REVEALING BRAIN CHOLESTEROL DYNAMICS AND ITS RELATIONSHIP WITH AGGRESSION IN PSYCHIATRIC PATIENTS

Abstract Background It is known that cholesterol is essential for the normal functioning of the brain. Sterol metabolism dysfunction contributes to many psychiatric and neurodegenerative disorders. Cholesterol intermediates, such as lathosterol and desmosterol, are considered better markers of endogenous cholesterol biosynthesis than cholesterol itself; thus, they are reliable markers of cholesterol metabolism dysfunction. Methods To gain insight into cholesterol metabolism, we conducted a study to determine the levels of cholesterol intermediates in blood samples from a population of psychiatric patients. Participants were recruited over a 6-month period from hospitalized patients at the Psychiatry Clinic in Osijek. Patients underwent a comprehensive clinical psychiatric examination, accompanied by a questionnaire specifically designed for this research. Special attention was focused on clinical determinants of aggression symptoms. Blood samples were collected from the patients in serum tubes, and these samples were analyzed by LC-MS/MS. Results Through the analysis of collected data using the χ2 test and Fisher's exact test, 34% of participants reported engaging in or carrying out self-harming behaviors in the past, 7.8% of participants reported having self-harming thoughts during hospitalization, 4.9% of participants exhibited heteroaggressive behavior before hospital treatment (N=205). Among participants with elevated oxysterol levels (7DHC), 31.8% reported engaging in or carrying out self-harming behaviors in the past, 4.5% reported having self-harming thoughts during hospitalization, and none of the selected population exhibited heteroaggressive behavior before hospital treatment. Conclusion Detailed analysis of the available literature reveals a connection between symptoms of depression and elevated oxysterol levels. While suicidality and self- or other-directed aggression are potential symptoms of depressive disorders, it is not possible to definitively conclude that there is a biological association between them. Our results did not demonstrate statistical significance regarding the association between elevated oxysterol levels and the manifestation of aggressive behaviors throughout life.