Changes Of Angiogenesis-related Factors In Schizophrenia Before And After Electroconvulsive Therapy

Objective: To compare the difference of angiogenesis-related factors levels—Angiopoietin-2(Ang-2),Basic Fibroblast Growth Factor(bFGF),Matrix metalloproteinase-9(MMP-9),Vascular Endothelial Growth Factor(VEGF)— before and after Modified Electroconvulsive Therapy(MECT),and analyze their correlations with clinical efficacy in patients with schizophrenia,preliminarily to explore the role of angiogenesis-related factors in the onset of schizophrenia and in MECT antipsychotic treatment.Methods: 42 patients(19 males and 23 females)with schizophrenia were diagnosed by at least two psychiatrists in accordance with the International Classification of Diseases and Related Health Problems 10(ICD-10),aged between 18 and 60 years.They could complete the one course of MECT therapy(6-16 times).Clinical data,scale assessment and fasting anterior cubital venous blood were collected one day before MECT and within one week after the end of MECT.Enzyme-linked Immunosorbent Assay(ELISA)was used to detect the concentrations of factors before and after MECT,and the PANSS reduction rate was calculated as the clinical efficacy judgment.The paired sample t test was used to compare the changes in the PANSS score before and after MECT,and the Wilcoxon symbol rank sum test was used to compare the differences in Ang-2,bFGF,MMP-9,and VEGF concentrations beforeand after MECT treatment.Spearman rank correlation analysis was used to analyze the relationship of factors and to analyze their correlations with clinical efficacy.The Mann-Whitney U test was used to analyze the differences of factor levels between categorical variables such as genders.Stepwise multiple linear regression analysis was used to analyze the influencing factors of each factor and facter level changes.Results:1.The level of Ang-2 after MECT was higher than the baseline level of it,and the difference was statistically significant(P<0.001),while the levels of bFGF,MMP-9,and VEGF were not significantly different before and after MECT(P = 0.339,P = 0.694,P = 0.247,P > 0.05).2.Each subscale scores after MECT — Positive Syndrome Scale(PANSS-P),Negative Syndrome Scale(PANSS-N),General psychopathology scale(PANSS-G)and Total score(PANSS-T)—were significantly lower than the baseline subscale scores(t = 10.767,P =0.000;t = 7.537,P<0.001;t = 9.325,P<0.001;t = 12.868,P<0.001),the difference is statistically significant.3.Changes in VEGF level before and after MECT — △VEGF —has a negative correlation with the reduction rate(r =-0.308,P = 0.047).There was no correlation between changes in other factors — △ Ang-2,△ bFGF,△ MMP-9 — and the reduction rate(r =-0.138,P = 0.658;r=-0.037,P = 0.690;r =-0.239,P = 0.672;P> 0.05).4.Ang-2,bFGF,MMP-9,and VEGF levels are pairwise correlated before MECT(P <0.001).Ang-2,bFGF,MMP-9,and VEGF levels are pairwise correlated after MECT(P <0.001).5.There were no significant differences in Ang-2,bFGF,MMP-9,and VEGF levels between different genders,personality,marriage,amily history of mental disorders,history of tobacco and alcohol,treatment efficacy and severity of disease(P> 0.05).6.The course of disease was negatively correlated with the levels of Ang-2(r =-0408,P = 0.007),bFGF(r =-0.421,P = 0.006)and MMP-9before MECT(r =-0.355,P = 0.021).Conclusions:1.Modified Electroconvulsive Therapy has positive effect on schizophrenia.Angiogenesis-related factors may play a certain role in the mechanism of antipsychotic therapy.The changes of angiogenesis-related factors may be involved in the onset of schizophrenia.2.The duration of disease has an effect on the degree of angiogenesis in schizophrenia.Probably the longer the course,the lower the ability of angiogenesis in schizophrenia.