the cue event signaling that an intended action should be performed) and intention retrieval (retrieval of an intention from long-term memory following the recognition of a prospective cue) are two important processes underlying prospective memory. The purpose of this study was to examine prospective memory deficit and underlying cognitive processes in patients with first-episode schizophrenia. METHODS: This study examined cue identification and intention retrieval components of event-based prospective memory using a dual-task paradigm in 30 patients with first-episode schizophrenia and 30 healthy controls. All participants were also administered a set of tests assessing working memory and retrospective memory. RESULTS: Both cue identification and intention retrieval were impaired in patients with first-episode schizophrenia compared with healthy controls ( ps < 0.05), with a large effect size for cue identification (Cohen's d = 0.98) and a medium effect size for intention retrieval (Cohen's d = 0.62). After controlling for working memory and retrospective memory, the difference in cue identification between patients and healthy controls remained significant. However, the difference in intention retrieval between the two groups was no longer significant. In addition, there was a significant inverse relationship between cue identification and negative symptoms ( r = -0.446, p = 0.013) in the patient group. CONCLUSION: These findings suggest that both cue identification and intention retrieval in event-based prospective memory are impaired in patients with first-episode schizophrenia. Cue identification and intention retrieval could be potentially used as biomarkers for early detection and treatment prognosis of schizophrenia. In addition, addressing cue identification deficit through cognitive enhancement training may potentially improve negative symptoms as well.

Clinical significance of decreased protein expression of dehydroepiandrosterone sulfate in the development of depression: a meta-analysis.

BACKGROUND: Previous evidence has shown that adrenal androgens, dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEAS) have significant functions related to the control of mood, affect, and anxiety. Changes in their expression levels are reportedly related to several psychiatric disorders. The objective of this meta-analysis was to explore the role of DHEAS protein expression in patients with depression. METHOD: Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine (CBM) and China National Knowledge Infrastructure (CNKI) were electronically searched. Only those studies that analyzing DHEAS expression in depression patients were considered eligible for inclusion. Standardized mean differences (SMDs) were pooled with a 95% confidence interval (CI) in accordance with the random-effects model. RESULTS: Ten clinical case-control studies, consisting of 4496 subjects (493 patients with depression and 4003 healthy controls) were incorporated for analysis. Results revealed a lower DHEAS protein expression level in patients with depression than in normal controls (SMD=0.17, 95% CI: 0.06-0.27, P=0.002). Ethnicity-stratified analysis indicated that lower levels of DHEAS expression in depression patients were not observed in Caucasians or Asians (both P>0.05). CONCLUSION: Elevated DHEAS protein expression may be correlated with the biological pathophysiology of depression, indicating that checking DHEAS levels and administration of DHEAS could contribute to the effective treatment of depression.

Prospective memory performance in patients with drug-naïve, first-episode psychosis.

Schizophrenia is associated with an impairment of prospective memory (PM) which refers to the ability to remember to carry out an intended action in the future. However, most of these studies were limited to chronic samples. The current study examined the event-based PM and time-based PM using a dual-task paradigm in 22 drug-naïve, first-episode psychosis (FEP) patients and 23 healthy controls. Results indicated that FEP patients performed significantly poorer than healthy controls in both event-based and time-based PM. However, the significant difference in time-based PM disappeared after controlling for working memory. Correlation analysis indicated that both types of PM did not correlate with positive symptoms or negative symptoms, duration of illness, or duration of untreated psychosis. However, time-based PM was correlated with the general psychopathology subscale of the PANSS. Taken together, these findings suggest that PM deficits are present in drug-naïve FEP patients; impairment of event-based PM appears to occur independently, whereas time-based PM impairment may be, in part, a secondary consequence of a working memory deficit.

[Identification of protoporphyrin IX fluorescence spectrum in human blood serum by biorthogonal spline wavelet].

For the low content and weak fluorescence intensity, usually presenting shoulder peaks, it is often hard to locate protoporphyrin IX and identify its fluorescence intensity in human blood serum. Biorthogonal spline wavelet may work for the identification of its weak signal Superimposing protoporphyrin IX fluorescence signal on the background of blood serum spectrum, a series of varied fluorescence spectra of them can be obtained. The protoporphyrin IX fluorescence signal from blood serum background is separated and the fluorescence spectrum can be divided into corresponding discrete approximate signals (a1-a7) and discrete details signals (d1-d7) by biorthogonal spline wavelet bior 5.5 seven levels decomposition. The signal frequency shows a gradual decrease with increasing decomposition. Protoporphyrin IX fluorescence peak emerges when it comes to the 7th decomposition. The signal peak shifts about 2.5 mm downwards as the signal intensity decreases, whereas the signal peak from wavelet filter remains where it was. As the synchronization disappears between signal intensity and signal peak, usually it is hard to assure the fluorescence intensity and peak location. However, signal from wavelet filter may ignore the affect and identify the protoporphyrin IX in human blood serum with the help of biorthogonal spline wavelet. As the linear alternation of wavelet and discrete details signals maintain their inborn linear relations, the authors can carry out the qualitative and quantitative analysis for the precise content and quantity of protoporphyrin IX in blood serum, which provides a feasible method for the application of blood serum fluorescence spectrum to tumor early diagnosis.

[Fluorescence spectrum analysis system for protoporphyrin IX in serum based on wavelet transform].

Protoporphyrin IX is an important kind of organic compound for vital movement, and can be used as the sign of tumour blood. Human protoporphyrin IX content in serum is very low, and affected by various factors. The serum fluorescence spectrum analysis system based on wavelet transform was used to discriminated the protoporphyrin IX weak signals. The protoporphyrin IX fluorescence spectrum was obtained by a multi-function spectrum measuring system, and decomposed several times by wavelet transform to distinguish the noise and spectrum signals. The fluorescence spectrum can be divided into corresponding discrete approximations signals (a1-a6) and discrete details signals (d1-d6) by six times of decomposition, showing the signal frequency decreasing with decomposition times increasing and the protoporphyrin IX fluorescence character peak appears here. The weak signals were discriminated and the exactly component and quantity can be acquired for further analysis. So it can be analysed quantitatively. The researches in the present paper provide the potential application in the diagnosis of incipient tumous using the serum fluorescence spectrum