Introduction Alterations of glutamate, energy and glutathione metabolism contribute to the pathogenesis of psychotic disorders Objectives Revealing clinical-biological correlations in patients with late onset schizophrenia and delusional disorder by determining clinical parameters and activity of platelet enzymes of energy, glutamate, and glutathione metabolism. Methods 27 women of 45-80 years old were studied, with late onset schizophrenia or delusional disorder. Activity of platelet cytochrome c-oxidase (COX), glutamate dehydrogenase (GDH), glutathione reductase (GR) and glutathione-S-transferase (GST), and scores by PANSS, HAMD, MMSE, and CGI-S were evaluated twice: before and after the 28-th day of treatment. Activity of COX, GDH, GR, and GST was measured once in 23 women of 44-81 years old comprising the control group. Results As compared with controls, only GDH activity was found significantly decreased (before and after treatment, p<0.001). Clusterisation of patients by enzymatic activities resulted in 3 clusters significantly different by COX, GDH and GST. Significant correlations were found between enzymatic activities and scores by psychometric scales: in the cluster 1 (n=9) baseline COX activity correlated with scores by PANSS positive subscale (R=0.9, p=0.001) and with scores by MMSE (R=-0.9, p=0.002); in the cluster 2 (n=12) GR activity after treatment negatively correlated with scores by PANSS (R=-0.9, p=0.001), PANSS negative subscale (R=-0.8, p=0.004), and CGI-S (R=-0.9, p=0.001). Conclusions The revealed correlations between enzymatic activities and clinical parameters give hope on detection of useful biochemical markers which, after enlargement of patients’ group with late onset psychotic disorders, would be validated for prediction of the pharmacotherapy efficiency and outcome of treatment. Disclosure No significant relationships.
Цель: представить исторические и современные научные данные по проблеме поздней шизофрении. Материал и методы: были проанализированы результаты классических исследований по шизофрении, а также современные научные публикации по ключевым словам «поздняя шизофрения», «поздно манифестирующая шизофрения», «очень поздние шизофреноподобные психозы» в научных базах PubMed, MEDLINE и других.Результаты: проанализированы публикации и описаны основные этапы исторического развития концепции поздней шизофрении. Несмотря на сохраняющуюся неоднозначность этого понятия, признана возможность как поздней манифестации шизофрении (после 40 лет), так и очень поздней (после 60 лет). Рассмотрены вопросы классификации, диагностики, клиники и течения поздней шизофрении. Приведены результаты современных параклинических методов исследования. Показаны актуальность и перспективы дальнейшего изучения расстройств шизофренического спектра в позднем возрасте, их возможная связь с органическими изменениями головного мозга.Вывод: совершенствование диагностики расстройств шизофренического спектра в позднем возрасте создает перспективы разработки эффективных методов их профилактики и лечения. Использование биологических (параклинических) методов обследования позволит получить новые сведения об этиологии и патогенезе данной патологии, что, в свою очередь, позволит разработать персонализированный подход к ведению пациентов с поздней шизофренией, определить степень выраженности органической патологии и методы ее коррекции, а также спрогнозировать течение и исход заболевания.Ключевые слова: поздняя шизофрения; очень поздние шизофреноподобные психозы; пожилой возраст.
Background: basing on the hypothesis that oxidative stress participates in schizophrenia pathogenesis, the authors suggested that the activities of glutathione reductase (GR) and glutathione-S-transferase (GST), the enzymes metabolizing the central antioxidant glutathione, are altered in patients with schizophrenia spectrum disorders.Objective: determination of activity of platelet glutathione reductase (GR) and glutathione-S-transferase (GST) in patients with late-onset schizophrenic spectrum disorders (LOS - spectrum psychoses) and evaluation of their possible connection to clinical indicators.Patients and methods: 28 female in-patients aged 45–86 years with LOS-spectrum psychoses were examined: schizophrenia (n = 16), schizoaffective disorder (n = 6), chronic delusional disorder (n = 6). A control group of women of the same age range without mental and neurological diseases was recruited. Platelet GR and GST activities in patients were determined before and after the course of pharmacotherapy, and in the control group - only once.Results: assessment of the patients’ symptoms’ severity using PANSS, HAMD, and MMSE was carried out before and after the course of pharmacotherapy (at the 28th day of the therapy course). The efficacy of therapy was determined by the change in the PANSS and HAMD total score. While the GR activity did not differ significantly in patients and in the control group, GST activity was found substantially and significantly reduced in patients (before and after the course of therapy) compared with the control group, although GST activity in patients did not significantly change during their treatment. In both cases (GR and GST), three patients were observed among the patients with enzymatic activity exceeding > 1.5 times the medians in the group. After the course of treatment, the activity of enzymes decreased to a level within the range of control values or values for other patients.Conclusion: the results of a pilot study indicate the promise of determining the activity of GR and GST in a group of patients with LOS-spectrum endogenous psychoses to distinguish among them subgroups with glutathione metabolism abnormalities that correlate with clinical and pathopsychological features.
Aim. To evaluate cognitive functions and independent living skills in patients with late-onset schizophrenia (LOS) compared to patients with early-onset schizophrenia (EOS). Methods. The study included two clinical groups: 8 EOS patients (M=51.37.2; 7 males) and 8 LOS patients (M=67.89.9; 8 females), with comparable illness duration (22.69.1 and 19.911.9 respectively). Cognitive functions were assessed through the Brief Assessment of Cognition in Schizophrenia (BACS). The Autonomy Assessment Scale (AS) was used to measure independent living skills. The MannWhitney U-test was applied to determine differences between groups. Results. LOS group performed significantly better on Digit Sequencing Task, Verbal Fluency and Tower Test of the BACS. Composite score on AS was also significantly better in LOS group along with better scores on AS`s subscales assessing primarily social skills. Conclusion. LOS patients have milder cognitive dysfunction along with better independent living and social skills compared to AOS patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.