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Decrease in cognitive performance and increase of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with
Ilgner Justa Frota1, Alissandra Lima Barbosa de Oliveira2, David Nunes De Lima3
1Neuropsychopharmacology and Translational Psychiatry Laboratory, Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1000 - Rodolfo Teófilo, Fortaleza, CE, Postal Code 60430-275, Brazil. ilgner0@gmail.com.
Background:
We explored the relationship between symptoms, cognitive performance, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) (three markers of inflammation), and antipsychotic dose (in chlorpromazine units) in male and female patients with schizophrenia.
Methods:
We conducted a cross-sectional analysis in patients with schizophrenia of the complete blood count and the results of neuropsychological testing, using the Welch t-test to compare groups and the Pearson test for correlations.
Results:
We found that the NLR and the PLR are higher among women with schizophrenia when compared with men. In women, the NLR and the PLR correlate positively with antipsychotic drug dose and inversely with a working memory test (Direct Digit Span). Higher doses of antipsychotics are associated with worse working and semantic memory and mental flexibility in the women in our sample.
Conclusion:
Higher doses of antipsychotics were associated with worse working and semantic memory and mental flexibility in women with schizophrenia. No such correlations were present in men, suggesting that, in female patients, cognitive performance deteriorates as the antipsychotic dose is increased, a finding that could be mediated by inflammatory mechanisms, given the demonstrated relationship to biomarkers of inflammation - e.g., the NLR and the PLR.
Trial Registration:
NCT03788759 (ClinicalTrials.gov).
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