Changes of Hypocretin (Orexin) System in Schizophrenia: From Plasma to Brain

Schizophr Bull. 2021 Aug 21;47(5):1310-1319. doi: 10.1093/schbul/sbab042.

Abstract

Hypocretin (also called orexin) regulates various functions, such as sleep-wake rhythms, attention, cognition, and energy balance, which show significant changes in schizophrenia (SCZ). We aimed to identify alterations in the hypocretin system in SCZ patients. We measured plasma hypocretin-1 levels in SCZ patients and healthy controls and found significantly decreased plasma hypocretin-1 levels in SCZ patients, which was mainly due to a significant decrease in female SCZ patients compared with female controls. In addition, we measured postmortem hypothalamic hypocretin-1-immunoreactivity (ir), ventricular cerebrospinal fluid (CSF) hypocretin-1 levels, and hypocretin receptor (Hcrt-R) mRNA expression in the superior frontal gyrus (SFG) in SCZ patients and controls We observed a significant decrease in the amount of hypothalamic hypocretin-1 ir in SCZ patients, which was due to decreased amounts in female but not male patients. Moreover, Hcrt-R2 mRNA in the SFG was decreased in female SCZ patients compared with female controls, while male SCZ patients showed a trend of increased Hcrt-R1 mRNA and Hcrt-R2 mRNA expression compared with male controls. We conclude that central hypocretin neurotransmission is decreased in SCZ patients, especially female patients, and this is reflected in the plasma.

Keywords: cerebrospinal fluid; hypocretin; hypothalamus; orexin, hypocretin receptor; plasma; schizophrenia; superior frontal gyrus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Autopsy
  • Female
  • Humans
  • Hypothalamus / metabolism*
  • Male
  • Middle Aged
  • Orexin Receptors / metabolism*
  • Orexins / blood
  • Orexins / metabolism*
  • Prefrontal Cortex / metabolism*
  • Schizophrenia / blood
  • Schizophrenia / metabolism*
  • Sex Factors

Substances

  • HCRT protein, human
  • Orexin Receptors
  • Orexins