This study aims to explore the objective markers concerning schizophrenia risk and functional outcome from multiple dimensions such as multi-omics including genomics, proteomics, metabolomics, electrophysiology, imaging, psychosocial, and cognition. In summary, based on this trial, the significant outcomes may effectively improve the accuracy of early warning and recognition in patients with schizophrenia, and provide clues for the study of new drug targets.
This trial is a prospective, longitudinal observation clinical trial. In this trial, a total of 300 SZ patients who were never treated with antipsychotic medications or other psychotropics were recruited from out- or in-patients in Tianjin Anding Hospital. Patients received antipsychotic treatment at the discretion of their clinicians. The types of antipsychotics were not restricted. In this longitudinal study, all patients received clinical evaluation scales including the Positive and Negative Syndrome Scale (PANSS), and so on at the main visits (baseline, week8, week12, 1-year, 2-year, 5-year). Importantly, cognitive evaluation using the MATRICS Consensus Cognitive Battery (MCCB) and functional Magnetic Resonance Imaging (fMRI) imaging were collected only at five follow-ups（baseline，week8， 1-year， 2-year， 5-year）. Meanwhile, we also collect related measured factors by collecting a peripheral blood sample and electrophysiological index including Electroencephalogram (EEG) and Functional Near-Infrared Spectroscopy (fNIRS) at multiple time points (baseline, week8, week12, 1-year, 2-year,5-year). 100 healthy subjects were matched to patients in age, gender, race, and education. They completed the same baseline assessment as the patients. what's more, part of the enrolled healthy group will receive an assessment at week8 follow-up.
Study Type
OBSERVATIONAL
Enrollment
384
Tianjin Anding Hospital
Tianjin, China
Changes of psychiatric symptoms
The psychiatric symptoms of schizophrenia were assessed in all enrolled patients using the Positive and Negative Syndrome Scale (PANSS). The PANSS is a 30-item clinician-rated scale yielding a total score ranging from 30 (least symptomatic) to 210 (symptomatic), where higher scores indicate more severe psychopathology. Trained raters administered the PANSS at multiple follow-up visits: baseline, Week 8, Week 12, 1 year, 2 years, and 5 years.
Time frame: Baseline, week8, week12, 1year, 2year, 5year
Changes of cognitive function
All subjects received baseline cognitive evaluation using the MATRICS Consensus Cognitive Battery (MCCB). It involves seven cognitive areas: (1) Speed of Processing Information; (2) Attention and Vigilance Awareness; (3) Working Memory; (4): Verbal Learning; (5) Visual Learning; (6) Reasoning and Problem-Solving; (7) Social Cognition. The MCCB scoring program generates T-scores that are standardized and corrected for age and sex. A higher T score indicates better cognitive function. The cognitive composite is the standardized sum of the seven domains.
Time frame: Baseline, week8, 1year, 2year, 5year
Allelic Frequency of Target Single-Nucleotide Polymorphisms (SNPs)
We will quantify the allelic frequency of pre-specified SNPs using DNA extracted from peripheral blood. Results are reported as the percentage of each allele (%) at each locus.
Time frame: Baseline
Gene-Specific DNA Methylation Level
We will measure DNA methylation at CpG sites within candidate genes using bisulfite pyrosequencing. Results are reported as the percentage (%) of methylated cytosines at each interrogated site.
Time frame: Baseline
Changes of C-reactive protein (CRP) levels
Serum CRP will be quantitatively measured using an enzyme-linked immunosorbent assay. The results will be expressed as the absolute change in CRP concentration (mg/L) between the baseline value and the measured value, with higher values indicating more severe systemic inflammation.
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Time frame: Baseline, week8, week12
Changes of interleukin-1β (IL-1β) levels
Serum IL-1β will be quantitatively measured using an enzyme-linked immunosorbent assay. The results will be expressed as the absolute change in CRP concentration (pg/mL) between the baseline value and the measured value, with higher values indicating more severe systemic inflammation.
Time frame: Baseline, week8, week12
Changes of interleukin-6 (IL-6) levels
Serum IL-6 will be quantitatively measured using an enzyme-linked immunosorbent assay. The results will be expressed as the absolute change in CRP concentration (pg/mL) between the baseline value and the measured value, with higher values indicating more severe systemic inflammation.
Time frame: Baseline, week8, week12
Changes of tumour necrosis factor-α (TNF-α) levels
Serum TNF-α will be quantitatively measured using an enzyme-linked immunosorbent assay. The results will be expressed as the absolute change in CRP concentration (μg/L) between the baseline value and the measured value, with higher values indicating more severe systemic inflammation.
Time frame: Baseline, week8, week12
Resting-State electroencephalography (EEG) Relative Power
Resting-state EEG will be recorded with 32-channel active electrodes at 1 kHz sampling. Relative power in the theta (4-8 Hz) and alpha (8-13 Hz) bands will be calculated using fast Fourier transform.
Time frame: Baseline
Functional near-infrared spectroscopy (fNIRS)
The fNIRS will be used to monitor oxygenated hemoglobin (HbO₂) and deoxygenated hemoglobin (Hb) in the bilateral prefrontal cortex during a working-memory task.
Time frame: Baseline
Resting-state functional magnetic resonance imaging (fMRI)
A single resting-state BOLD-fMRI scan will be acquired at baseline using a 3 T scanner (TR=2000 ms, TE=30 ms, voxel size=3 mm isotropic). Functional connectivity between the dorsolateral prefrontal cortex (seed) and the whole brain will be computed as Fisher-z transformed correlation coefficients. The outcome is the baseline connectivity strength expressed as z-score; higher positive z-scores indicate stronger connectivity.
Time frame: Baseline