Plasma H2S levels rise with cognitive gains in schizophrenia patients on atypical antipsychotics
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Key Takeaway
Note association between rising plasma H2S and cognitive gains in schizophrenia, but evidence is observational.
This prospective observational study followed 25 schizophrenia patients with acute exacerbation and 28 healthy controls over two months. Patients received atypical antipsychotic treatment, while controls provided baseline comparisons. The primary outcome was cognitive function, with secondary measures of plasma hydrogen sulfide (H2S) levels and psychopathological symptoms.
At baseline, plasma H2S levels were significantly lower in schizophrenia patients compared to controls (p < 0.05). After two months of treatment, patients showed significant improvements across multiple cognitive domains including processing speed, working memory, visuospatial memory, attention, and executive function (all p < 0.01). Plasma H2S levels increased significantly from 0.712 ± 0.023 µmol/L to 0.918 ± 0.036 µmol/L (t = 6.807, p < 0.001).
The increase in H2S levels correlated positively with improvements in working memory (r = 0.291, p = 0.005) and visuospatial memory (r = 0.227, p = 0.016). Safety and tolerability data were not reported. The study had several limitations including small sample size, lack of a placebo or active comparator group, and the observational nature that prevents establishing causality.
For clinical practice, these findings suggest plasma H2S may serve as a potential biomarker associated with cognitive response to antipsychotic treatment. However, the evidence remains preliminary due to the small observational study design. Further research is needed to determine whether H2S modulation has therapeutic potential or clinical utility in schizophrenia management.
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View Original Abstract ↓
BackgroundHydrogen sulfide (H₂S) acts as a neuromodulator in the brain and is shown to be associated with cognitive impairments in schizophrenia. Atypical antipsychotics can provide cognitive benefits for schizophrenia patients. This prospective observational study aims to investigate whether H2S signaling is involved in the cognitive improvement effects of atypical antipsychotics in patients with schizophrenia.MethodsA total of 25 schizophrenia patients with acute exacerbation who completed follow-up and 28 healthy controls were included in this study. Psychopathological symptoms and cognitive function were assessed using the Positive and Negative Syndrome Scale (PANSS) and a neuropsychological test battery, respectively. Plasma H2S levels were determined using high-performance liquid chromatography (HPLC). ResultsWe found that compared with normal controls, schizophrenia patients exhibited poorer cognitive function and lower plasma H2S levels at baseline (p < 0.05). After two months of atypical antipsychotic treatment, the patients showed significant improvements in processing speed, working memory, visuospatial memory, attention, and executive function (all p < 0.01). At the same time, plasma H2S levels in patients after treatment were significantly elevated compared to baseline (0.918 ± 0.036 vs. 0.712 ± 0.023 µmol/L; t = 6.807, p < 0.001). Correlation analysis revealed that the increase in H2S was significantly associated with improvements in working memory (r = 0.291, p = 0.005) and visuospatial memory (r = 0.227, p = 0.016). ConclusionOur findings demonstrated that cognitive improvement in patients with schizophrenia after treatment with atypical antipsychotics is correlated with an increase of plasma H₂S levels, suggesting that H2S signaling is involved in the pathophysiological process of cognitive impairment in schizophrenia.
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