Assessment of nerve growth factor levels and clinical indicators for outcome prediction in first-episode schizophrenia

BACKGROUND Increasing evidence suggests that nerve growth factor (NGF) is a potential pathogenic factor for schizophrenia, as NGF levels tend to normalize following psychopathological improvement with antipsychotic treatment. However, how closely NGF changes are associated with treatment outcome remain unclear. This study investigated whether baseline and early changes in serum NGF levels could predict 8-week treatment response in patients with first-episode psychosis (FEP). AIM To investigate whether baseline and early changes in serum NGF levels could predict 8-week treatment response in FEP. METHODS This study was conducted in Yangzhou, Jiangsu Province, China. It was comprised of 78 FEP patients treated with atypical antipsychotics only and 75 sex- and age-matched healthy controls. Illness severity was measured weekly using the Positive and Negative Syndrome Scale. Serum NGF levels were measured at baseline for both groups and at 2, 4, 6, and 8 weeks for FEP patients. RESULTS Baseline serum NGF levels were significantly lower in the FEP group (174.21 ± 83.34 pg/mL) compared with healthy controls (219.21 ± 78.63 pg/mL; t = -3.450, P < 0.001). After antipsychotic treatment, NGF levels in the FEP group significantly increased, reaching 202.45 ± 97.61 pg/mL at week 8 (P = 0.003). In addition, multivariate logistic regression analysis identified baseline NGF [odds ratio (OR) = 1.018, 95% confidence interval (CI): 1.008-1.027], NGF at 2 weeks (OR = 1.016, 95%CI: 1.008-1.024), early NGF changes (OR = 1.088, 95%CI: 1.037-1.143), and early psychopathological improvement (OR = 7.312, 95%CI: 1.552-34.446) as significant predictors of individual treatment response in the FEP group. CONCLUSION Our results indicate that higher baseline NGF levels, NGF at 2 weeks after antipsychotic treatment, early NGF changes, and early psychopathological improvement can predict the response to antipsychotics in FEP patients.