A Comparative Study Of Serum Level Of TNF-??IL-2 And Cognitive Function Before And After Treatment In Patients With Initially-onset Obsessive-compulsive Disorder

ObjectivesTo explore the cognitive function and serum level of tumor necrosis factor alpha(TNF-?)and interleukin-2(IL-2)in patients with initially-onset obsessive-compulsive disorder(OCD),and observe the changes after drug treatment,this paper aims to provide theoretical basis for clinical diagnosis and treatment of obsessive-compulsive disorder.MethodsTo adopt case-control method,54 local patients diagnosed with obsessivecompulsive disorder based on Diagnostic and Statistical Manual of Mental DisordersFourth Edition(obsessive-compulsive disorder group),were selected and treated with sertraline,meanwhile,54 volunteers were selected as Healthy controls,who matched with patients in age,sex and years of education of patients.The Yale-Brown obsessive-compulsive disorder scale(Y-BOCS)and 8 neuropsychological tests in complete sets of MATRICS Consensus Cognitive Battery neuropsychological tests were adopted.They are:(1)Trail Making A Test;(2)Symbol Coding;(3)Hopking Verbal Learning Test-Revised;(4)Wechsler Memory Scale-III spatial span;(5)Neuropsychological Assessment Battery:Mazes;(6)Brief-Visuospatial Visuospatial Memory Test-Revised;(7)Category fluency:Animal Naming;(8)Mayer-Salovey-Caruso Emotional Intelligence Test:Emotion Management part were used to evaluate cognitive function,the Y-BOCS were used to evaluate symptoms of OCD and apply ELISA to measure serum level of TNF-? and IL-2.The severity of OCD symptoms,cognitive function and serum level of TNF-? and IL-2 were assessed in the same way on 21 patients after drug treatment for 12 weeks to make a comparative study before and after treatment.In the SPSS 17.0 statistical software,The data was processed by using T-test,Chi-square test and correlation analysis.Results1.General clinical data comparisonThere was no evident difference of 54 patients with OCD and 54 healthy controls between gender(?2=0.04,P=0.84),age(t=-0.13,P=0.89)and years of education(t=-1.10,P=0.27).2.Comparison of serum level of TNF-?,IL-2 and cognitive function between OCD group and healthy controls2.1 The serum level of TNF-?(393.64±49.27pg/ml)and IL-2(428.59±97.33pg/ml)in the patients with OCD was higher than that in healthy controls(292.21±60.03pg/ml,304.27±63.27pg/ml),and the difference was significant(P<0.01).2.2 The ability of information processing speed(32.63±9.52),visuospatial working memory(42.06±8.64),visual memory(44.30±10.32)and reasoning,problem solving and decision making(34.09±8.03)in OCD patients were lower than healthy controls(47.87±7.30,50.39±7.72,50.15±7.33,47.39±10.44),and there was a significant difference(P<0.01);No significant difference was discovered in the ability of verbal memory and social cognition between OCD group(47.11±10.36,44.13±13.05)and healthy controls(47.94±10.08,47.76±17.64)(P>0.05).2.3 There was negative correlation between age of onset,visual memory and social cognitive(r=0.38,0.35,0.38,P<0.01);There was negative correlation between information processing speed and compulsive behavior(r=0.34,P<0.05);serum TNF-? and IL-2 level and the cognitive function,clinical symptoms and the severity of OCD,age,age of onset and duration of illness were not significantly correlated(P>0.05).3.Comparison of the Y-BOCS scores,serum TNF-?,IL-2 levels and cognitive function in patients with obsessive-compulsive disorder before and after treatment3.1After the drug treatment,the obsessions(8.24±3.11),compulsive behaviors(6.00±3.38)and the Y-BOCS scores(14.24±5.96)of patients were lower than that before treatment(11.14±3.69,8.90±3.97,20.05±6.79),there was a significant difference(P<0.01).3.2There was no evident difference in serum level of TNF-? and IL-2 in patients with obsessive-compulsive disorder before(361.48±57.52pg/ml,385.14±89.30pg/ml)and after treatment(390.39±41.10pg/ml,433.53±109.60pg/ml)(P>0.05).3.3After the drug treatment,the information processing speed(39.29±9.63),verbal memory(55.81±9.94),visual memory(50.62±8.55)and social cognition(52.05±15.03)of OCD patients were higher than those before treatment(32.90±10.01,47.05±10.40,45.48±9.54,43.24±10.24),the difference was statistically significant(P<0.05 or P<0.01);There was no significant difference in visual spatial working memory and reasoning,problem solving and decision making before(43.95±11.95,34.81±9.83)and after treatment(42.52±7.31,32.86±9.21)in OCD patients(P>0.05).Conclusions1.The serum level of TNF-? and IL-2 was increased in patients with initially-onset obsessive-compulsive disorder,and the information processing speed,visual spatial working memory and reasoning,problem solving and decision making ability were impaired.2.After the drug treatment,part of the cognitive function of OCD patients was improved,but the changes of serum levels of TNF-? and IL-2 were not obvious.3.The earlier the onset of OCD was and the heavier the compulsive behaviors were,the more obvious the cognitive function damage was.