Importance of the dysregulation of the kynurenine pathway on cognition in schizophrenia: a systematic review of clinical studies

Schizophrenia is a chronic psychotic disease burdened by cognitive deficits which hamper daily functioning causing disability and costs for society. Biological determinants underlying cognitive impairment are only partially understood and there are no convincing pharmacological targets able to impro...

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Veröffentlicht in:European archives of psychiatry and clinical neuroscience 2023-09, Vol.273 (6), p.1317-1328
Hauptverfasser: Sapienza, Jacopo, Spangaro, Marco, Guillemin, Gilles J., Comai, Stefano, Bosia, Marta
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container_issue 6
container_start_page 1317
container_title European archives of psychiatry and clinical neuroscience
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creator Sapienza, Jacopo
Spangaro, Marco
Guillemin, Gilles J.
Comai, Stefano
Bosia, Marta
description Schizophrenia is a chronic psychotic disease burdened by cognitive deficits which hamper daily functioning causing disability and costs for society. Biological determinants underlying cognitive impairment are only partially understood and there are no convincing pharmacological targets able to improve cognitive outcome. Mounting evidence has shown the involvement of the kynurenine pathway in the pathophysiology of schizophrenia, also concerning cognitive symptoms. Therefore, the action of specific metabolites of kynurenine could affects cognition in schizophrenia. To evaluate the impact of the metabolites of kynurenine pathway on cognitive functions in schizophrenia spectrum disorders, with a focus on the modulating role of gender, to identify predictors of cognitive functioning and hypothetical pharmacological targets able to resize disability by improving cognition, thus functioning and quality of life. A systematic review was performed in PubMed/MEDLINE and Embase according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. All studies measuring the direct impact of kynurenine metabolites on cognitive performances in living individuals with schizophrenia spectrum disorders were included in the review. Six studies were included. The activation of the kynurenine pathway resulted associated with greater cognitive deficits in patients with schizophrenia and both elevations and reduction of metabolites seemed able to affect cognitive outcome. No modulating role of sex emerged. This systematic review provides evidence that the activation of the kynurenine pathway affects cognition in patients with schizophrenia and highlights this pathway as a possible future target for developing novel drugs toward this still unmet clinical need. However, evidence is still limited and future studies are needed to further clarify the relationship between kynurenine pathway and cognition in schizophrenia.
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subjects Amino acids
Clinical trials
Cognition & reasoning
Cognitive ability
Invited Review
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Memory
Mental disorders
Metabolites
Neurophysiology
Neurosciences
Psychiatry
Quality of life
Schizophrenia
Systematic review
title Importance of the dysregulation of the kynurenine pathway on cognition in schizophrenia: a systematic review of clinical studies
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