Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2023; 11(22): 5215-5223
Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5215
Changes in neurotransmitter levels, brain structural characteristics, and their correlation with PANSS scores in patients with first-episode schizophrenia
Xian-Jia Xu, Tang-Long Liu, Liang He, Ben Pu
Xian-Jia Xu, The Fifth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
Tang-Long Liu, Department of Science and Education, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
Liang He, The Sixteenth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
Ben Pu, The Twelfth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
Author contributions: Xu XJ and Pu B designed the research study; Liu TL and He L performed the research; Xu XJ and Pu B analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Ningbo Mental Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ben Pu, B.S.Me, Doctor, The Twelfth Ward, Ningbo Psychiatric Hospital, No. 11 Rixingfang, Tongjia Village, Zhuangqiao Street, Jiangbei District, Ningbo 315000, Zhejiang Province, China. vickipu@126.com
Received: May 31, 2023
Peer-review started: May 31, 2023
First decision: June 14, 2023
Revised: June 15, 2023
Accepted: July 10, 2023
Article in press: July 10, 2023
Published online: August 6, 2023
Processing time: 64 Days and 7.8 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with schizophrenia have abnormal brain glial cell activity, abnormal prefrontal, anterior cingulate, and striatal functions, and disrupted neurotransmitter secretion, and the degree of their lesions is related to the severity of their symptoms. The neurotransmitters, dopamine (DA), glutamic acid (Glu), and gamma-aminobutyric acid (GABA), are associated with mental activity, and their relationship with schizophrenia has been a popular topic in clinical research. The Positive and Negative Syndrome Scale (PANSS) is a common tool for clinically diagnosing and assessing schizophrenia.

Research motivation

The relationship between changes in neurotransmitters and structural brain features with the occurrence and development of schizophrenia remains unclear.

Research objectives

To explore the relationships between changes in neurotransmitters, brain structural characteristics, and the scores of the PANSS in patients with first-episode schizophrenia.

Research methods

A total of 97 patients with schizophrenia and 100 healthy participants were included into this study. For all participants, brain structural characteristics were explored by measuring brain DA, Glu, and GABA levels, with magnetic resonance imaging (MRI). The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis. Linear correlation analysis was used to analyze the correlations between neurotransmitters, brain structural characteristics, and PANSS scores.

Research results

Patients in the case group had higher levels of DA and lower levels of Glu and GABA, greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group. In patients with positive schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical and horizontal distances between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA. In patients with negative schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical distance between the corpus callosum and the infrafornix, horizontal distance between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA.

Research conclusions

In patients with first-episode schizophrenia, DA levels increased, Glu and GABA levels decreased, the thickness of the corpus callosum increased, and these variables were correlated with PANSS scores.

Research perspectives

Further research with large cohort and more types of neurotransmitters and brain structure measurement indicators is needed.