engleski

Emotional recognition as treatment outcome in first-episode psychosis: association with HSPA1B polymorphisms

Background: Schizophrenia is a complex psychiatric disorder affecting more than 21 million people worldwide. In most cases, it is a long-term illness defined by alternating periods of acute psychotic decompensations and their remission. It usually starts with prodromal symptoms lasting at least six months before first-episode of psychosis (FEP) occurs. According to previous literature, impairments of facial emotional recognition could present a possible trait marker of schizophrenia, as they are present even before the onset of FEP and are connected with worse overall outcome of the illness. Previous reports showed that the polymorphisms of Heat shock proteins (HSPs) gene might be implicated in the development of schizophrenia. However, association studies investigating HSP70 gene polymorphisms in schizophrenia are still limited and include specific populations. Our aim was to investigate the association of HSPA1B polymorphisms with psychopathology and facial emotional recognition as measures for treatment outcome. Methods: We recruited a cohort of patients with FEP in the acute phase of their illness, during their first hospital treatment at the University psychiatric hospital Vrapce and University hospital centre Zagreb. Assessment included genotyping for HSPA1B polymorphisms, Positive and Negative Syndrome Scale (PANSS) for psychopathology and Penn Emotion Recognition Task (ER-40) for facial emotional recognition. In ER-40, patients were shown 40 photos of human faces representing one of the following emotional expressions: happy, sad, fear, angry and neutral. Patients were assessed at baseline and after 18 months of follow- up. Associations of baseline ER-40 scores with HSP1AB genotypes and baseline with follow-up ER-40 scores were done using ANOVA. A test for Hardy–Weinberg equilibrium using Markov chain method was performed using the Genepop software. Significance level was set at p<0.05. Results: Out of 159 patients with FEP that were enrolled in the study, data for 122 patients that took part in the second assessment after 18 months of follow-up were used in the analysis. We did not find any statistically significant associations between psychopathology scores measured with PANSS and HSPA1B polymorphisms. When it comes to emotional recognition assessment, patients with FEP that were carriers of the HSPA1B risk allele (AA) had statistically significant better treatment response measured with the change in the recognition of neutral facial expression (F=4.4902, p=0.0132). Recognition of other four emotions (happiness, sadness, fear, anger) showed no statistically significant associations with HSPA1B polymorphisms. Conclusion: To our knowledge, this is the first study investigating the associations between HSPA1B polymorphisms and facial emotional recognition. Our results only partially confirmed the role of HSPA1B polymorphisms as potential pharmacogenetic marker of treatment response measured with changes in facial emotional recognition and psychopathology. While we found significant association with the recognition of neutral, there were no other statistically significant associations with other emotions nor with the psychopathology scores. These results have to be interpreted carefully, with consideration of relatively small sample size as a study limitation.

HSP ; genotyping ; emotional recognition ; first-episode psychosis ; follow-up

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