Decreased levels of nervonic acid in the erythrocyte membrane can predict the risk of psychosis

The use of biomarkers to predict schizophrenia (or other psychotic disorders) is an important direction of current psychiatric research and is important for the development of early and even preventive treatment strategies.

Neuronal membranes are mainly composed of phospholipids. Arachidonic acid (AA, C20: 4n-6), docosahexaenoic acid (DHA, C22: 6n-3) and nervonic acid (NA, C24: 1n-9) are the most important fatty acids in the nervous system. They are not only structural substances in the central nervous system, AA is also a prostaglandin, prostacyclin, thromboxane and leukotriene precursors in eicosanoids, which have complex effects in controlling immune and inflammatory responses. And is the messenger of the central nervous system; DHA is the most abundant polyunsaturated fatty acid in the brain, is the main component of the excitable membrane; and NA is the main component of the sphingolipid in the myelin membrane. Studies have shown that DHA, NA and AA levels are reduced in patients with schizophrenia compared to healthy controls.

The study sample included 81 individuals with ultra-high-risk psychosis (based on pre-existing criteria) (mean age = 16.4 years, sd = 2.1 years), and the samples were randomized to omega-3 fatty acids. In the controlled trial, the final indicator of the trial was converted to psychosis. The positive and negative symptom scales (PANSS, that is, score of 4 on hallucinations, 4 on delusions or 5 on conceptual disorganization) were defined. The exit criteria mark the threshold for starting treatment with antipsychotics (associated with positive symptoms). Secondary outcome indicators include PANSS (positive, negative, and general subscales) and the Global Assessment of Functioning. Capillary gas chromatography was used to determine fasting erythrocyte membrane fatty acid levels. The results showed that NA was negatively correlated with negative symptoms (Pearson correlation, r = 0.474, P < 0.0001) and general symptoms (r = 0.408, P < 0.0001) and positively correlated with global functioning (r = 0.331, P = 0.003).

Reference：GP Amminger et al. 2012. Decreased nervonic acid levels in erythrocyte membranees predict psychosis in help-seeking ultra-high-risk individuals. Molecular Psychiatry, 17: 1150–1152.