目的 分析中等强度有氧运动对慢性精神分裂症患者的疗效及神经可塑性指标血清脑源性神经生长因子(brain-derived growth factor,BDNF)及胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)的影响,并分析疗效与神经可塑性指标之间的联系.方法 选取 2021 年 1 月至 2023 年 12 月于温州医科大学附属康宁医院接受治疗的 200 例精神分裂症患者,按随机数字表法分为研究组和对照组,每组 100 例.采用阳性和阴性精神症状评定量表(positive and negative syndrome scale,PANSS)评定患者治疗前后的精神症状,重复性成套神经心理状态测验(repeatable battery for the assessment of neuropsychological status,RBANS)评定患者的认知功能水平,住院精神病患者社会功能评定量表(social functioning in psychosis patient inventory,SSFPI)评估患者的社会功能,同时检测患者外周血中的BDNF、IGF-1 含量.比较治疗前后相关指标差异,并分析相互关系.结果 ①与对照组比较,研究组患者的认知功能(RBANS总分、即刻记忆分、视觉广度分)、社会功能(SSFPI总分、日常生活能力分、动性和交往情况分、社会性活动技能分)及神经可塑性指标(BDNF及IGF-1 差值)均显著改善(P<0.05);②治疗后,患者血清中的IGF-1 差值与认知功能中的视觉广度改善程度呈正相关;同时,BDNF和IGF-1 的差值与社会功能的多项指标(SSFPI总分、日常生活能力、动性和交往情况、社会性活动技能)的改善也呈正相关(P<0.05);③逐步回归分析显示,BDNF和IGF-1 的差值可预测SSFPI总分及各项因子分的改善程度,可解释变异的 37.90%～41.70%.结论 中等强度有氧运动可改善慢性精神分裂症患者的认知功能,主要包括即刻记忆、视觉广度及社会功能,具体机制可能与患者的BDNF、IGF-1 水平升高有关.
The therapeutic efficacy and neuroplasticity effects of moderate-intensity aerobic exercise in patients with chronic schizophrenia
Objective To evaluate the effectiveness of moderate-intensity aerobic exercise in patients with chronic schizophrenia,focusing on its effects on neuroplasticity markers such as serum brain-derived growth factor(BDNF)and insulin-like growth factor-1(IGF-1),and analyze the relationship between therapeutic efficacy and neuroplasticity indicators.Methods A total of 200 schizophrenic patients treated at the Affiliated Kangning Hospital of Wenzhou Medical University from January 2021 to December 2023 were selected and randomly divided into study group and control group,100 patients in each group based on a random number table.The positive and negative syndrome scale(PANSS)was used to assess the patients'psychiatric symptoms before and after treatment.The repeatable battery for the assessment of neuropsychological status(RBANS)was employed to evaluate the patients'cognitive function,while the social functioning in psychosis patient inventory(SSFPI)was used to assess their social function.Additionally,the levels of BDNF and IGF-1 in the patients'peripheral blood were measured.Differences in relevant indicators before and after treatment were compared,and influencing factors were analyzed.Results ①Compared with control group,patients in study group exhibited significant improvements in cognitive function(RBANS total score,immediate memory score,visual span score),social function(SSFPI total score,daily living ability score,kineses and social interaction score,social activity skill score),and neuroplasticity indicators(BDNF and IGF-1 differences)(P<0.05);②After treatment,the IGF-1 difference in patients'serum was positively correlated with the improvement in visual span within cognitive function.Furthermore,the differences in BDNF and IGF-1 were also positively correlated with improvements in multiple indicators of social function,including SSFPI total score,daily living ability,kineses and social interaction,and social activity skills(P<0.05);③Stepwise regression analysis revealed that the differences in BDNF and IGF-1 could predict the degree of improvement in SSFPI total score and various factor scores,accounting for 37.90%to 41.70%of the variation.Conclusion Moderate intensity aerobic exercise can improve cognitive function in patients with chronic schizophrenia,mainly including immediate memory,visual breadth,and social function.The specific mechanism may be related to the elevated levels of BDNF and IGF-1 in patients.
Aerobic exerciseChronic schizophreniaNeuroplasticityCognitive functionSocial function
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