Sex differences in association between cognitive impairment and clinical correlates in Chinese patients with first-episode drug-naïve schizophrenia

Abstract Background Schizophrenia is a complex mental illness with significant sex differences. Cognitive impairment is common in patients with schizophrenia, even in remission. This study was designed to examine the sex differences in the relationship between cognitive impairment and clinical correlations with first-episode drug-naïve (FEDN) schizophrenia. Methods 93 FEDN patients (male/female = 45/48) and 160 controls (male/female = 74/86) were enrolled to compare the sex differences in cognitive functions measured by the MATRICS Consensus Cognitive Battery (MCCB). Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Scale (HAMD) were used to evaluate patients' clinical symptoms. We compared cognitive impairment with sociodemographic characteristics and measures of different genders, as well as group-by-sex interactions. Results Our results showed that male patients had significantly lower scores for symbol coding, digital sequence, and verbal learning than female patients, while the healthy controls showed similar sex differences. In female patients, multiple linear regression analysis confirmed that PANSS negative symptoms and general psychopathology scores, HAMD total score, and education level were independent contributors to MCCB total score. In male patients, only education was an independent contributor to MCCB total score. Conclusions These findings revealed significant sex differences in cognitive impairments and clinical symptoms in FEDN, which will be worthy of a follow-up study of schizophrenia in the future.

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Sex differences in association between cognitive impairment and clinical correlates in Chinese patients with first-episode drug-naïve schizophrenia

10.21203/rs.3.rs-143729/v1 ◽

2021 ◽

Author(s):

Na Zhao ◽

Xiao Hong Wang ◽

Chuan Yi Kang ◽

Yue Zheng ◽

Li Ying Yang ◽

...

Keyword(s):

Sex Differences ◽

Cognitive Impairment ◽

Clinical Symptoms ◽

Verbal Learning ◽

First Episode ◽

Control Group ◽

Hamilton Depression Scale ◽

Female Patients ◽

Drug Naïve ◽

Male Patients

Abstract Background Schizophrenia is a complex mental illness with significant sex differences. Cognitive impairment is common in patients with schizophrenia, even in remission. This study was designed to examine the sex differences in the relationship between cognitive impairment and clinical correlations with first-episode drug-naïve (FEDN) schizophrenia. Methods 93 FEDN patients (male/female = 45/48) and 160 controls (male/female = 74/86) were enrolled to compare the sex differences in cognitive functions measure by the MATRICS Consensus Cognitive Battery (MCCB). Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Scale (HAMD) were used to evaluated patients' clinical symptoms. We compared cognitive impairment with sociodemographic characteristics and measures of different genders, as well as group-by-sex interactions. Results Our results showed that the MCCB total and index score in FEDN were lower than in the control group, except for category fluency and social cognition. Male patients had significantly lower symbol coding, digital sequence, and verbal learning scores than female patients, and the controls showed a similar sex difference. Interestingly, we also found six indexes and MCCB total score that showed diagnosis-by-sex interactions, belonging to the speed of processing, attention, working memory, and verbal learning. The MCCB total score showed correlations with PANSS total score and education for both genders. In female patients, education showed significant positive correlations with MCCB total and all ten index scores. Multiple linear regression analysis confirmed that negative symptoms and general psychopathology of PANSS, HAMD total score, and education were independent contributors to MCCB total score. In male patients, only education was an independent contributor to MCCB total score. Conclusions These findings revealed significant sex differences in cognitive impairments and clinical symptoms in FEDN. These results should be considered, which will be worthy of a follow-up study of schizophrenia in the future.

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Interrelationships Between BDNF, Superoxide Dismutase, and Cognitive Impairment in Drug-Naive First-Episode Patients With Schizophrenia

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa062 ◽

2020 ◽

Vol 46 (6) ◽

pp. 1498-1510 ◽

Cited By ~ 3

Author(s):

Mei Hong Xiu ◽

Zezhi Li ◽

Da Chun Chen ◽

Song Chen ◽

Maile E Curbo ◽

...

Keyword(s):

Superoxide Dismutase ◽

Cognitive Impairment ◽

Clinical Symptoms ◽

Interactive Effect ◽

Redox System ◽

First Episode ◽

Sod Activity ◽

Neuropsychological Status ◽

Syndrome Scale ◽

Drug Naïve

Abstract The pathogenesis and etiology of schizophrenia (SCZ) remains unclear. Accumulating studies showed that complex interrelationships between brain-derived neurotrophic factor (BDNF) and an imbalanced redox system has a crucial role in the psychopathology of SCZ. However, the influence of the interrelationships of BDNF and superoxide dismutase (SOD) on cognitive impairment and clinical symptomatology in drug-naive first-episode (DNFE) SCZ patients has not been studied thoroughly. Serum BDNF levels, plasma total SOD, manganese-SOD (Mn-SOD), copper/zinc-containing SOD (CuZn-SOD) activities, and malondialdehyde (MDA) levels were measured in 327 DNFE patients with SCZ and 391 healthy controls. Cognitive functions were measured using the Repeatable Battery for the Assessment of Neuropsychological status (RBANS) and clinical symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). Compared with the controls, the DNFE patients had increased activities of total SOD and CuZn-SOD, and reduced levels of BDNF and MDA. BDNF levels were positively correlated with CuZn-SOD activity in patients. In addition, we found that elevated Mn-SOD and CuZn-SOD activities were related to PANSS depression factor. Moreover, an interactive effect of BDNF levels and Mn-SOD activity was associated with attentional index score in the patients. Therefore, our findings suggested that interrelationships between BDNF and antioxidant mechanisms might underlie the pathological mechanisms of cognitive impairments and symptomatology in the DNFE patients with SCZ.

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Sex Difference in the Interrelationship Between TNF-α and Oxidative Stress Status in First-episode Drug-naïve Schizophrenia

10.21203/rs.3.rs-126760/v1 ◽

2020 ◽

Author(s):

Minghuan Zhu ◽

Zhenjing Liu ◽

Jaelin Rippe ◽

Mst. Sadia Sultana ◽

Kang Wu ◽

...

Keyword(s):

Oxidative Stress ◽

Sex Differences ◽

Sex Difference ◽

Psychotic Symptoms ◽

First Episode ◽

Healthy Controls ◽

Tnf Α ◽

Drug Naïve ◽

Male Patients ◽

And Oxidative Stress

Abstract BackgroundIncreasing evidence indicates that dysregulated TNF-α and oxidative stress (OxS) contribute to the pathophysiology of schizophrenia. Additionally, previous evidence has demonstrated sex differences in many aspects of schizophrenia including clinical characteristics, cytokines and OxS markers. However, to the best of our knowledge, there is no study investigating sex differences in the association between TNF-α, the OxS system, and their interaction with clinical symptoms in schizophrenia patients, especially in first-episode drug-naïve (FEDN) patients. MethodsA total of 119 FEDN schizophrenia patients and 135 healthy controls were recruited for this study. Serum TNF-α, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and malondialdehyde (MDA) were measured. The Positive and Negative Syndrome Scale (PANSS) was applied to evaluate psychotic symptoms. Two-way ANOVA, partial correlation analysis and multivariate regression analysis were performed. ResultsA sex difference in MDA levels was demonstrated only in healthy controls (F = 7.06, p Bonferroni = 0.045) and not seen in patients. Furthermore, only male patients had higher MDA levels than male controls (F = 8.19, p Bonferroni = 0.03). Additionally, sex differences were observed in the association of TNF-α and MDA levels with psychotic symptoms (all pBonferroni<0.05). The interaction of TNF-α and MDA was only associated with general psychopathology symptom in male patients (B = -0.07, p = 0.02). ConclusionOur results demonstrate the sex difference in the relationship between TNF-α, MDA, and their interaction with psychopathological symptoms of patients with schizophrenia.

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Sex difference in the interrelationship between TNF-α and oxidative stress status in first-episode drug-naïve schizophrenia

Journal of Neuroinflammation ◽

10.1186/s12974-021-02261-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Minghuan Zhu ◽

Zhenjing Liu ◽

Yanhong Guo ◽

Mst. Sadia Sultana ◽

Kang Wu ◽

...

Keyword(s):

Oxidative Stress ◽

Sex Differences ◽

Sex Difference ◽

Psychotic Symptoms ◽

First Episode ◽

Healthy Controls ◽

Tnf Α ◽

Drug Naïve ◽

Male Patients ◽

And Oxidative Stress

Abstract Background Increasing evidence indicates that dysregulated TNF-α and oxidative stress (OxS) contribute to the pathophysiology of schizophrenia. Additionally, previous evidence has demonstrated sex differences in many aspects of schizophrenia including clinical characteristics, cytokines, and OxS markers. However, to the best of our knowledge, there is no study investigating sex differences in the association between TNF-α, the OxS system, and their interaction with clinical symptoms in schizophrenia patients, especially in first-episode drug-naïve (FEDN) patients. Methods A total of 119 FEDN schizophrenia patients and 135 healthy controls were recruited for this study. Serum TNF-α, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and malondialdehyde (MDA) were measured. The Positive and Negative Syndrome Scale (PANSS) was applied to evaluate psychotic symptoms. Two-way ANOVA, partial correlation analysis, and multivariate regression analysis were performed. Results A sex difference in MDA levels was demonstrated only in healthy controls (F = 7.06, pBonferroni = 0.045) and not seen in patients. Furthermore, only male patients had higher MDA levels than male controls (F = 8.19, pBonferroni = 0.03). Additionally, sex differences were observed in the association of TNF-α and MDA levels with psychotic symptoms (all pBonferroni < 0.05). The interaction of TNF-α and MDA was only associated with general psychopathology symptom in male patients (B = − 0.07, p = 0.02). Conclusion Our results demonstrate the sex difference in the relationship between TNF-α, MDA, and their interaction with psychopathological symptoms of patients with schizophrenia.

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An Audit of Treatment of Genital Warts: Opening the Feedback Loop

International Journal of STD & AIDS ◽

10.1177/095646249300400410 ◽

1993 ◽

Vol 4 (4) ◽

pp. 226-231 ◽

Cited By ~ 4

Author(s):

M Reynolds ◽

M Murphy ◽

M A Waugh ◽

C J N Lacey

Keyword(s):

Specific Treatment ◽

Genital Warts ◽

Therapeutic Modality ◽

First Episode ◽

Anogenital Warts ◽

Treatment Protocols ◽

Female Patients ◽

General Infirmary ◽

Male Patients ◽

Time Of Presentation

An audit of the treatment of patients (100 men and 90 women) presenting with a first episode of anogenital warts to the Genitourinary Medicine Department at Leeds General Infirmary was performed. Treatment of patients was monitored for a period of 6 months from the time of presentation. The management of patients with genital warts lacked a clearly defined strategy and treatment was unselective and poorly monitored. Excluding patients who defaulted, at follow-up 44 (44%) men and 36 (38%) women still had genital warts at 3 months. Of those patients clear of warts at 3 months, the mean time to remission for men and women was 7.1 and 8.3 weeks respectively. Podophyllin 25% in tincture of benzoin was by far the predominant therapeutic modality used. A total of 96 (96%) men and 76 (84%) women received treatment with podophyllin. Both male and female patients had a mean of 5 treatments with podophyllin 25% (range 1–19 and 1–12 respectively). Physical methods of treatment i.e. cryotherapy and electrocautery, were underutilized, both as primary therapies and when topical agents had failed. Patients saw an average of 3 (range 1–7) doctors over the course of their treatment. Patients with warts affecting 2 or more sites, male patients with anal/perianal warts, and female patients with cervical and vaginal warts had higher failure rates from treatment at 3 months. On the basis of these findings, specific treatment protocols for the management of anogenital warts have been devised.

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Abnormalities of EEG Microstates In Drug-Naïve, First-Episode Schizophrenia

10.21203/rs.3.rs-1042706/v1 ◽

2021 ◽

Author(s):

Qiaoling Sun ◽

Linlin Zhao ◽

Liwen Tan

Keyword(s):

Clinical Symptoms ◽

Early Stage ◽

First Episode ◽

Healthy Controls ◽

Brain Functions ◽

Class D ◽

Syndrome Scale ◽

Drug Naïve ◽

Microstate Analysis ◽

First Episode Schizophrenia

Abstract Objective: Microstate analysis is a powerful tool to probe the brain functions, and changes in microstates under electroencephalography (EEG) have been repeatedly reported in patients with schizophrenia. This study aimed to investigate the dynamics of EEG microstates in drug-naïve, first-episode schizophrenia (FE-SCH) and to test the relationship between EEG microstates and clinical symptoms.Methods: Resting-state EEG were recorded for 23 patients with FE-SCH and 23 healthy controls using a 64-channel cap. Three parameters, i.e., contribution, duration, and occurrence, of the four microstate classes were calculated. Group differences in EEG microstates and their clinical symptoms (assessed using the Positive and Negative Syndrome Scale) were analyzed.Results: Compared with healthy controls, patients with FE-SCH showed increased duration, occurrence and contribution of microstate class C and decreased contribution and occurrence of microstate class D. In addition, the score of positive symptoms in PANSS was negatively correlated with the occurrence of microstate D.Conclusions: Our findings showed abnormal patterns of EEG microstates in drug-naïve, first-episode schizophrenia, which might help distinguish individuals with schizophrenia in the early stage and develop early intervention strategies.

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The Condition of Cognitive Functions in Patients with Stage 1 and Stage 2 Hypertension of 2-3 Degrees, with Moderate and High Cardiovascular Risk and Gender Characteristics of the Revealed Disorders

Lviv clinical bulletin ◽

10.25040/lkv2021.01-02.014 ◽

2021 ◽

Vol 1-2 (33-34) ◽

pp. 14-18

Author(s):

V. Skybchyk ◽

◽

O. Pylypiv ◽

Keyword(s):

Blood Pressure ◽

Cognitive Impairment ◽

Cardiovascular Risk ◽

Cognitive Functions ◽

Healthy Individuals ◽

High Cardiovascular Risk ◽

Hypertensive Patients ◽

Female Patients ◽

Male Patients ◽

Stage 1

Context. It is known that in addition to transient ischemic attacks and insults, hypertension is often the cause of asymptomatic brain damage, including cognitive impairment (CI). Most of these studies show a positive relationship between midlife hypertension and cognitive decline at the advanced age. CI significantly affect the quality of life of patients, reduce the ability to learn, acquire new knowledge and skills, force them to change their usual way of life and often stop or reduce professional activities. Objective. To analyze the condition of cognitive functions in patients with stage 1 and stage 2 hypertension of 2nd-3rd degrees, with moderate and high cardiovascular risk and evaluate their gender peculiarities. Materials and methods. The study included 90 patients with stage 1 and stage 2 hypertension. The average age of patients with hypertension was 49.66 ± 8.74 years old. The average course of the disease was 7.7 ± 3.9 years. The comparison group consisted of 46 healthy individuals with normal blood pressure levels and without hypertension in anamnesis (the average age - 45.88 ± 3.03 years old). Applied methods included general clinical, methods of neuropsychological testing (MMSE, GPCOG, W. Schulte test), standard general clinical and biochemical laboratory methods (blood lipid spectrum, blood glucose, creatinine with GFR, electrolytes), instrumental (12-lead ECG, ambulatory monitoring of blood pressure, echocardiography in B-, D-modes), and statistical methods. Results. Patients with hypertension scored significantly less on the MMSE scale (26.82 ± 1.41 scores vs. 28.89 ± 0.82 scores, p = 0.001) and GPCOG (6.63 ± 1.88 scores vs. 8.35 ± 0.71 scores, p = 0.001) compared with healthy individuals and spent more time on performing Walter Schulte test (46.51 ± 8.59 seconds vs. 36.69 ± 6.77 seconds, p = 0.001). Moderate CI were detected in 36 patients (40.00 %) among the examined hypertensive patients; it means that the total score of MMSE was 24-26 scores (the norm is 27-30 scores). The total score on the MMSE scale was 25.47 ± 0.88 in hypertensive patients with CI and was significantly lower than in hypertensive patients without CI (р = 0.001). Cognitive functions in patients with CI were characterized by poorer indices of memory, counting and executive functions. It should be noted that the revealed changes had more reliable manifestations in male hypertensive patients. In particular, the total score on the MMSE scale was 26.57 ± 1.37, while in female ones it was 27.19 ± 1.41 scores (p = 0.04). CI on the MMSE scale were diagnosed in 43.4 % (n = 23) of male patients and in 35.1 % (n = 13) of female patients. The total score was also higher on the GPCOG scale in female patients - 6.89 ± 1.85 scores vs. 6.45 ± 1.89 scores, p = 0.26. Instead, the time to complete the tasks according to the Walter Schulte tables was longer in male patients - 47.74 ± 8.85 seconds vs. 47.73 ± 7.99 seconds, p = 0.10, respectively. The parameters of counting functions were significantly lower (p = 0.01) in the group of male hypertensive patients compared with female ones. Besides, men had lower indicators of short-term memory and orientation, women reproduced worse verbal material, but the difference was statistically insignificant (p-value more than 0.05). The sum of scores on the MMSE scale conversely correlated with male gender (r = -0.22, p = 0.03). The risk of low values of MMSE indices in male patients with hypertension was 42.00 % higher than in female ones (OR = 1.42 ± 0.32, with 95% CІ [0.18-2.65]). Conclusions. Hypertension is a significant independent risk factor for developing new cases of cognitive impairment. In particular, among the patients with stage 1 and stage 2 hypertension of 2nd-3rd degrees, with moderate and high cardiovascular risk, moderate cognitive impairment was revealed in 36 patients (40,00 %), the revealed changes were more manifested in male hypertensive patients.

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Cognitive Deficits and Clinical Symptoms with Hippocampal Subfields in First-Episode and Never-Treated Patients with Schizophrenia

Cerebral Cortex ◽

10.1093/cercor/bhaa208 ◽

2020 ◽

Vol 31 (1) ◽

pp. 89-96

Author(s):

Mei Hong Xiu ◽

XiaoE Lang ◽

Da Chun Chen ◽

Bo Cao ◽

Thomas R Kosten ◽

...

Keyword(s):

Regression Analysis ◽

Cognitive Deficits ◽

Clinical Symptoms ◽

Molecular Layer ◽

Verbal Learning ◽

Multivariate Regression Analysis ◽

Granule Cell Layer ◽

First Episode ◽

Intracranial Volume ◽

Hippocampal Subfields

Abstract Memory dysfunction and associated hippocampal disturbances play crucial roles in cognitive impairment of schizophrenia. To examine the relationships between cognitive function and the hippocampal subfields (HSs) in first-episode never-treated (FENT) schizophrenia patients, the HSs were segmented in 39 FENT patients and 30 healthy controls using a state-of the-art automated algorithm. We found no significant differences in any HSs between the patients and controls. However, multivariate regression analysis showed that the left cornu ammonis 1 (CA1), left hippocampal tail, left presubiculum, and right molecular layer contributed 40% to the variance of the PANSS negative symptom score. After adjusting for sex, age, education, and intracranial volume, the partial correlation analysis showed that the volumes of left CA1, CA3, CA4, molecular layer, granule cell layer and both left and right subiculum were negatively correlated with the MATRICS consensus cognitive battery (MCCB) Hopkins Verbal Learning Test (HVLT). Multiple regression analysis showed that the left CA1 and CA3 hippocampal abnormalities contributed 66% to the variance of the HVLT. Our results suggest no detectable HS deficits were found in FENT schizophrenia patients. However, the HSs may be involved in the symptoms and cognitive deficits of schizophrenia patients in the early phase of their illness.

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Sex Differences in Cancer Immunotherapy Efficacy, Biomarkers, and Therapeutic Strategy

Molecules ◽

10.3390/molecules24183214 ◽

2019 ◽

Vol 24 (18) ◽

pp. 3214 ◽

Cited By ~ 22

Author(s):

Shixiang Wang ◽

Li An Cowley ◽

Xue-Song Liu

Keyword(s):

Sex Differences ◽

Cancer Immunotherapy ◽

Cancer Patients ◽

Checkpoint Inhibitors ◽

Research Progress ◽

Lung Cancer Patients ◽

Female Patients ◽

Tumor Mutational Burden ◽

Male Patients ◽

Cancer Germline

Sex differences in innate and adaptive immune responses are known, and women generally mount a stronger immune response than men. Cancer immunotherapy, represented by immune checkpoint inhibitors (ICIs), has revolutionized the treatment of cancer, and sex differences in cancer immunotherapy are just starting to be revealed. Here, we summarize recent research progress concerning sex differences in cancer immunotherapy efficacy. On their own, ICIs tend to be more effective in male cancer patients compared with female patients, while ICIs combined with chemotherapy tend to be more effective in female patients than male patients. Male tumors are usually more antigenic than female tumors, and this is reflected by their increased number of tumor mutations and cancer germline antigens. The biomarker tumor mutational burden (TMB), which reflects tumor antigenicity, is more effective at predicting immunotherapy response for female lung cancer patients than for male patients. In this review, we propose different therapeutic strategies for the different sexes: For male cancer patients, the immune environment should be enhanced, whereas for female cancer patients, tumor antigenicity should be enhanced.

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Influence of Depressive Disorder on Epilepsy Patients Life Quality

European Psychiatry ◽

10.1016/s0924-9338(09)70916-2 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

E. Suljic ◽

A. Kucukalic ◽

N. Loncarevic ◽

A. Bravo-Mehmedbasic

Keyword(s):

Depressive Disorder ◽

Depressive Disorders ◽

Life Quality ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Female Patients ◽

Duration Of Illness ◽

Clinical Center ◽

Male Patients ◽

Patients With Epilepsy

Introduction:Interictal depression as a co-morbid disorder can be seen among more than 40% of patients with epilepsy. Sex, epilepsy duration, type of seizures as well as applied antiepileptic drugs can cause development of depression which influence patient's life quality.Goal:To test relation between depressive disorders and patients sex, duration of illness, type of epileptic fits, antiepileptic therapy and life quality.Material and methods:Prospectively, randomly selected, we tested 300 patients with epilepsy, with or without depressive affective disorder at the Outpatient Department for Epilepsies at the Clinical Center Sarajevo. All patients answered Beck and Hamilton depression scale.Results:Baseline is consisded of male patients which made 54 % with the average age of 37.7 years, as well as female patients at average age 32.83 years. Depressive disorder according to the results at the Beck scale was present in 34%, and according to the Hamilton scale in 38.9%. Duration of illnesses longer than 20 years had 56% women with the expressed depressive disorder, compared to the 42% men's with depression (p< 0.01). Partial complex seizures were more often among women (p< 0.05). Carbamazepin as monotherapy was applied for more than a half of the baseline, and combined with carbamazepin significantly more frequently among men's (p< 0.0001), while female patients had significantly more often Lamotrigil.Conclusion:Depressive disorder is significantly more frequent among women with partial complex seizures, earlier epilepsy onset, and significantly more often on Phenobarbital therapy. Presence of depression with epilepsy significantly reduced patient's life quality.

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