Factors related to neuroplasticity in acute period in schizophrenia

Introduction: Many hypotheses have been put forward regarding the etiology of schizophrenia and one of them is neurodegeneration. Neurodegeneration occurs in many different ways. Loss of neuroplasticity is one of the most important causes of neurodegenation. Different mechanisms and biochemical mediators that provide neuroplasticity in the brain have been described. Among them, the best known are neurotrophic factors in BDNF, GDNF, and NGF (Brain-induced Neurotrophic Factor (BDNF), Glia-Induced Neurotrophic Factor (GDNF) and Neuron Growth Factor (NGF) are most researched in schizophrenia. There are neurotrophic factors, among all these markers, Klotho is a new marker and there is only one study in patients with schizophrenia. In studies conducted with schizophrenia patients, significant neurocognitive dysfunctions were found. While the prevalence of delusions and hallucinations decrease in the remission period in patients with schizophrenia, the absence of cognitive disorders also indicates the prevalence of cognitive disorders in schizophrenia Although there are studies examining the relationship between cognitive functions and neurotrophic factors, there is no study that combines 3 biomarkers and Klotho. Aim: The aim of this study is to compare the healthy control group with the cognitive test results performed on the 1st and 20th day of patients with acute psychotic exacerbation with schizophrenia and admission to the service, to investigate the effects of cognitive functions on disease severity, symptoms, and functionality, blood BDNF, GDNF, NGF and Klotho levels in patients to determine the effects on cognitive capacity and compare with healthy controls. Materials and Methods: The study included 42 male schizophrenia patients with schizophrenia acute exacerbation in Sakarya University Training and Research Hospital Psychiatry Male ward and 42 healthy controls matched in terms of age, gender and education level. Sociodemographic data form, Stroop Test Wechsler Memory Scale (WMS V) - Visual Memory test and applied to all participants. The diagnosis of the patients was first made by DSM V-oriented clinical interview The first day of hospitalization (within the first 3 days to wait for compliance with the tests if necessary) Short Psychiatric Evaluation Scale (BPRS), Positive and Negative in the clinical evaluation to evaluate the symptoms and cognitive functions simultaneously. Symptom Scale (PANSS), Clinical Global Impression Scale (CGI), General Evaluation of Functionality Scale were applied. Patients' clinical scales and cognitive tests were repeated on Day 20. In this process, patients will continue their usual treatment. On the 1st and 20th days, 10 ml venous blood was collected from the patient group before filling the scale and analyzed by ELISA method. In the analysis of the data, the percentage distributions of the variables were taken, the centrality and prevalence criteria (mean, standard deviation) for continuous variables were calculated, the relationships between dependent and independent variables were evaluated using chi-square, student'st test, pearson correlation test. Results: When the sociodemographic data of the patient and healthy control group were examined, no significant difference was found in terms of age, education level, height, weight and BMI of the patient and healthy control group. A significant difference was found between stroop and Weschler Visual Memory test between patient and healthy controls. The patient group showed lower performance in neurocognitive tets than the control group. A correlation was found between PANSS overall, PANSS total, BPRS and IGD scale scores and stroop test. Stroop test performance increased as disease symptoms decreased, functionality increased. Clinical scale data with neuroplasticity markers were evaluated separately for Day 1 and Day 20. No correlation was detected in the correlation analysis. When the 1st and 20th day neuroplasticity biomarkers were compared, the 20th day BDNF levels were statistically higher than the 1st day BDNF levels. When the neuroplasticity biomarkers of the healthy control group were compared with the 1st and 20th day of the patients, all biomarker levels of the healthy control group were statistically higher than the patient group. When comparing neuroplasticity markers and neurocognitive tests in the healthy control group, the time to read the colored words and the time to say the color of the colored words in the stroop test BDNF; GDNF was positively correlated with NGF and Klotho. Reading times increased as the levels of neuroplasticity marker increased. In the stroop test, a positive correlation was found between the number of false reading of the colored words and the GDNF. When the GDNF level increased, the number of false readings increased. When the neuroplasticity markers and the Weschler visual memory test were compared in the healthy control group, the 1st and 40th minute test scores showed a negative correlation with the GDNF levels. BDNF, GDNF, NGF and Klotho levels in all groups showed a positive correlation with each other Conclusion: BDNF, GDNF and NGF neuroplasticity are also thought to be important neurotrophic factors. Klotho is a newly studied biomarker in this field, and there is no previous study examining its relationship with cognitive functions. In our study, BDNF, GDNF, NGF and Klotho levels were found to be related to cognitive functions in healthy controls, and our study is the first study to investigate Klotho's relationship with cognitive functions. Keywords: BDNF, Cognitive functions, GDNF, Klotho, NGF, Schizophrenia