Assessment of nerve growth factor levels and clinical indicators for outcome prediction in first-episode schizophrenia

doi:10.5498/wjp.120278

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 120278
Published online Aug 19, 2026. doi: 10.5498/wjp.120278

Assessment of nerve growth factor levels and clinical indicators for outcome prediction in first-episode schizophrenia

Wen-Huan Xiao, Mo-Lan Wang, Kuan-Yu Chen, Dou-Dou Yu, Ya-Qin Zhao, Jin-Rong Sun

Wen-Huan Xiao, Kuan-Yu Chen, Dou-Dou Yu, Ya-Qin Zhao, Jin-Rong Sun, Department of Psychiatry, Affiliated Wutaishan Hospital of Medical College of Yangzhou University, Yangzhou 225003, Jiangsu Province, China

Mo-Lan Wang, Department of Neurology, Affiliated Wutaishan Hospital of Medical College of Yangzhou University, Yangzhou 225003, Jiangsu Province, China

Co-first authors: Wen-Huan Xiao and Mo-Lan Wang.

Co-corresponding authors: Ya-Qin Zhao and Jin-Rong Sun.

Author contributions: Xiao WH and Wang ML were responsible for study design, statistical analysis, manuscript preparation; they contributed equally to this work and share co-first authorship; Chen KY, Yu DD, and Zhao YQ were responsible for recruiting the subjects, collecting clinical data, and performing the clinical rating; Xiao WH, Zhao YQ, and Sun JR were involved in writing the protocol and providing funding for the study; Zhao YQ and Sun JR contributed equally to this work and share co-corresponding authorship; Sun JR is the primary corresponding author responsible for all communication with the journal. All authors contributed to and have approved the final manuscript.

AI contribution statement: This manuscript used DeepL for language spelling and grammar checking, as well as for language polishing and expression optimization in specific paragraphs. The AI tool did not directly generate any original scientific content. All ideas, data, and conclusions were independently completed by the authors.

Supported by Yangzhou City Basic Research Program (Joint Special Project) - Health and Wellness Category, No. 2023-2-36, No. 2023-4-24, No. 2024-3-31, and No. 2025-2-21; and Scientific Research Project of Wutaishan Hospital of Yangzhou, Jiangsu Province, No. WTS2025001 and No. WTS2025003.

Institutional review board statement: The Yangzhou Wutaishan Hospital Ethics Committee approved the study protocol.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Jin-Rong Sun, Department of Psychiatry, Affiliated Wutaishan Hospital of Medical College of Yangzhou University, No. 2 Wutaishan Road, Yangzhou 225003, Jiangsu Province, China. 1723487395@qq.com

Received: February 26, 2026
Revised: April 1, 2026
Accepted: May 28, 2026
Published online: August 19, 2026
Processing time: 145 Days and 19.9 Hours

Abstract

BACKGROUND

Increasing evidence suggests that nerve growth factor (NGF) is a potential pathogenic factor for schizophrenia, as NGF levels tend to normalize following psychopathological improvement with antipsychotic treatment. However, how closely NGF changes are associated with treatment outcome remain unclear. This study investigated whether baseline and early changes in serum NGF levels could predict 8-week treatment response in patients with first-episode psychosis (FEP).

AIM

To investigate whether baseline and early changes in serum NGF levels could predict 8-week treatment response in FEP.

METHODS

This study was conducted in Yangzhou, Jiangsu Province, China. It was comprised of 78 FEP patients treated with atypical antipsychotics only and 75 sex- and age-matched healthy controls. Illness severity was measured weekly using the Positive and Negative Syndrome Scale. Serum NGF levels were measured at baseline for both groups and at 2, 4, 6, and 8 weeks for FEP patients.

RESULTS

Baseline serum NGF levels were significantly lower in the FEP group (174.21 ± 83.34 pg/mL) compared with healthy controls (219.21 ± 78.63 pg/mL; t = -3.450, P < 0.001). After antipsychotic treatment, NGF levels in the FEP group significantly increased, reaching 202.45 ± 97.61 pg/mL at week 8 (P = 0.003). In addition, multivariate logistic regression analysis identified baseline NGF [odds ratio (OR) = 1.018, 95% confidence interval (CI): 1.008-1.027], NGF at 2 weeks (OR = 1.016, 95%CI: 1.008-1.024), early NGF changes (OR = 1.088, 95%CI: 1.037-1.143), and early psychopathological improvement (OR = 7.312, 95%CI: 1.552-34.446) as significant predictors of individual treatment response in the FEP group.

CONCLUSION

Our results indicate that higher baseline NGF levels, NGF at 2 weeks after antipsychotic treatment, early NGF changes, and early psychopathological improvement can predict the response to antipsychotics in FEP patients.

Keywords: Nerve growth factor; Schizophrenia; First-episode schizophrenia; Treatment outcome; Biomarker

Core Tip: This study in first-episode schizophrenia found that baseline serum nerve growth factor (NGF) levels were significantly lower than in healthy controls and increased after 8 weeks of antipsychotic treatment. Baseline NGF, NGF at week 2, early NGF changes, and early psychopathological improvement each independently predicted treatment response. Combining all four indicators yielded superior predictive performance over any single measure, suggesting that dynamic NGF monitoring may assist early clinical decision-making.