Abnormal
brain-derived neurotrophic factor (
BDNF) levels are involved in
cognitive decline in patients with
schizophrenia. The role of atypical
antipsychotic risperidone in improving cognitive function remains unclear. The study aimed to investigate the effect of
risperidone monotherapy on
cognitive impairment in drug-naïve first-episode (DNFE) patients with
schizophrenia and whether
BDNF levels were correlated to the improvement of cognition. 354 DNFE patients and 152 healthy controls were recruited, and we compared their serum
BDNF levels and cognition shown on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). High and low
BDNF subgroups were defined by median split. Then, 211 patients were treated with
risperidone monotherapy for 12 weeks, and their serum
BDNF levels and cognition were measured again
after treatment. DNFE patients had poorer cognitive functions and lower
BDNF levels compared to controls. Lower
BDNF levels were correlated with delayed memory in DNFE patients with high baseline
BDNF levels. After 12 weeks of treatment,
risperidone significantly improved immediate memory, delayed memory and RBANS total scores and
BDNF levels were slightly increased. In patients with low-
BDNF,
BDNF levels were significantly increased after
risperidone treatment, while in patients with high-
BDNF,
BDNF levels were significantly decreased. In addition, baseline
BDNF levels were associated with improvement of delayed memory and were a prognostic factor for the improvement of the delayed memory and RBANS total score in patients with high-
BDNF. Our result suggests
risperidone treatment can partially improve certain domains of the
cognitive impairment and baseline
BDNF levels are related to cognitive response to
risperidone in DNFE patients with
schizophrenia.