Basic information
Investigator: MUDr. Radana Měrková
Main recipient: National Institute of Mental Health (NIMH)
Research period: 1/8/2023 – 31/7/2025
Total budget: 99,000 CZK
Supported by: Other
Annotation
Schizophrenia is a serious neurodevelopmental disorder with a global prevalence of around 1%, typically developing in adolescence or early adulthood. Most medical care is focused on patients with chronic illness, while early psychotic episodes have received only marginal attention. However, early treatment of patients experiencing their first psychotic episode can prevent further neurotoxic damage to the brain, potentially leading to an improved overall outcome and, most importantly, a better quality of life for patients. This project is part of a large longitudinal study by the National Institute of Mental Health, titled the Early-stage Schizophrenia Outcome Study (ESO), focusing on first episodes in patients with psychotic disorders. In recent years, sleep has emerged as a key area in the pathophysiology of schizophrenia. Sleep disturbances are a major prodromal and early warning sign of this disorder. Schizophrenia is associated with changes in both the macrostructure and microstructure of sleep. One of the most significant changes that affects the clinical state of the patient is the reduction of slow-wave sleep (SWS). The recently described glymphatic system, responsible for removing metabolites from the central nervous system (CNS), is active during SWS. Due to the reduced presence of SWS, patients with schizophrenia may experience the accumulation of toxic substances in the brain, leading to subsequent damage. Schizophrenia is primarily associated with significant structural changes in the CNS during the first few years after the onset of the disease. In the proposed project, video-polysomnography will be used to objectively assess the macro- and microstructure of sleep, and magnetic resonance imaging will be employed to evaluate the function of the glymphatic system. The study will include 25 patients at the time of their first psychotic episode and 25 healthy controls matched for age and gender. The main outcome of the project will be to determine whether the structure of sleep at the time of the first clinical manifestation of the disease correlates with the function of the glymphatic system. This finding could lead to a new direction in schizophrenia treatment.