Lower plasma tumor necrosis factor-α is associated with symptomatic remission in patients with schizophrenia.

We investigated the plasma tumor necrosis factor (TNF)-α levels between patients with schizophrenia remission and healthy controls, and the association between the plasma TNF-α levels and cognitive function and social function. This cross-sectional study included 48 patients with schizophrenia who fulfilled the remission criteria and 20 healthy controls. Plasma TNF-α levels were measured using the enzyme-linked immunosorbent assay, and cognitive function was assessed using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J). We measured social function using the Social Functioning Scale (SFS-J). The plasma TNF-α levels were significantly lower in the remission schizophrenia group (31.7 ± 27.4 ng/mL) compared to the heathy control group (55.1 ± 38.5 ng/mL) (P = 0.01). In contrast, no correlation was observed between the plasma levels of TNF-α and all BACS-J scores and all SFS-J scores in either group. This result suggests that plasma TNF-α levels may serve as a clinical biomarker of remission of schizophrenia and that the plasma TNF-α levels bore no association with cognitive function. Thus, TNF-α may have potential as a useful indicator of the therapeutic response in patients with schizophrenia.

Bipolar disorder and Lewy body dementia: case report and literature review.

Depressive episodes with psychotic symptoms are prevalent among the older adults, emphasizing the need to differentiate them from dementia with Lewy bodies (DLB), in which depressive and psychotic symptoms commonly coexist. In contrast, psychotic symptoms occur more frequently in depressive episodes of bipolar disorder (BD) than in major depressive disorder (MDD). Although MDD is a significant risk factor for dementia, studies exploring the relationship between BD and dementia are lacking. This report details the case of a 74-year-old female who experienced severe psychotic depression that led to suicide attempts during a long-term course of young-onset BD. Ultimately, she was diagnosed with DLB based on her neurocognitive symptoms and results of the neuroimaging examination. She had experienced multiple relapses in the past, predominantly characterized by depressive episodes in her old age. Notably, she had never undergone lithium treatment, which is known for its potential efficacy in preventing relapse and dementia. Recent systematic reviews and meta-analyses have suggested that patients with BD have a higher risk of dementia than the general population, and that lithium usage is associated with a reduced risk. Moreover, patients with BD have been suggested to have an elevated risk of developing Parkinson's disease (PD), and the pathophysiological relationship between BD and PD may be attributed to dopamine dysregulation resulting from multiple relapses. Future research is imperative to identify strategies for preventing dementia in patients with BD and to develop interventions for the comorbidities of BD and DLB.

Effects of Exercise on Functional Recovery in Patients with Bipolar Depression: A Study Protocol for a Randomized Controlled Trial.

Treatment of bipolar disorder is prone to prolongation despite various treatments, including medication. The efficacy of exercise treatment (i.e., interventions involving physical exercise and sports intervention) for major depressive disorders has been reported for depressive symptoms, cognitive function, and sleep disturbances. However, its efficacy for bipolar disorder has yet to be established. We designed a randomized, controlled, double-blind clinical trial that includes 100 patients with bipolar disorder aged 20-65 years. This will be a cluster-randomized, two-group trial that will be conducted in ten psychiatric hospitals. The hospitals will be randomly assigned to an exercise intervention + treatment as usual (exercise) group or a placebo exercise intervention (stretching) + treatment as usual (control) group. Patients will be assessed using an extensive battery of clinical tests, physical parameters, sleep status, biological parameters (cytokines, neurotrophic factors), and genetic parameters (DNA and RNA) at baseline after a 6-week intervention period, at 10-week follow-up, and at 6-month follow-up. This innovative study may provide important evidence for the effectiveness of exercise in the treatment of bipolar depression based on clinical, biological, genetic, and physiological markers.