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Objective: To test the hypothesis that genetic variations of cannabinoid receptors contribute to the pathophysiology of cognitive deficits in schizophrenia. Methods: In this genetic association case-control study, cannabinoid receptor polymorphisms CNR1 rs12720071 and CNR2 rs2229579 were tested for association with neurocognitive performance in 69 patients with schizophrenia and 45 healthy controls. Neurocognition was assessed by the Brief Assessment of Cognition in Schizophrenia (BACS). Results: We found a consistent association between CNR1 rs12720071 polymorphism and the cognitive performance of patients in several cognitive domains. Patients with C/C polymorphism presented significantly worse performance in motor speed, verbal fluency, attention/processing speed and reasoning/problem solving. Conclusion: Although limited, our data support the hypothesis that CNR1 variations may be associated with the pathogenesis of cognitive deficits of schizophrenia.

Objective: To analyze the correlation between quality of life, symptoms, and cognition assessed by the interview-based Schizophrenia Cognition Rating Scale (SCoRS). Methods: Seventy-nine outpatients diagnosed with schizophrenia were evaluated with the Quality of Life Scale – Brazilian version (QLS-BR), the SCoRS, and symptoms scales (Positive and Negative Syndrome Scale [PANSS]). After determining the potential explanatory variables using Spearman’s correlation and Student’s t test results, we ran simple, multivariate, and decision-tree regression analyses to assess the impact of SCoRS and PANSS ratings on mean overall quality of life. Results: Cognitive deficits and negative symptoms were the best predictors of quality of life. A low degree of negative symptoms (PANSS negative < 11) was a strong predictor of better quality of life (QLS ∼ 75), regardless of SCoRS rating. Among participants with more severe negative symptoms, elevated cognitive impairment (interviewer SCoRS ∼ 44) was a predictor of worse quality of life (QLS ∼ 44). Conclusions: Cognitive impairment determined by interview-based assessment seems to be a strong predictor of quality of life in subjects with severe negative symptoms. These results support the usefulness of SCoRS for cognitive assessment that is relevant to the everyday life of patients with schizophrenia.

A etiopatogênese da esquizofrenia é complexa e envolve a interação entre fatores genéticos e ambientais. Alterações no sistema imune vêm sendo apontadas como possíveis participantes na fisiopatologia da esquizofrenia. Neste artigo, apresentamos uma revisão narrativa sobre as alterações imunes na fisiopatologia da esquizofrenia e o potencial de moléculas e/ou mecanismos do sistema imune serem biomarcadores e/ou alvos terapêuticos. Enquanto alguns estudos observam maior participação de citocinas da resposta imune do tipo células T auxiliares (Th1), interferon-gama (IFN-γ), interleucina 2 (IL-2) e fator de necrose tumoral-alfa (TNF-α), outros observam maior participação das citocinas IL-4, IL-6 e IL-10, pertencentes à reposta imune tipo Th2. A infecção pelo protozoário Toxoplasma gondii tem sido apontada como fator de risco para esquizofrenia, e uma possível explicação seria o desvio no metabolismo do triptofano, com consequente aumento de quinureninas, causado pela resposta inflamatória frente à presença do parasita. Ensaios clínicos têm sido realizados utilizando anti-inflamatórios como adjuvantes ao tratamento antipsicótico. Resultados promissores, como redução da sintomatologia negativa e melhora cognitiva, foram observados. O uso de antiinflamatórios com consequente melhora clínica reforçam a ideia da participação de componentes imunes/inflamatórios na fisiopatologia da esquizofrenia.

Historically, measures of everyday functioning have focused exclusively on real-world performance. Despite the unquestionable value of “real-world functioning”, it has become clear that instruments for its assessment might not be as accurate as desirable. Functional capacity is a domain of everyday functioning that can be assessed through performance-based measures. In the last decade, functional capacity has become a cornerstone for the assessment of everyday functioning, since, alongside measures of real-world functioning, it provides a much more comprehensive picture of functional outcomes than any measurement alone. Functional capacity is more stable and less vulnerable to influence from environmental factors than other domains, and its correlation with cognitive functions has encouraged the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) project to suggest that a performance-based measure of functional capacity be included as a co-primary assessment of cognition in clinical trials. Functional capacity assessment instruments may be also useful in the evaluation of remission in schizophrenia. Validation of these instruments in different countries is desirable, and should always include cross-cultural adaptation; within large countries, adjustment for regional variations should be considered.

OBJECTIVE: The Rey Auditory-Verbal Learning Test is a widely recognized test in neuropsychological literature to evaluate learning and memory. This paper presents the performance of six age groups of Brazilian elderly on the Rey Auditory-Verbal Learning Test. METHOD: A version of the test was developed with a list of high-frequency one-syllable and two-syllable concrete Portuguese substantives. Two hundred and twenty-three subjects of both genders were allocated to 6 age groups (60-64, 65-69; 70-74; 75-79; 80-84 and 85-89 years old) and tested with the Rey Auditory-Verbal Learning Test. RESULTS: Educational level and age had a positive and a negative correlation, respectively, with performance on the Rey Auditory-Verbal Learning Test. Women performed significantly better than men. Our results were similar to those found for the Rey Auditory-Verbal Learning Test English version, across similar age ranges. CONCLUSION: Our results suggest that the Brazilian Portuguese Rey Auditory-Verbal Learning Test adaptation was adequate and applicable for evaluating the memory capacity of Brazilian subjects, across similar age and educational levels. OBJETIVO: O teste de aprendizagem auditivo-verbal de Rey é um teste mundialmente reconhecido na literatura neuropsicológica que avalia aprendizagem e memória. Este trabalho apresenta a performance de seis grupos de idosos brasileiros (agrupados em faixas etárias distintas) no teste de aprendizagem auditivo-verbal de Rey. MÉTODO: A versão utilizada do teste foi desenvolvida com uma lista de substantivos concretos com uma ou duas sílabas muito freqüentes na língua portuguesa falada no Brasil. Duzentos e vinte e três sujeitos de ambos os sexos foram alocados em seis grupos de acordo com a idade (60-64, 65-69; 70-74; 75-79; 80-84 e 85-89 anos) e submetidos ao teste de aprendizagem auditivo-verbal de Rey. RESULTADOS: O nível educacional e a idade tiveram correlação positiva e negativa, respectivamente, com a performance no teste de aprendizagem auditivo-verbal de Rey. Mulheres desempenharam o teste significativamente melhor que os homens. Nossos resultados são semelhantes aos encontrados na versão inglesa do teste de aprendizagem auditivo-verbal de Rey para sujeitos com idade semelhante. CONCLUSÃO: Nossos resultados sugerem que a adaptação brasileira do teste de aprendizagem auditivo-verbal de Rey é adequada e aplicável para avaliação da memória em sujeitos brasileiros de mesma idade e nível educacional.