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Can Levels of Essential Fatty Acids Predict Risk for Psychosis?

Schizophrenic womanRecent studies demonstrate a critical role of fatty acids in the structure and function of the developing nervous system. Essential fatty acids (EFAs), omega-3s in particular, are an absolute requirement for a healthy brain, as they are involved in the composition of neural membranes and in the production of neurotransmitters. Their role in psychiatric and cognitive function is also being intensely explored as low levels of omega-3s, such as docosahexaenoic (DHA), eicosapentaenoic, and docosapentaenoic acid, have been correlated with a variety of psychological maladies, including impaired memory and abstract thinking, slow mental processing, and psychotic disorders.

A study published in Schizophrenia Research investigated the associations among erythrocyte membrane (whose composition closely reflects that of neuronal membranes and therefore provides an easily accessible indicator of brain phospholipids) fatty acids and cognitive functioning in patients at ultra-high risk for psychosis.

The subjects of the study were divided into 3 groups (intact, borderline, and impaired) based on the cognitive factor assessed with the PANSS Test, which provides a measure of cognitive symptoms and impairment.

The researchers found significantly higher levels of two omega-9 fatty acids, eicosenoic and erucic acids, in the cognitively impaired group than in the cognitively intact one. On the other hand, levels of DHA were significantly lower in the cognitively impaired.

At a later stage, they investigated whether the abnormalities in the levels of membrane fatty acids that correlated with the cognitive measures were also related to intracranial area (ICA), a reliable estimate of intracranial volume. ICA measurements were obtained from MRI images of whole brain aligned to anterior – posterior commissure and all area and volume image analyses were carried out using Analyze software. The results showed a negative association between ICA and higher membrane levels of eicosenoic acid, suggesting a relationship between eicosenoic acid metabolism and neurodevelopmental abnormalities. Eicosenoic acid has recently been reported as one of the five biomarkers for diagnosis of schizophrenia: in fact, elevated levels of this fatty acid (which is one of the metabolites produced from the degradation of fatty acids) might indicate increased fatty acids catabolism, an alternative energy source in the brain when mitochondrial glycolytic energy generation is insufficient.

No biochemical markers of cognitive deficits in individuals at ultra-high risk or in the very early stages of schizophrenia had been investigated before this study. These findings imply that fatty acid deficits may be present before illness onset and may be associated with the development of cognitive impairment in the early stages of schizophrenia. Levels of fatty acids, therefore, provide a potential biological risk marker of schizophrenia which may be used to target early preventive intervention.

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