Journal Article

DZNE-2026-00952

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Effects of quetiapine on cognitive functioning in schizophrenia: evidence for the remyelination hypothesis?

Ising, M. ; Raabe, F. ; Fischer, L. ; Schmitt, A. ; Sämann, P. ; Adorjan, K. ; Anghelescu, I.-G. ; Arolt, V. ; Baune, B. T. ; Dannlowski, U. ; Dietrich, D. E. ; Fallgatter, A.Extern* ; Figge, C. ; Heilbronner, M. ; Jäger, M. ; Juckel, G. ; Konrad, C. ; Navarro-Flores, A. ; Kohshour, M. O. ; Reich-Erkelenz, D. ; Reimer, J. ; Reininghaus, E. Z. ; Schmauß, M. ; Schulte, E. C. ; Senner, F. ; Spitzer, C. ; Wiltfang, J.DZNE* ; Zimmermann, J. ; Schulze, T. G. ; Heilbronner, U. ; Budde, M. ; Papiol, S. ; Falkai, P.

2026
Steinkopff Darmstadt

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Please use a persistent id in citations: doi:10.1007/s00406-026-02309-8

Abstract: Postmortem findings, neuroimaging data, and in-vitro models suggest a decrease in number and density of oligodendrocytes is driving cognitive deficits in schizophrenia (SCZ). Second-generation antipsychotics are discussed to improve oligodendrocyte dysfunction with most conclusive evidence available for quetiapine (QET). We postulate that sustained QET treatment leads to cognitive improvement in SCZ, particularly, in tests with high demands for working memory function. We further hypothesize that these effects are moderated by polygenic factors associated with hippocampus-related brain volumes, general white matter integrity, and/or oligodendroglia-related SCZ risk. Using data of the prospective PsyCourse study, we identified 166 patients with SCZ spectrum disorder receiving QET at one or two consecutive visits plus 166 matched patients without QET. Polygenic scores were calculated for subcortical brain volumes, measures of white matter integrity, and for cell type-specific genetic SCZ risks. QET treatment was consistently associated with improved cognitive function independent of time, specifically, in tests with high, but not with low to medium working memory load. Polygenic analyses did not reveal significant moderation effects. In contrary, low genetic SCZ risk specific for genes related to human oligodendrocyte function was associated with higher cognitive performance independent from QET. While we observed improved cognitive performance under QET in high working memory tests, we did not find evidence that polygenic factors associated with hippocampus-related brain volumes, white matter integrity, or oligodendroglia-related SCZ risk moderate this association. Thus, our tentative findings do not provide evidence for the hypothesis that polygenic estimates of hippocampal remyelination capacities influence the association between QET and cognitive performance in SCZ.

Keyword(s): Humans (MeSH) ; Schizophrenia: drug therapy (MeSH) ; Schizophrenia: complications (MeSH) ; Schizophrenia: pathology (MeSH) ; Schizophrenia: genetics (MeSH) ; Schizophrenia: physiopathology (MeSH) ; Quetiapine Fumarate: pharmacology (MeSH) ; Quetiapine Fumarate: administration & dosage (MeSH) ; Male (MeSH) ; Female (MeSH) ; Antipsychotic Agents: pharmacology (MeSH) ; Antipsychotic Agents: administration & dosage (MeSH) ; Adult (MeSH) ; Middle Aged (MeSH) ; Memory, Short-Term: drug effects (MeSH) ; Remyelination: drug effects (MeSH) ; White Matter: pathology (MeSH) ; White Matter: drug effects (MeSH) ; White Matter: diagnostic imaging (MeSH) ; Cognitive Dysfunction: drug therapy (MeSH) ; Cognitive Dysfunction: etiology (MeSH) ; Cognitive Dysfunction: physiopathology (MeSH) ; Oligodendroglia: drug effects (MeSH) ; Oligodendroglia: pathology (MeSH) ; Cognitive Enhancement (MeSH) ; Magnetic Resonance Imaging (MeSH) ; Prospective Studies (MeSH) ; Genetic Risk Score (MeSH) ; Cell-type specific polygenic risk ; Subcortical brain volumes ; White matter integrity ; Working memory ; Quetiapine Fumarate ; Antipsychotic Agents

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Contributing Institute(s):

1. Molecular biomarkers for predictive diagnostics of neurodegenerative diseases (AG Wiltfang)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Springer ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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