State marker properties of niacin skin sensitivity in ultra-high risk groups for psychosis - An optical reflection spectroscopy study

Abstract Impaired niacinsensitivity (NS) is one of the most replicated findings in untreated schizophrenia, and reflects a disturbance of prostaglandin-mediated pathways in association with deregulated arachidonic acid metabolism, pro-inflammatory activation, and vasomotorfunction. In ultra-high risk individuals (UHR) increased NS was reported recently, pointing towards dynamic alterations of the underlying pathomechanisms in the period preceding psychosis. However, these characteristics are still unresolved in the diverse UHR groups. We tested the hypothesis that NS is attenuated in patients who have transitioned to psychosisand in the Brief Limited Intermittent Psychotic Symptoms (BLIPS, UHR-B) and/or the attenuated symptoms (UHR-A) groups, while it is unchanged or increased in the genetic risk group (UHR-G). Sensitivity to three concentrations (0.1–0.001 M) of aqueous methylnicotinate was tested in 84 UHR patients, 105 first-episode psychosispatients (FEP) and 180 healthy individuals (HC), using optical reflection spectroscopy (ORS). The UHR subgroup and transition/non-transition outcomes were assessed according to PACE criteria using the CAARMS. Psychopathology was assessed using SANS, SAPS, and BPRS or SCL-90-R self-ratings. In 0.001 M data, decreased NS was found in the UHR-B (n = 12), UHR-A (n = 45) and the transition groups (n = 13), similar to the result in FEP. NS in the UHR-G (n = 27) and HC groups did not differ. In the UHR-B and FEP groups, NS and positive symptom scores were inversely correlated. These state marker properties could be used to characterize the intensity of the underlying pathomechanisms during the onset of psychosisor to identify UHR individuals that might benefit from related indicated prevention strategies.