To investigate peripheral metabolic alterations in patients with schizophrenia using a two-stage metabolomic workflow of untargeted analysis and targeted re-analysis,explore the associated metabolic pathways, identify potential peripheral metabolic biomarkers, and elucidate the underlying metabolic dysregulation mechanisms.
Plasma samples were collected from 24 schizophrenia patients and 10 healthy controls for non-derivatized targeted metabolomics analysis. Differential metabolites were identified and visualized using box plots. Hierarchical clustering analysis was performed to evaluate expression pattern differences across samples, and KEGG pathway enrichment analysis was conducted to map the involved biological pathways. False discovery rate (FDR) correction was applied for multiple comparisons.
Among the 21 quantified metabolites, four exhibited significant differences after FDR correction (FDR < 0.05). α-Ketoglutarate was significantly elevated in the patient group, whereas succinic acid, tryptamine, and amino butyric acid were significantly reduced. The opposite variations of α-ketoglutarate and succinic acid suggest a peripheral TCA cycle metabolic bottleneck. Hierarchical clustering based on these four metabolites effectively distinguished patients from healthy controls. KEGG enrichment demonstrated that these metabolites converged predominantly on amino acid metabolism, energy metabolism, and most notably the GABAergic synapse pathway, offering peripheral evidence supporting the core position of GABAergic dysfunction in schizophrenia.
Schizophrenia patients display significant peripheral metabolic disturbances characterized by dysregulated amino acid metabolism, synaptic transmission abnormalities, and energy metabolism imbalance. The four-metabolite panel (α-ketoglutarate, succinic acid, tryptamine, and amino butyric acid) may provide experimental basis for further mechanistic research and therapeutic development.
Bing Han, Yu Guo, Baie Feng et al.· Frontiers in Psychiatry· 0 citations
Objective Electroconvulsive therapy (ECT) is a core treatment modality for severe mental disorders, and the choice of anesthetic induction agent directly impacts seizure quality and therapeutic outcomes. This study aimed to compare the effects of remimazolam versus propofol on seizure adequacy during ECT. Methods This retrospective secondary analysis was conducted using data from a prospective observational cohort. A total of 859 ECT sessions from 114 patients were included. The primary outcome was the rate of adequate seizure, defined as an electroencephalographic (EEG) ictal duration of ≥15 seconds. Secondary outcomes included EEG seizure duration, post-ictal suppression index (PSI), maximum sustained power (MSP), and average seizure energy index (ASEI). Stabilized inverse probability of treatment weighting was employed to balance baseline covariates between groups, with balance assessed by standardized mean differences. Generalized linear mixed models were used to compare intergroup differences, accounting for random effects at the patient level. Subgroup analysis, E-value calculation, and propensity score matching (PSM) at 1:1 and 1:2 ratios were performed as sensitivity analyses to assess the robustness of the results. Results A total of 859 ECT sessions were included, with 179 in the remimazolam group and 680 in the propofol group. Baseline characteristics were well-balanced between groups after weighting. The remimazolam group exhibited a significantly higher rate of adequate seizures compared with the propofol group (adjusted odds ratio: 12.054, 95% confidence interval: 5.758–25.233, P < 0.001), along with prolonged EEG seizure duration and elevated MSP. No significant between-group differences were observed in PSI or ASEI. The results of all sensitivity analyses were consistent with those of the primary analysis. Conclusion Remimazolam was associated with a higher rate of EEG seizure adequacy and longer EEG seizure duration; however, whether this electrophysiological advantage translates into better clinical outcomes remains to be investigated in prospective studies.
Haibo Song, Xingxing Yin, Feng Wang et al.· Frontiers in Psychiatry· 0 citations
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