Correlations of serum c-Jun N-terminal kinase expression with cognitive function and prognosis in patients with first-episode schizophrenia

Objective  To investigate the correlations of serum c-Jun N-terminal kinase (JNK) expression with cognitive function and 1-year prognosis after discharge in patients with first-episode schizophrenia.

Methods  A total of 168 patients with first-episode schizophrenia were investigated for clinical data, cognitive function measurement and one-year follow-up after discharge. According to the presence or absence of cognitive impairment, 168 patients were divided into cognitive impairment group (65 cases) and normal cognitive function group (103 cases). Pearson correlation analysis was used to analyze correlation of serum JNK expression and cognitive functionMATRICS Consensus Cognitive Battery (MCCB)score in patients with first-episode schizophrenia. Logistic regression was used to analyze the influencing factors of cognitive dysfunction in first-episode schizophrenics, receiver operating characteristic (ROC) curve was drawn to analyze the predictive efficacy of independent risk factors of cognitive dysfunction in first-episode schizophrenics, and Cox regression analysis was used to analyze the univariate and multivariate prognosis of patients one year after discharge.

Results  The level of JNK expression in the cognitively impaired group was (78.12±9.28) %, which was significantly higher than (59.38±6.17) % in the cognitively normal group, and the difference was statistically significant (t=10.420, P < 0.001). There was a significant negative correlation between MCCB score and JNK expression (r=-0.490, P < 0.01). JNK expression was an independent risk factor for cognitive function impairment in patients with first-episode schizophrenia (OR=3.080; 95%CI, 1.864 to 12.157). The area under the curve (AUC) of serum JNK expression in predicting cognitive impairment was 0.756, the optimal cut-off value was 73.49, the specificity was 0.885, and the sensitivity was 0.913. At 1-year follow-up after discharge, the disease-free survival of patients with high JNK level was shorter than those with low JNK level (P < 0.05). Cox regression analysis showed that age, sleep disorder, depression, anxiety and serum JNK expression level were independent influencing factors of poor prognosis in patients with first-episode schizophrenia after discharge (P < 0.05).

Conclusion  Serum JNK level is correlated with cognitive function and prognosis one year after discharge in patients with first-episode schizophrenia. Clinical staff should closely monitor the serum JNK level of patients.