Abstract Background and hypothesis Following the first episode of psychosis, some patients develop poor social and occupational outcomes, while others display a pattern of preserved functioning. Evidence from preclinical, genetic, and biochemical studies suggest a role for high oxidative stress in poor functional outcomes among patients. The measurement of intracortical glutathione (GSH) using magnetic resonance spectroscopy (MRS) enables investigating the relationship between central antioxidant tone and functional outcomes at the time of first-episode psychosis (FEP). We hypothesized that patients with higher central antioxidant tone at first presentation will have better functional outcomes in early stages of illness. Study design We scanned 57 patients with FEP and 30 matched healthy controls and estimated GSH resonance using 7-Tesla MRS. We minimized the confounding effects of illness chronicity, long-term treatment exposure, and metabolic complications by recruiting patients with <2 weeks of lifetime antipsychotic exposure on average and followed up this cohort for the next 1 year to determine functional outcomes. Study results Patients who achieved employment/education or training status (EET) in the first year, had higher GSH at the baseline than healthy controls. Social and occupational functioning assessment scale (SOFAS) scores were also significantly higher in patients with higher GSH levels at the outset, after adjusting for various confounds including baseline SOFAS. Patients who were not in EET did not differ from healthy subjects in their GSH levels. Conclusion Our observations support a key role for the central antioxidant tone in the functional outcomes of early psychosis.

中文翻译：

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首发精神病的中枢氧化应激和早期职业结果：谷胱甘肽的 7 特斯拉磁共振光谱研究

摘要 背景和假设 在第一次精神病发作后，一些患者的社会和职业结果较差，而其他患者则表现出一种保留功能的模式。来自临床前、遗传和生化研究的证据表明，高氧化应激在患者功能不良结果中起作用。使用磁共振波谱 (MRS) 测量皮质内谷胱甘肽 (GSH) 可以研究首发精神病 (FEP) 时中枢抗氧化基调与功能结果之间的关系。我们假设首次就诊时具有较高中枢抗氧化张力的患者在疾病早期会有更好的功能结果。研究设计 我们扫描了 57 名 FEP 患者和 30 名匹配的健康对照，并使用 7-Tesla MRS 估计了 GSH 共振。我们通过招募平均一生抗精神病药物暴露时间小于 2 周的患者来最小化慢性病、长期治疗暴露和代谢并发症的混杂影响，并在接下来的 1 年对该队列进行随访以确定功能结果。研究结果 在第一年获得就业/教育或培训身份 (EET) 的患者的基线 GSH 高于健康对照组。一开始 GSH 水平较高的患者的社会和职业功能评估量表 (SOFAS) 评分也明显较高，在针对包括基线 SOFAS 在内的各种混杂因素进行调整后。未处于 EET 的患者的 GSH 水平与健康受试者没有差异。结论 我们的观察支持中枢抗氧化基调在早期精神病功能结果中的关键作用。