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López-Caballero F, Curtis M, Coffman BA, Salisbury DF. Is source-resolved magnetoencephalographic mismatch negativity a viable biomarker for early psychosis? Eur J Neurosci 2024; 59:1889-1906. [PMID: 37537883 PMCID: PMC10837325 DOI: 10.1111/ejn.16107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/04/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Mismatch negativity (MMN) is an auditory event-related response reflecting the pre-attentive detection of novel stimuli and is a biomarker of cortical dysfunction in schizophrenia (SZ). MMN to pitch (pMMN) and to duration (dMMN) deviant stimuli are impaired in chronic SZ, but it is less clear if MMN is reduced in first-episode SZ, with inconsistent findings in scalp-level EEG studies. Here, we investigated the neural generators of pMMN and dMMN with MEG recordings in 26 first-episode schizophrenia spectrum (FEsz) and 26 matched healthy controls (C). We projected MEG inverse solutions into precise functionally meaningful auditory cortex areas. MEG-derived MMN sources were in bilateral primary auditory cortex (A1) and belt areas. In A1, pMMN FEsz reduction showed a trend towards statistical significance (F(1,50) = 3.31; p = .07), and dMMN was reduced in FEsz (F(1,50) = 4.11; p = .04). Hypothesis-driven comparisons at each hemisphere revealed dMMN reduction in FEsz occurred in the left (t(56) = 2.23; p = .03; d = .61) but not right (t(56) = 1.02; p = .31; d = .28) hemisphere, with a moderate effect size. The added precision of MEG source solution with high-resolution MRI and parcellation of A1 may be requisite to detect the emerging pathophysiology and indicates a critical role for left hemisphere pathology at psychosis onset. However, the moderate effect size in left A1, albeit larger than reported in scalp MMN meta-analyses, casts doubt on the clinical utility of MMN for differential diagnosis, as a majority of patients will overlap with the healthy individual's distribution.
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Affiliation(s)
- Fran López-Caballero
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mark Curtis
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brian A Coffman
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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2
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López-Caballero F, Auksztulewicz R, Howard Z, Rosch RE, Todd J, Salisbury DF. Computational Synaptic Modeling of Pitch and Duration Mismatch Negativity in First-Episode Psychosis Reveals Selective Dysfunction of the N-Methyl-D-Aspartate Receptor. Clin EEG Neurosci 2024:15500594241238294. [PMID: 38533562 DOI: 10.1177/15500594241238294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Mismatch negativity (MMN) to pitch (pMMN) and to duration (dMMN) deviant stimuli is significantly more attenuated in long-term psychotic illness compared to first-episode psychosis (FEP). It was recently shown that source-modeling of magnetically recorded MMN increases the detection of left auditory cortex MMN deficits in FEP, and that computational circuit modeling of electrically recorded MMN also reveals left-hemisphere auditory cortex abnormalities. Computational modeling using dynamic causal modeling (DCM) can also be used to infer synaptic activity from EEG-based scalp recordings. We measured pMMN and dMMN with EEG from 26 FEP and 26 matched healthy controls (HCs) and used a DCM conductance-based neural mass model including α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid, N-methyl-D-Aspartate (NMDA), and Gamma-aminobutyric acid receptors to identify any changes in effective connectivity and receptor rate constants in FEP. We modeled MMN sources in bilateral A1, superior temporal gyrus, and inferior frontal gyrus (IFG). No model parameters distinguished groups for pMMN. For dMMN, reduced NMDA receptor activity in right IFG in FEP was detected. This finding is in line with literature of prefrontal NMDA receptor hypofunction in chronic schizophrenia and suggests impaired NMDA-induced synaptic plasticity may be present at psychosis onset where scalp dMMN is only moderately reduced. To the best of our knowledge, this is the first report of impaired NMDA receptor activity in FEP found through computational modeling of dMMN and shows the potential of DCM to non-invasively reveal synaptic-level abnormalities that underly subtle functional auditory processing deficits in early psychosis.
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Affiliation(s)
- F López-Caballero
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - R Auksztulewicz
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Z Howard
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - R E Rosch
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - J Todd
- School of Psychological Sciences, University of Newcastle, Callaghan, Australia
| | - D F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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3
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Todd J, Salisbury D, Michie PT. Why mismatch negativity continues to hold potential in probing altered brain function in schizophrenia. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e144. [PMID: 38867817 PMCID: PMC11114358 DOI: 10.1002/pcn5.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 06/14/2024]
Abstract
The brain potential known as mismatch negativity (MMN) is one of the most studied indices of altered brain function in schizophrenia. This review looks at what has been learned about MMN in schizophrenia over the last three decades and why the level of interest and activity in this field of research remains strong. A diligent consideration of available evidence suggests that MMN can serve as a biomarker in schizophrenia, but perhaps not the kind of biomarker that early research supposed. This review concludes that MMN measurement is likely to be most useful as a monitoring and response biomarker enabling tracking of an underlying pathology and efficacy of interventions, respectively. The role of, and challenges presented by, pre-clinical models is discussed as well as the merits of different methodologies that can be brought to bear in pursuing a deeper understanding of pathophysiology that might explain smaller MMN in schizophrenia.
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Affiliation(s)
- Juanita Todd
- School of Psychological SciencesUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Dean Salisbury
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Patricia T. Michie
- School of Psychological SciencesUniversity of NewcastleNewcastleNew South WalesAustralia
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4
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Nakajima S, Higuchi Y, Tateno T, Sasabayashi D, Mizukami Y, Nishiyama S, Takahashi T, Suzuki M. Duration Mismatch Negativity Predicts Remission in First-Episode Schizophrenia Patients. Front Psychiatry 2021; 12:777378. [PMID: 34899430 PMCID: PMC8656455 DOI: 10.3389/fpsyt.2021.777378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/22/2021] [Indexed: 12/12/2022] Open
Abstract
Objective: Remission in schizophrenia patients is associated with neurocognitive, social, and role functioning during both the early and chronic stages of schizophrenia. It is well-established that the amplitudes of duration mismatch negativity (dMMN) and frequency MMN (fMMN) are reduced in schizophrenia patients. However, the potential link between MMN and remission has not been established. In this study, we investigated the relationship between MMNs and remission in first-episode schizophrenia (FES) and their association with neurocognitive and social functioning. Method: dMMN and fMMN were measured in 30 patients with FES and 22 healthy controls at baseline and after a mean of 3 years. Clinical symptoms and cognitive and social functioning in the patients were assessed at the time of MMN measurements by using the Positive and Negative Syndrome Scale (PANSS), modified Global Assessment of Functioning (mGAF), Schizophrenia Cognition Rating Scale (SCoRS), and the Brief Assessment of Cognition in Schizophrenia (BACS). Remission of the patients was defined using the criteria by the Remission in Schizophrenia Working Group; of the 30 patients with FES, 14 achieved remission and 16 did not. Results: Baseline dMMN amplitude was reduced in FES compared to healthy controls. Further, baseline dMMN in the non-remitters had decreased amplitude and prolonged latency compared to the remitters. MMN did not change during follow-up period regardless of parameters, diagnosis, or remission status. Baseline dMMN amplitude in FES was correlated with future SCoRS and PANSS total scores. Logistic regression analysis revealed that dMMN amplitude at baseline was a significant predictor of remission. Conclusions: Our findings suggest that dMMN amplitude may be a useful biomarker for predicting symptomatic remission and improvement of cognitive and social functions in FES.
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Affiliation(s)
- Suguru Nakajima
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Takahiro Tateno
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Mizukami
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Health Administration Center, Faculty of Education and Research Promotion, Academic Assembly, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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5
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Perrottelli A, Giordano GM, Brando F, Giuliani L, Mucci A. EEG-Based Measures in At-Risk Mental State and Early Stages of Schizophrenia: A Systematic Review. Front Psychiatry 2021; 12:653642. [PMID: 34017273 PMCID: PMC8129021 DOI: 10.3389/fpsyt.2021.653642] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/06/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction: Electrophysiological (EEG) abnormalities in subjects with schizophrenia have been largely reported. In the last decades, research has shifted to the identification of electrophysiological alterations in the prodromal and early phases of the disorder, focusing on the prediction of clinical and functional outcome. The identification of neuronal aberrations in subjects with a first episode of psychosis (FEP) and in those at ultra high-risk (UHR) or clinical high-risk (CHR) to develop a psychosis is crucial to implement adequate interventions, reduce the rate of transition to psychosis, as well as the risk of irreversible functioning impairment. The aim of the review is to provide an up-to-date synthesis of the electrophysiological findings in the at-risk mental state and early stages of schizophrenia. Methods: A systematic review of English articles using Pubmed, Scopus, and PsychINFO was undertaken in July 2020. Additional studies were identified by hand-search. Electrophysiological studies that included at least one group of FEP or subjects at risk to develop psychosis, compared to healthy controls (HCs), were considered. The heterogeneity of the studies prevented a quantitative synthesis. Results: Out of 319 records screened, 133 studies were included in a final qualitative synthesis. Included studies were mainly carried out using frequency analysis, microstates and event-related potentials. The most common findings included an increase in delta and gamma power, an impairment in sensory gating assessed through P50 and N100 and a reduction of Mismatch Negativity and P300 amplitude in at-risk mental state and early stages of schizophrenia. Progressive changes in some of these electrophysiological measures were associated with transition to psychosis and disease course. Heterogeneous data have been reported for indices evaluating synchrony, connectivity, and evoked-responses in different frequency bands. Conclusions: Multiple EEG-indices were altered during at-risk mental state and early stages of schizophrenia, supporting the hypothesis that cerebral network dysfunctions appear already before the onset of the disorder. Some of these alterations demonstrated association with transition to psychosis or poor functional outcome. However, heterogeneity in subjects' inclusion criteria, clinical measures and electrophysiological methods prevents drawing solid conclusions. Large prospective studies are needed to consolidate findings concerning electrophysiological markers of clinical and functional outcome.
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Affiliation(s)
- Andrea Perrottelli
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Francesco Brando
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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6
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Salisbury DF, Shafer AR, Murphy TK, Haigh SM, Coffman BA. Pitch and Duration Mismatch Negativity and Heschl's Gyrus Volume in First-Episode Schizophrenia-Spectrum Individuals. Clin EEG Neurosci 2020; 51:359-364. [PMID: 32241184 PMCID: PMC8118142 DOI: 10.1177/1550059420914214] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. The mismatch negativity (MMN) brainwave indexes novelty detection. MMN to infrequent pitch (pMMN) and duration (dMMN) deviants is reduced in long-term schizophrenia. Although not reduced at first psychosis, pMMN is inversely associated with left hemisphere Heschl's gyrus (HG) gray matter volume within 1 year of first hospitalization for schizophrenia-spectrum psychosis, consistent with pathology of left primary auditory cortex early in disease course. We examined whether the relationship was present earlier, at first psychiatric contact for psychosis, and whether the same structural-functional association was apparent for dMMN. Method. Twenty-seven first-episode schizophrenia-spectrum (FESz) and 27 matched healthy comparison (HC) individuals were compared. EEG-derived pMMN and dMMN were measured by subtracting the standard tone waveform (80%) from the pitch- and duration-deviant waveforms (10% each). HG volumes were calculated from T1-weighted structural magnetic resonance imaging using Freesurfer. Results. In FESz, pMMN amplitudes at Fz were inversely associated with left HG (but not right) gray matter volumes, and dMMN amplitudes were associated significantly with left HG volumes and at trend-level with right HG. There were no structural-functional associations in HC. Conclusions. pMMN and dMMN index gray matter reduction in left hemisphere auditory cortex early in psychosis, with dMMN also marginally indexing right HG volumes. This suggest conjoint functional and structural pathology that affects the automatic detection of novelty with varying degrees of penetrance prior to psychosis. These brainwaves are sensitive biomarkers of pathology early in the psychotic disease course, and may serve as biomarkers of disease progression and as therapeutic outcome measures.
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Affiliation(s)
- Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh School of Medicine, Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - Anna R Shafer
- Department of Psychiatry, University of Pittsburgh School of Medicine, Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - Timothy K Murphy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - Sarah M Haigh
- Department of Psychiatry, University of Pittsburgh School of Medicine, Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - Brian A Coffman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Pittsburgh, PA, USA
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7
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Del Re EC, Maekawa T, Mesholam-Gately RI, Wojcik J, Seidman LJ, McCarley RW, Niznikiewicz MA. Abnormal Frequency Mismatch Negativity in Early Psychosis Outpatient Subjects. Clin EEG Neurosci 2020; 51:207-214. [PMID: 31826666 DOI: 10.1177/1550059419886691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Abnormalities of mismatch negativity (MMN), an event-related potential, indexing preattentive mechanisms, are consistently reported in schizophrenia (SZ). MMN abnormalities elicited to different deviant types have been recently shown to distinguish among patients according to length of their illness as well as inpatient versus outpatient status, and to be modulated by premorbid IQ. The objective of this study was to evaluate the MMN elicited by both frequency and duration deviant stimuli in patients with early schizophrenia (EP) recruited from an outpatient clinic in Boston, Massachusetts. Methods. Twenty-two healthy controls (HC) and 22 age-, handedness-, and gender-matched EP were tested using a frequency and duration MMN paradigm. Clinical data were also collected. Results. Frequency MMN amplitude but not duration MMN was significantly reduced in EP relative to HC subjects (P = .015). Conclusions. These results indicate that in this sample of early psychosis outpatient group, reductions in frequency MMN but not in duration MMN index clinical status. The relationship between age at first hospitalization and MMN frequency and duration amplitude and latency indicates that neurodevelopmental stage, auditory function, and clinical status are tightly linked.
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Affiliation(s)
- Elisabetta C Del Re
- VA Boston Healthcare System, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA
| | - Toshihiko Maekawa
- VA Boston Healthcare System, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Okinawa, Japan
| | - Raquelle I Mesholam-Gately
- Harvard Medical School, Boston, MA, USA.,Massachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joanne Wojcik
- Harvard Medical School, Boston, MA, USA.,Massachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Larry J Seidman
- Harvard Medical School, Boston, MA, USA.,Massachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Robert W McCarley
- VA Boston Healthcare System, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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8
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Shiga T, Horikoshi S, Kanno K, Kanno-Nozaki K, Hikita M, Itagaki S, Miura I, Yabe H. Plasma levels of dopamine metabolite correlate with mismatch negativity in patients with schizophrenia. Psychiatry Clin Neurosci 2020; 74:289-293. [PMID: 31994282 DOI: 10.1111/pcn.12984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/20/2019] [Accepted: 01/17/2020] [Indexed: 01/10/2023]
Abstract
AIM Mismatch negativity (MMN) deficit is one of the most robust and replicable findings in schizophrenia, and primarily reflects deficient functioning of the N-methyl-D-aspartate (NMDA) receptor system. Although the dopamine receptor is known not to modulate MMN over the short term, it is unclear whether the dopamine system affects MMN in the long term. METHODS We explored correlations between MMN and levels of plasma dopamine and serotonin metabolites in 18 patients with schizophrenia psychiatrically evaluated with the Positive and Negative Syndrome Scale (PANSS). RESULTS A significant negative correlation exists between MMN amplitude and plasma levels of dopamine metabolites. Plasma serotonin metabolite levels were not correlated with MMN. The PANSS total score and Negative score also showed negative correlations with MMN amplitude. CONCLUSION The usual strong therapeutic blockade of dopamine receptors applied in cases of schizophrenia may reduce MMN over the long term.
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Affiliation(s)
- Tetsuya Shiga
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Sho Horikoshi
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Kazuko Kanno
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Keiko Kanno-Nozaki
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Masayuki Hikita
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
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9
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Lho SK, Kim M, Park J, Hwang WJ, Moon SY, Oh S, Kwon JS. Progressive Impairment of Mismatch Negativity Is Reflective of Underlying Pathophysiological Changes in Patients With First-Episode Psychosis. Front Psychiatry 2020; 11:587. [PMID: 32625126 PMCID: PMC7314980 DOI: 10.3389/fpsyt.2020.00587] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although mismatch negativity (MMN) is associated with the pathophysiology of schizophrenia, whether MMN progressively worsens during the initial years of psychotic disorder has not yet been sufficiently studied. We aimed to investigate whether longitudinal reduction of MMN occurs in patients with first-episode psychosis (FEP) and whether it is reflective of change in cognitive functioning or clinical status. METHODS MMN and the clinical status of 25 patients with FEP were measured and the Trail Making Test (TMT) was administered at baseline and reassessed after 1 year of usual treatment. The MMN of 25 matched healthy controls (HCs) was measured at baseline. Repeated-measures analysis of variance was used to compare MMNs at baseline among the groups, and paired t-test was utilized to compare the baseline and 1-year MMN amplitudes of FEP patients. To identify the association between changes in MMN and changes in cognitive, symptomatic, or functional status over 1 year, multiple regression analysis was used to control for other possible confounders. RESULTS MMN amplitudes at baseline were significantly attenuated in FEP patients compared to those in HC. The 1-year follow-up MMN amplitude decreased significantly at the Fz electrode site in the FEP group. Additionally, the decreased MMN amplitude significantly correlated with worsened TMT part B (TMT-B) performance over 1 year but did not correlate with symptomatic or functional improvement. CONCLUSIONS FEP patients with an MMN amplitude reduction showed worsening of cognitive functioning, which might reflect pathophysiological progression during the early years of a psychotic episode.
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Affiliation(s)
- Silvia Kyungjin Lho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Minah Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Jihye Park
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Sun-Young Moon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Sanghoon Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea.,Institute of Human Behavioral Medicine, SNU-MRC, Seoul, South Korea
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10
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Fong CY, Law WHC, Uka T, Koike S. Auditory Mismatch Negativity Under Predictive Coding Framework and Its Role in Psychotic Disorders. Front Psychiatry 2020; 11:557932. [PMID: 33132932 PMCID: PMC7511529 DOI: 10.3389/fpsyt.2020.557932] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/18/2020] [Indexed: 12/13/2022] Open
Abstract
Traditional neuroscience sees sensory perception as a simple feedforward process. This view is challenged by the predictive coding model in recent years due to the robust evidence researchers had found on how our prediction could influence perception. In the first half of this article, we reviewed the concept of predictive brain and some empirical evidence of sensory prediction in visual and auditory processing. The predictive function along the auditory pathway was mainly studied by mismatch negativity (MMN)-a brain response to an unexpected disruption of regularity. We summarized a range of MMN paradigms and discussed how they could contribute to the theoretical development of the predictive coding neural network by the mechanism of adaptation and deviance detection. Such methodological and conceptual evolution sharpen MMN as a tool to better understand the structural and functional brain abnormality for neuropsychiatric disorder such as schizophrenia.
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Affiliation(s)
- Chun Yuen Fong
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Japan
| | - Wai Him Crystal Law
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Japan
| | - Takanori Uka
- Department of Integrative Physiology, Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-ku, Japan.,University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, Bunkyo-ku, Japan
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11
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Lavoie S, Polari AR, Goldstone S, Nelson B, McGorry PD. Staging model in psychiatry: Review of the evolution of electroencephalography abnormalities in major psychiatric disorders. Early Interv Psychiatry 2019; 13:1319-1328. [PMID: 30688016 DOI: 10.1111/eip.12792] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/03/2018] [Accepted: 12/29/2018] [Indexed: 12/29/2022]
Abstract
AIM Clinical staging in psychiatry aims to classify patients according to the severity of their symptoms, from stage 0 (increased risk, asymptomatic) to stage 4 (severe illness), enabling adapted treatment at each stage of the illness. The staging model would gain specificity if one or more quantifiable biological markers could be identified. Several biomarkers reflecting possible causal mechanisms and/or consequences of the pathophysiology are candidates for integration into the clinical staging model of psychiatric illnesses. METHODS This review covers the evolution (from stage 0 to stage 4) of the most important brain functioning impairments as measured with electroencephalography (EEG), in psychosis spectrum and in severe mood disorders. RESULTS The present review of the literature demonstrates that it is currently not possible to draw any conclusion with regard to the state or trait character of any of the EEG impairments in both major depressive disorder and bipolar disorder. As for schizophrenia, the most promising markers of the stage of the illness are the pitch mismatch negativity as well as the p300 event-related potentials, as these components seem to deteriorate with increasing severity of the illness. CONCLUSIONS Given the complexity of major psychiatric disorders, and that not a single impairment can be observed in all patients, future research should most likely consider combinations of markers in the quest for a better identification of the stages of the psychiatric illnesses.
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Affiliation(s)
- Suzie Lavoie
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrea R Polari
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Orygen Youth Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Sherilyn Goldstone
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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12
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Newton R, Rouleau A, Nylander AG, Loze JY, Resemann HK, Steeves S, Crespo-Facorro B. Diverse definitions of the early course of schizophrenia-a targeted literature review. NPJ SCHIZOPHRENIA 2018; 4:21. [PMID: 30323274 PMCID: PMC6189105 DOI: 10.1038/s41537-018-0063-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a debilitating psychiatric disorder and patients experience significant comorbidity, especially cognitive and psychosocial deficits, already at the onset of disease. Previous research suggests that treatment during the earlier stages of disease reduces disease burden, and that a longer time of untreated psychosis has a negative impact on treatment outcomes. A targeted literature review was conducted to gain insight into the definitions currently used to describe patients with a recent diagnosis of schizophrenia in the early course of disease ('early' schizophrenia). A total of 483 relevant English-language publications of clinical guidelines and studies were identified for inclusion after searches of MEDLINE, MEDLINE In-Process, relevant clinical trial databases and Google for records published between January 2005 and October 2015. The extracted data revealed a wide variety of terminology and definitions used to describe patients with 'early' or 'recent-onset' schizophrenia, with no apparent consensus. The most commonly used criteria to define patients with early schizophrenia included experience of their first episode of schizophrenia or disease duration of less than 1, 2 or 5 years. These varied definitions likely result in substantial disparities of patient populations between studies and variable population heterogeneity. Better agreement on the definition of early schizophrenia could aid interpretation and comparison of studies in this patient population and consensus on definitions should allow for better identification and management of schizophrenia patients in the early course of their disease.
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Affiliation(s)
- Richard Newton
- Austin Health, University of Melbourne, Melbourne, VIC, Australia.,Peninsula Health, Frankston, VIC, Australia
| | | | | | | | | | | | - Benedicto Crespo-Facorro
- Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
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13
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Hamilton HK, Perez VB, Ford JM, Roach BJ, Jaeger J, Mathalon DH. Mismatch Negativity But Not P300 Is Associated With Functional Disability in Schizophrenia. Schizophr Bull 2018; 44:492-504. [PMID: 29036701 PMCID: PMC5890465 DOI: 10.1093/schbul/sbx104] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Mismatch negativity (MMN) and P300 event-related potential (ERP) reductions in schizophrenia (SZ) reflect preattentive and attention-mediated auditory processing deficits, respectively. Although both have been linked to cognitive deficits in SZ, their relative contributions to real-world functioning are unclear. We sought to determine the functional significance of disrupted auditory processing in SZ by examining MMN and P300 in typically disabled low-functioning patients and in patients with high levels of independent role functioning. MMN to auditory deviants and P300 to infrequent auditory target and nontarget novel stimuli were assessed in 20 high-functioning SZ patients (HF-SZ), 17 low-functioning patients (LF-SZ), and 35 healthy comparison (HC) subjects. There was a group effect on MMN and P300 amplitudes across stimulus types. MMN was significantly diminished in LF-SZ compared to HF-SZ and HC, and HF-SZ demonstrated comparable MMN to HC. In contrast, P300 was significantly reduced in both LF-SZ and HF-SZ compared to HC. Logistic regression suggested independent sensitivity of MMN to functioning in SZ over and above P300 measures. Neither MMN nor P300 were associated with positive or negative symptom severity. Results replicate MMN and P300 abnormalities in SZ, and also suggest that the neural mechanisms associated with the preattentive detection of auditory deviance are most compromised in patients with functional disability. MMN may index pathophysiological processes that are critical for optimal functioning in SZ.
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Affiliation(s)
- Holly K Hamilton
- San Francisco VA Health Care System, San Francisco, CA,University of California, San Francisco, San Francisco, CA
| | - Veronica B Perez
- California School of Professional Psychology, San Diego, CA,University of California, San Diego, San Diego, CA
| | - Judith M Ford
- San Francisco VA Health Care System, San Francisco, CA,University of California, San Francisco, San Francisco, CA
| | - Brian J Roach
- Northern California Institute for Research and Education, San Francisco, CA
| | - Judith Jaeger
- Albert Einstein College of Medicine, New York, NY,CognitionMetrics, LLC, Wilmington, DE
| | - Daniel H Mathalon
- San Francisco VA Health Care System, San Francisco, CA,University of California, San Francisco, San Francisco, CA,To whom correspondence should be addressed; San Francisco VA Health Care System, 4150 Clement Street, 116D, San Francisco, CA 94121; tel: 415-221-4810-x23860; e-mail:
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14
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Corcoran CM, Stoops A, Lee M, Martinez A, Sehatpour P, Dias EC, Javitt DC. Developmental trajectory of mismatch negativity and visual event-related potentials in healthy controls: Implications for neurodevelopmental vs. neurodegenerative models of schizophrenia. Schizophr Res 2018; 191:101-108. [PMID: 29033283 PMCID: PMC5866919 DOI: 10.1016/j.schres.2017.09.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/22/2017] [Accepted: 09/26/2017] [Indexed: 12/26/2022]
Abstract
Sensory processing deficits are core features of schizophrenia, reflected in impaired generation of event-related potential (ERP) measures such as auditory mismatch negativity (MMN) and visual P1. To understand the potential time course of development of deficits in schizophrenia, we obtained MMN to unattended duration, intensity and frequency deviants, and visual P1 to attended LSF stimuli, in 43 healthy individuals ages 6 to 25years (mean 17), and compared results to data from 30 adult schizophrenia patients (mean age 38). We analyzed "time-domain" measures of amplitude and latency, and event-related spectral perturbation (ERSP, "time-frequency") to evaluate underlying neurophysiological mechanisms. Duration and intensity MMN amplitudes increased from childhood to late adolescence, while frequency MMN reached maximum amplitude during early development. As reported previously, in ERSP analyses, MMN activity corresponded primarily to theta-band (4-7Hz) activity, while responses to standards occurred primarily in alpha (8-12Hz) across age groups. Both deviant-induced theta and standard-induced alpha activity declined significantly with age for all deviant types. Likewise, visual P1 also showed an amplitude decline over development, reflecting a reduction in both evoked power and ITC. While MMN "difference" waveform ERP data suggest failure of maturation in schizophrenia, MMN ERSP analyses instead support a neurodegenerative process, as these isolate responses to deviants and standards, showing large low-frequency evoked power for both in children. Neurodegenerative processes are also supported by large visual P1 amplitudes and large low-frequency evoked power in children, in contrast with adult schizophrenia. Sensory processing deficits in schizophrenia may be related to accelerated synaptic pruning.
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Affiliation(s)
- Cheryl M Corcoran
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute at Columbia University, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Anastasia Stoops
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Migyung Lee
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute at Columbia University, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Antigona Martinez
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute at Columbia University, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Pejman Sehatpour
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute at Columbia University, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Elisa C Dias
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Daniel C Javitt
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute at Columbia University, New York, NY, USA; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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15
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Lavoie S, Jack BN, Griffiths O, Ando A, Amminger P, Couroupis A, Jago A, Markulev C, McGorry PD, Nelson B, Polari A, Yuen HP, Whitford TJ. Impaired mismatch negativity to frequency deviants in individuals at ultra-high risk for psychosis, and preliminary evidence for further impairment with transition to psychosis. Schizophr Res 2018; 191:95-100. [PMID: 29132815 DOI: 10.1016/j.schres.2017.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is evidence to suggest that people with established psychotic disorders show impairments in the mismatch negativity induced by a frequency-deviant sound (fMMN), and that these impairments worsen with the deterioration of psychotic symptoms. This study aimed to test whether individuals at ultra-high risk (UHR) for psychosis show pre-morbid impairments in fMMN, and if so, whether fMMN continues to deteriorate with transition to psychosis. METHOD fMMN was recorded in a cohort of UHR individuals (n=42) and compared to healthy controls (n=29). Of the 27 UHR participants who returned for a second EEG session, six participants had transitioned to psychosis by 12-month follow-up (UHR-T) and were compared to the 21 participants who did not transition (UHR-NT). RESULTS fMMN amplitude was significantly reduced, relative to healthy controls, in the UHR cohort. Furthermore, UHR-T individuals showed a significant decrease in fMMN amplitude over the period from baseline to post-transition; this reduction was not observed in UHR-NT. CONCLUSIONS These results suggest that fMMN is abnormal in UHR individuals, as has repeatedly been found previously in people with established psychotic disorders. The finding that fMMN impairment worsens with transition to psychosis is consistent with the staging model of psychosis; however, caution must be taken in interpreting these findings, given the extremely small sample size of the UHR-T group.
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Affiliation(s)
- Suzie Lavoie
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia.
| | - Bradley N Jack
- School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
| | - Oren Griffiths
- School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
| | - Ayaka Ando
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Paul Amminger
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Anthony Couroupis
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Aidan Jago
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Connie Markulev
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Patrick D McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Barnaby Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Andrea Polari
- Orygen Youth Health, Melbourne Health, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Hok Pan Yuen
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia
| | - Thomas J Whitford
- School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
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16
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Koshiyama D, Kirihara K, Tada M, Nagai T, Koike S, Suga M, Araki T, Kasai K. Duration and frequency mismatch negativity shows no progressive reduction in early stages of psychosis. Schizophr Res 2017; 190:32-38. [PMID: 28314681 DOI: 10.1016/j.schres.2017.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/02/2017] [Accepted: 03/05/2017] [Indexed: 10/20/2022]
Abstract
The auditory mismatch negativity (MMN) is a component of event-related potentials, which is being increasingly recognized as a candidate biomarker for early stages of psychosis. Although previous cross-sectional studies have demonstrated small MMN amplitude in early stages of psychosis, it remains unknown whether small MMN amplitude is due to progressive reduction during the early course. In this study, we investigated longitudinal changes of MMN in early stages of psychosis. Participant included 14 patients with first-episode psychosis (FEP), 16 individuals with ultra-high risk (UHR), and 16 healthy control subjects (HC). We measured MMN in response to duration deviants (dMMN) and that in response to frequency deviants (fMMN), respectively. The amplitudes of dMMN in FEP and UHR were significantly smaller in comparison to those in HC, which did not show a progressive decrease over time. The amplitude of fMMN did not differ among groups, which again did not show progression. There was no significant correlation between the length of the follow-up period and the longitudinal change of either deviant-type MMN in the FEP or UHR. These results suggest that dMMN is a trait marker in the early stages of psychosis, and that small dMMN amplitude in early stages of psychosis may reflect altered developmental process rather than progressive brain pathology. The amplitude of fMMN may not alter in early stages of psychosis. These findings may contribute to the future establishment of MMN as a biomarker in early stages of psychosis.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Psychiatry, Kawamuro Memorial Hospital, Niigata, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan; Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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17
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Oranje B, Aggernaes B, Rasmussen H, Ebdrup BH, Glenthøj BY. Selective attention and mismatch negativity in antipsychotic-naïve, first-episode schizophrenia patients before and after 6 months of antipsychotic monotherapy. Psychol Med 2017; 47:2155-2165. [PMID: 28443529 DOI: 10.1017/s0033291717000599] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Attention deficits have been frequently reported in schizophrenia. It has been suggested that treatment with second-generation antipsychotics can ameliorate these deficits. In this study, the influence of 6 months treatment with quetiapine, a compound with less affinity for dopamine D2 receptors than for serotonergic 5-HT2A receptors, on electrophysiological parameters of attention was investigated in a group of antipsychotic-naïve, first-episode schizophrenia patients compared with a group of age- and gender-matched healthy controls. METHOD A total of 34 first-episode, antipsychotic-naïve patients with schizophrenia and an equal number of healthy controls were tested in a selective attention and a typical mismatch negativity (MMN) paradigm at baseline and after 6 months. The patients were treated with quetiapine according to their clinical needs during the period between baseline and follow-up, whereas controls received no treatment. RESULTS Patients showed lower MMN and P200 amplitude than healthy controls in the selective attention paradigm at baseline, while this was not the case for MMN of the typical MMN paradigm. Interestingly, after 6 months treatment, this MMN deficit was only ameliorated in patients treated with above median dosages of quetiapine. Patients had lower P3B amplitude, yet showed similar levels of processing negativity and N100 amplitude compared with healthy controls, both at baseline and follow-up. CONCLUSIONS The results indicate that deficits in MMN, P200 and P3B amplitude are present at early stages of schizophrenia, although depending on the paradigm used. Furthermore, the results indicate that 6 months quetiapine treatment ameliorates MMN but not P3B deficits, and only in those subjects on higher dosages.
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Affiliation(s)
- B Oranje
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - B Aggernaes
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - H Rasmussen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - B H Ebdrup
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - B Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
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18
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Biagianti B, Roach BJ, Fisher M, Loewy R, Ford JM, Vinogradov S, Mathalon DH. Trait aspects of auditory mismatch negativity predict response to auditory training in individuals with early illness schizophrenia. NEUROPSYCHIATRIC ELECTROPHYSIOLOGY 2017; 3:2. [PMID: 28845238 PMCID: PMC5568850 DOI: 10.1186/s40810-017-0024-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 06/05/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Individuals with schizophrenia have heterogeneous impairments of the auditory processing system that likely mediate differences in the cognitive gains induced by auditory training (AT). Mismatch negativity (MMN) is an event-related potential component reflecting auditory echoic memory, and its amplitude reduction in schizophrenia has been linked to cognitive deficits. Therefore, MMN may predict response to AT and identify individuals with schizophrenia who have the most to gain from AT. Furthermore, to the extent that AT strengthens auditory deviance processing, MMN may also serve as a readout of the underlying changes in the auditory system induced by AT. METHODS Fifty-six individuals early in the course of a schizophrenia-spectrum illness (ESZ) were randomly assigned to 40 h of AT or Computer Games (CG). Cognitive assessments and EEG recordings during a multi-deviant MMN paradigm were obtained before and after AT and CG. Changes in these measures were compared between the treatment groups. Baseline and trait-like MMN data were evaluated as predictors of treatment response. MMN data collected with the same paradigm from a sample of Healthy Controls (HC; n = 105) were compared to baseline MMN data from the ESZ group. RESULTS Compared to HC, ESZ individuals showed significant MMN reductions at baseline (p = .003). Reduced Double-Deviant MMN was associated with greater general cognitive impairment in ESZ individuals (p = .020). Neither ESZ intervention group showed significant change in MMN. We found high correlations in all MMN deviant types (rs = .59-.68, all ps < .001) between baseline and post-intervention amplitudes irrespective of treatment group, suggesting trait-like stability of the MMN signal. Greater deficits in trait-like Double-Deviant MMN predicted greater cognitive improvements in the AT group (p = .02), but not in the CG group. CONCLUSIONS In this sample of ESZ individuals, AT had no effect on auditory deviance processing as assessed by MMN. In ESZ individuals, baseline MMN was significantly reduced relative to HCs, and associated with global cognitive impairment. MMN did not show changes after AT and exhibited trait-like stability. Greater deficits in the trait aspects of Double-Deviant MMN predicted greater gains in global cognition in response to AT, suggesting that MMN may identify individuals who stand to gain the most from AT. TRIAL REGISTRATION NCT00694889. Registered 1 August 2007.
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Affiliation(s)
- Bruno Biagianti
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Brian J. Roach
- Department of Mental Health, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Rachel Loewy
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Judith M. Ford
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
- Department of Mental Health, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Daniel H. Mathalon
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
- Department of Mental Health, San Francisco VA Medical Center, San Francisco, CA, USA
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19
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Erickson MA, Albrecht M, Ruffle A, Fleming L, Corlett P, Gold J. No association between symptom severity and MMN impairment in schizophrenia: A meta-analytic approach. SCHIZOPHRENIA RESEARCH-COGNITION 2017; 9:13-17. [PMID: 28740829 PMCID: PMC5514390 DOI: 10.1016/j.scog.2017.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 11/16/2022]
Abstract
The mismatch negativity (MMN) is an event-related potential that is consistently attenuated in people with schizophrenia. Within the predictive coding model of psychosis, MMN impairment is thought to reflect the same prediction failures that are also thought to underlie the development and crystallization of delusions and hallucinations. However, the true relationship between symptom severity and MMN impairment across studies has not yet been established. The present meta-analysis used meta-regressions to examine the relationship between MMN impairment (quantified as Hedges' g) and PANSS positive and negative symptom totals across 62 and 68 samples, respectively. Furthermore, we examined the relationship between MMN impairment and group differences in educational achievement (n = 47 samples), cognitive ability (n = 36 samples), and age (n = 86 samples). Overall, we found no significant associations between MMN impairment and symptom severity (p's > 0.50); however, we did observe a trend-level association between MMN impairment and lower education (p = 0.07) and a significant association with older age (p < 0.01) in the schizophrenia patient group. Taken together, these results challenge a simple predictive coding model of psychosis, and suggest that MMN impairment may be more closely associated with premorbid functioning than with the expression of psychotic symptoms.
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Affiliation(s)
- Molly A Erickson
- University Behavioral Healthcare, Rutgers University, 671 Hoes Lane West, Piscataway, NJ 08854, United States
| | - Matthew Albrecht
- Maryland Psychiatric Research Center, University of Maryland, 55 Wade Avenue, Catonsville, MD 21228, United States.,School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Abigail Ruffle
- Maryland Psychiatric Research Center, University of Maryland, 55 Wade Avenue, Catonsville, MD 21228, United States
| | - Leah Fleming
- Interdepartmental Neuroscience Program, Yale University, 34 Park Street, New Haven, CT, 06519, United States
| | - Philip Corlett
- Department of Psychiatry, Yale University; 34 Park Street, New Haven, CT, 06519, United States
| | - James Gold
- Maryland Psychiatric Research Center, University of Maryland, 55 Wade Avenue, Catonsville, MD 21228, United States
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20
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Salisbury DF, Polizzotto NR, Nestor PG, Haigh SM, Koehler J, McCarley RW. Pitch and Duration Mismatch Negativity and Premorbid Intellect in the First Hospitalized Schizophrenia Spectrum. Schizophr Bull 2017; 43:407-416. [PMID: 27231308 PMCID: PMC5605266 DOI: 10.1093/schbul/sbw074] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Mismatch negativity (MMN) is a robustly abnormal brainwave in chronically ill schizophrenia that has generated interest as a disease presence biomarker. Reports of MMN reduction in first-episode schizophrenia have been equivocal, raising uncertainty about its reduction at first psychotic break. Here we tested 29 schizophrenia-spectrum participants under 1 year from their first hospitalization for psychosis and 40 age-, gender-, parental socioeconomic status-, and Wechsler Adult Intelligence Scales III Information-matched healthy controls on both pitch and duration MMN. Participants performed a visual checkerboard tracking task while standard (1kHz, 50ms, 80%), pitch-deviant (1.2kHz, 50ms, 10%) and duration-deviant (1kHz, 100ms, 10%) tones were presented over headphones (75 dB) and EEG was recorded. Independent component analysis was used to remove eye movements and visual stimulus processing activity. Groups did not differ in pitch MMN or duration MMN amplitudes. Smaller pitch and duration MMN amplitudes were associated with lower estimates of premorbid intellect in all participants and independently with greater positive symptoms in first hospitalized schizophrenia. Overall MMN reduction was not present in these relatively high functioning individuals at the first episode of schizophrenia, and therefore is not a good disease presence biomarker for this sample. Future research is warranted to determine the degree of MMN reduction at the first episode of psychosis across a greater range of cognitive impairment, the utility of MMN as an indicator of risk or diagnosis, and its role for understanding pathophysiological mechanisms in emerging psychosis.
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Affiliation(s)
- Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nicola R Polizzotto
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul G Nestor
- Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Sarah M Haigh
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Justine Koehler
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert W McCarley
- Department of Psychiatry, Harvard Medical School, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
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21
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Haigh SM, Coffman BA, Salisbury DF. Mismatch Negativity in First-Episode Schizophrenia: A Meta-Analysis. Clin EEG Neurosci 2017; 48:3-10. [PMID: 27170669 PMCID: PMC5768309 DOI: 10.1177/1550059416645980] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/23/2016] [Accepted: 03/31/2016] [Indexed: 01/15/2023]
Abstract
Mismatch negativity (MMN) to deviant stimuli is robustly smaller in individuals with chronic schizophrenia compared with healthy controls (Cohen's d > 1.0 or more), leading to the possibility of MMN being used as a biomarker for schizophrenia. However, there is some debate in the literature as to whether MMN is reliably reduced in first-episode schizophrenia patients. For the biomarker to be used as a predictive marker for schizophrenia, it should be reduced in the majority of cases known to have the disease, particularly at disease onset. We conducted a meta-analysis on the fourteen studies that measured MMN to pitch or duration deviants in healthy controls and patients within 12 months of their first episode of schizophrenia. The overall effect size showed no MMN reduction in first-episode patients to pitch-deviants (Cohen's d < 0.04), and a small-to-medium reduction to duration-deviants (Cohen's d = 0.47). Together, this indicates that pitch-deviant MMN is not a candidate biomarker for schizophrenia prediction, while duration-deviant MMN may hold some promise, albeit nearly a third as large an effect as in chronic schizophrenia. Potential causes for discrepancies between studies are discussed.
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Affiliation(s)
- Sarah M Haigh
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian A Coffman
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dean F Salisbury
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Düring S, Glenthøj BY, Oranje B. Effects of Blocking D2/D3 Receptors on Mismatch Negativity and P3a Amplitude of Initially Antipsychotic Naïve, First Episode Schizophrenia Patients. Int J Neuropsychopharmacol 2015; 19:pyv109. [PMID: 26453696 PMCID: PMC4815474 DOI: 10.1093/ijnp/pyv109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/11/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Reduced mismatch negativity and P3a amplitude have been suggested to be among the core deficits in schizophrenia since the late 1970s. Blockade of dopamine D2 receptors play an important role in the treatment of schizophrenia. In addition, there is some evidence indicating that deficits in mismatch negativity and P3a amplitude are related to increased dopaminergic activity. This is the first study investigating the effect of amisulpride, a potent D2-antagonist, on mismatch negativity and P3a amplitude in a large group of antipsychotic-naïve, first-episode schizophrenia patients. METHODS Fifty-one antipsychotic-naïve, first-episode schizophrenia patients were tested in a mismatch negativity paradigm at baseline and after 6 weeks of treatment with amisulpride. We further examined 48 age- and gender-matched controls in this paradigm. RESULTS At baseline, the patients showed significantly reduced P3a amplitude compared with healthy controls, but no differences in mismatch negativity. Although the treatment with amisulpride significantly improved the patients' psychopathological (PANSS) and functional (GAF) scores, it did not influence their mismatch negativity amplitude, while also their reduced P3a amplitude persisted. CONCLUSION Our findings show that antipsychotic naïve, first-episode patients with schizophrenia have normal mismatch negativity yet reduced P3a amplitude compared with healthy controls. In spite of the fact that the 6-week amisulpride treatment improved the patients both clinically and functionally, it had no effect on either mismatch negativity or P3a amplitude. This suggests that even though there is a dopaminergic involvement in global functioning and symptomatology in schizophrenia, there is no such involvement in these particular measures of early information processing.
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Affiliation(s)
- Signe Düring
- Center for Neuropsychiatric Schizophrenia Research, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Center Glostrup, Glostrup, Denmark; Faculty of Health Sciences, Department of Neurology, Psychiatry, and Sensory Sciences, Copenhagen, University of Copenhagen.
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Hay RA, Roach BJ, Srihari VH, Woods SW, Ford JM, Mathalon DH. Equivalent mismatch negativity deficits across deviant types in early illness schizophrenia-spectrum patients. Biol Psychol 2015; 105:130-7. [PMID: 25603283 DOI: 10.1016/j.biopsycho.2015.01.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 01/08/2015] [Accepted: 01/12/2015] [Indexed: 11/17/2022]
Abstract
Neurophysiological abnormalities in auditory deviance processing, as reflected by the mismatch negativity (MMN), have been observed across the course of schizophrenia. Studies in early schizophrenia patients have typically shown varying degrees of MMN amplitude reduction for different deviant types, suggesting that different auditory deviants are uniquely processed and may be differentially affected by duration of illness. To explore this further, we examined the MMN response to 4 auditory deviants (duration, frequency, duration+frequency "double deviant", and intensity) in 24 schizophrenia-spectrum patients early in the illness (ESZ) and 21 healthy controls. ESZ showed significantly reduced MMN relative to healthy controls for all deviant types (p<0.05), with no significant interaction with deviant type. No correlations with clinical symptoms were present (all ps>0.05). These findings support the conclusion that neurophysiological mechanisms underlying processing of auditory deviants are compromised early in illness, and these deficiencies are not specific to the type of deviant presented.
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Affiliation(s)
- Rachel A Hay
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Brian J Roach
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Vinod H Srihari
- Yale University School of Medicine, New Haven, CT, United States
| | - Scott W Woods
- Yale University School of Medicine, New Haven, CT, United States
| | - Judith M Ford
- University of California, San Francisco, CA, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Daniel H Mathalon
- University of California, San Francisco, CA, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States.
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24
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Mismatch negativity (MMN) deficiency: a break-through biomarker in predicting psychosis onset. Int J Psychophysiol 2015; 95:338-44. [PMID: 25562834 DOI: 10.1016/j.ijpsycho.2014.12.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/14/2014] [Accepted: 12/26/2014] [Indexed: 11/24/2022]
Abstract
Currently, the mismatch negativity (MMN) deficit is one of the most robust and replicable findings in schizophrenia, reflecting cognitive and functional decline, psychosocial and socio-occupational impairment, and executive dysfunction in these patients. An important break-through has very recently taken place here in the prediction of conversion to psychosis when the MMN in particular to change in tone duration was recorded in clinically at risk-mental state (ARMS) individuals. Attenuations in the MMN in these patients may be very useful in helping clinicians determine who are most likely to develop a psychotic disorder, as we will review in the present article.
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McGorry P, Keshavan M, Goldstone S, Amminger P, Allott K, Berk M, Lavoie S, Pantelis C, Yung A, Wood S, Hickie I. Biomarkers and clinical staging in psychiatry. World Psychiatry 2014; 13:211-23. [PMID: 25273285 PMCID: PMC4219053 DOI: 10.1002/wps.20144] [Citation(s) in RCA: 198] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well-established, largely chronic illness, do not support a pre-emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre-emptive psychiatry.
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Affiliation(s)
- Patrick McGorry
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Centre, Harvard Medical SchoolBoston, MA, USA
| | - Sherilyn Goldstone
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Paul Amminger
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Kelly Allott
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Michael Berk
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia,School of Medicine, Deakin UniversityGeelong, Australia
| | - Suzie Lavoie
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Alison Yung
- Institute of Brain, Behaviour and Mental Health, University of Manchester, ManchesterUK
| | - Stephen Wood
- School of Psychology, University of Birmingham, BirminghamUK
| | - Ian Hickie
- Brain and Mind Research Institute, University of Sydney, SydneyAustralia
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Fulham WR, Michie PT, Ward PB, Rasser PE, Todd J, Johnston PJ, Thompson PM, Schall U. Mismatch negativity in recent-onset and chronic schizophrenia: a current source density analysis. PLoS One 2014; 9:e100221. [PMID: 24949859 PMCID: PMC4064992 DOI: 10.1371/journal.pone.0100221] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 05/23/2014] [Indexed: 01/09/2023] Open
Abstract
Mismatch negativity (MMN) is a component of the event-related potential elicited by deviant auditory stimuli. It is presumed to index pre-attentive monitoring of changes in the auditory environment. MMN amplitude is smaller in groups of individuals with schizophrenia compared to healthy controls. We compared duration-deviant MMN in 16 recent-onset and 19 chronic schizophrenia patients versus age- and sex-matched controls. Reduced frontal MMN was found in both patient groups, involved reduced hemispheric asymmetry, and was correlated with Global Assessment of Functioning (GAF) and negative symptom ratings. A cortically-constrained LORETA analysis, incorporating anatomical data from each individual's MRI, was performed to generate a current source density model of the MMN response over time. This model suggested MMN generation within a temporal, parietal and frontal network, which was right hemisphere dominant only in controls. An exploratory analysis revealed reduced CSD in patients in superior and middle temporal cortex, inferior and superior parietal cortex, precuneus, anterior cingulate, and superior and middle frontal cortex. A region of interest (ROI) analysis was performed. For the early phase of the MMN, patients had reduced bilateral temporal and parietal response and no lateralisation in frontal ROIs. For late MMN, patients had reduced bilateral parietal response and no lateralisation in temporal ROIs. In patients, correlations revealed a link between GAF and the MMN response in parietal cortex. In controls, the frontal response onset was 17 ms later than the temporal and parietal response. In patients, onset latency of the MMN response was delayed in secondary, but not primary, auditory cortex. However amplitude reductions were observed in both primary and secondary auditory cortex. These latency delays may indicate relatively intact information processing upstream of the primary auditory cortex, but impaired primary auditory cortex or cortico-cortical or thalamo-cortical communication with higher auditory cortices as a core deficit in schizophrenia.
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Affiliation(s)
- W. Ross Fulham
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Patricia T. Michie
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- School of Psychology, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Philip B. Ward
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Schizophrenia Research Unit, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Paul E. Rasser
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Juanita Todd
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- School of Psychology, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Patrick J. Johnston
- Department of Psychology and York Neuroimaging Centre, University of York, Heslington, United Kingdom
| | - Paul M. Thompson
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Departments of Neurology, Psychiatry, Radiology, Engineering, Pediatrics, and Ophthalmology, University of Southern California, Los Angeles, California, United States of America
| | - Ulrich Schall
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Näätänen R, Sussman ES, Salisbury D, Shafer VL. Mismatch negativity (MMN) as an index of cognitive dysfunction. Brain Topogr 2014; 27:451-66. [PMID: 24838819 DOI: 10.1007/s10548-014-0374-6] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 04/29/2014] [Indexed: 01/08/2023]
Abstract
Cognition is often affected in a variety of neuropsychiatric, neurological, and neurodevelopmental disorders. The neural discriminative response, reflected in mismatch negativity (MMN) and its magnetoencephalographic equivalent (MMNm), has been used as a tool to study a variety of disorders involving auditory cognition. MMN/MMNm is an involuntary brain response to auditory change or, more generally, to pattern regularity violation. For a number of disorders, MMN/MMNm amplitude to sound deviance has been shown to be attenuated or the peak-latency of the component prolonged compared to controls. This general finding suggests that while not serving as a specific marker to any particular disorder, MMN may be useful for understanding factors of cognition in various disorders, and has potential to serve as an indicator of risk. This review presents a brief history of the MMN, followed by a description of how MMN has been used to index auditory processing capability in a range of neuropsychiatric, neurological, and neurodevelopmental disorders. Finally, we suggest future directions for research to further enhance our understanding of the neural substrate of deviance detection that could lead to improvements in the use of MMN as a clinical tool.
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Affiliation(s)
- Risto Näätänen
- Department of Psychology, University of Tartu, Tartu, Estonia
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Pang X, Xu J, Chang Y, Tang D, Zheng Y, Liu Y, Sun Y. Mismatch negativity of sad syllables is absent in patients with major depressive disorder. PLoS One 2014; 9:e91995. [PMID: 24658084 PMCID: PMC3962367 DOI: 10.1371/journal.pone.0091995] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 02/18/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is an important and highly prevalent mental disorder characterized by anhedonia and a lack of interest in everyday activities. Additionally, patients with MDD appear to have deficits in various cognitive abilities. Although a number of studies investigating the central auditory processing of low-level sound features in patients with MDD have demonstrated that this population exhibits impairments in automatic processing, the influence of emotional voice processing has yet to be addressed. To explore the automatic processing of emotional prosodies in patients with MDD, we analyzed the ability to detect automatic changes using event-related potentials (ERPs). METHOD This study included 18 patients with MDD and 22 age- and sex-matched healthy controls. Subjects were instructed to watch a silent movie but to ignore the afferent acoustic emotional prosodies presented to both ears while continuous electroencephalographic activity was synchronously recorded. Prosodies included meaningless syllables, such as "dada" spoken with happy, angry, sad, or neutral tones. The mean amplitudes of the ERPs elicited by emotional stimuli and the peak latency of the emotional differential waveforms were analyzed. RESULTS The sad MMN was absent in patients with MDD, whereas the happy and angry MMN components were similar across groups. The abnormal sad emotional MMN component was not significantly correlated with the HRSD-17 and HAMA scores, respectively. CONCLUSION The data indicate that patients with MDD are impaired in their ability to automatically process sad prosody, whereas their ability to process happy and angry prosodies remains normal. The dysfunctional sad emotion-related MMN in patients with MDD were not correlated with depression symptoms. The blunted MMN of sad prosodies could be considered a trait of MDD.
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Affiliation(s)
- Xiaomei Pang
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Liaoning Province, China
- Research Institute of Integrated Traditional and Western Medicine, Dalian Medical University, Liaoning Province, China
| | - Jing Xu
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Liaoning Province, China
- Research Institute of Integrated Traditional and Western Medicine, Dalian Medical University, Liaoning Province, China
| | - Yi Chang
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Liaoning Province, China
| | - Di Tang
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Liaoning Province, China
- Research Institute of Integrated Traditional and Western Medicine, Dalian Medical University, Liaoning Province, China
| | - Ya Zheng
- Department of Psychology, Dalian Medical University, Liaoning Province, China
| | - Yanhua Liu
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Liaoning Province, China
| | - Yiming Sun
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Liaoning Province, China
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Perez VB, Woods SW, Roach BJ, Ford JM, McGlashan TH, Srihari VH, Mathalon DH. Automatic auditory processing deficits in schizophrenia and clinical high-risk patients: forecasting psychosis risk with mismatch negativity. Biol Psychiatry 2014; 75:459-69. [PMID: 24050720 PMCID: PMC4028131 DOI: 10.1016/j.biopsych.2013.07.038] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 07/02/2013] [Accepted: 07/29/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Only about one third of patients at high risk for psychosis based on current clinical criteria convert to a psychotic disorder within a 2.5-year follow-up period. Targeting clinical high-risk (CHR) individuals for preventive interventions could expose many to unnecessary treatments, underscoring the need to enhance predictive accuracy with nonclinical measures. Candidate measures include event-related potential components with established sensitivity to schizophrenia. Here, we examined the mismatch negativity (MMN) component of the event-related potential elicited automatically by auditory deviance in CHR and early illness schizophrenia (ESZ) patients. We also examined whether MMN predicted subsequent conversion to psychosis in CHR patients. METHODS Mismatch negativity to auditory deviants (duration, frequency, and duration + frequency double deviant) was assessed in 44 healthy control subjects, 19 ESZ, and 38 CHR patients. Within CHR patients, 15 converters to psychosis were compared with 16 nonconverters with at least 12 months of clinical follow-up. Hierarchical Cox regression examined the ability of MMN to predict time to psychosis onset in CHR patients. RESULTS Irrespective of deviant type, MMN was significantly reduced in ESZ and CHR patients relative to healthy control subjects and in CHR converters relative to nonconverters. Mismatch negativity did not significantly differentiate ESZ and CHR patients. The duration + frequency double deviant MMN, but not the single deviant MMNs, significantly predicted the time to psychosis onset in CHR patients. CONCLUSIONS Neurophysiological mechanisms underlying automatic processing of auditory deviance, as reflected by the duration + frequency double deviant MMN, are compromised before psychosis onset and can enhance the prediction of psychosis risk among CHR patients.
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Affiliation(s)
- Veronica B. Perez
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
| | | | - Brian J. Roach
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
| | - Judith M. Ford
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
| | | | | | - Daniel H. Mathalon
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
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Kaser M, Soltesz F, Lawrence P, Miller S, Dodds C, Croft R, Dudas RB, Zaman R, Fernandez-Egea E, Müller U, Dean A, Bullmore ET, Nathan PJ. Oscillatory underpinnings of mismatch negativity and their relationship with cognitive function in patients with schizophrenia. PLoS One 2013; 8:e83255. [PMID: 24358266 PMCID: PMC3866183 DOI: 10.1371/journal.pone.0083255] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 10/31/2013] [Indexed: 11/23/2022] Open
Abstract
Background Impairments in mismatch negativity (MMN) generation have been consistently reported in patients with schizophrenia. However, underlying oscillatory activity of MMN deficits in schizophrenia and the relationship with cognitive impairments have not been investigated in detail. Time-frequency power and phase analyses can provide more detailed measures of brain dynamics of MMN deficits in schizophrenia. Method 21 patients with schizophrenia and 21 healthy controls were tested with a roving frequency paradigm to generate MMN. Time-frequency domain power and phase-locking (PL) analysis was performed on all trials using short-time Fourier transforms with Hanning window tapering. A comprehensive battery (CANTAB) was used to assess neurocognitive functioning. Results Mean MMN amplitude was significantly lower in patients with schizophrenia (95% CI 0.18 - 0.77). Patients showed significantly lower EEG power (95% CI -1.02 - -0.014) in the ~4-7 Hz frequency range (theta band) between 170 and 210 ms. Patients with schizophrenia showed cognitive impairment in multiple domains of CANTAB. However, MMN impairments in amplitude and power were not correlated with clinical measures, medication dose, social functioning or neurocognitive performance. Conclusion The findings from this study suggested that while MMN may be a useful marker to probe NMDA receptor mediated mechanisms and associated impairments in gain control and perceptual changes, it may not be a useful marker in association with clinical or cognitive changes. Trial-by-trial EEG power analysis can be used as a measure of brain dynamics underlying MMN deficits which also can have implications for the use of MMN as a biomarker for drug discovery.
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Affiliation(s)
- Muzaffer Kaser
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Bahcesehir University, Istanbul, Turkey
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| | - Fruzsina Soltesz
- GlaxoSmithKline, Clinical Unit Cambridge, Medicines Discovery and Development, Cambridge, United Kingdom
| | - Phil Lawrence
- GlaxoSmithKline, Clinical Unit Cambridge, Medicines Discovery and Development, Cambridge, United Kingdom
| | - Sam Miller
- GlaxoSmithKline, Clinical Unit Cambridge, Medicines Discovery and Development, Cambridge, United Kingdom
| | - Chris Dodds
- GlaxoSmithKline, Clinical Unit Cambridge, Medicines Discovery and Development, Cambridge, United Kingdom
| | - Rodney Croft
- Department of Psychology, University of Wollongong, Wollongong, Australia
| | - Robert B. Dudas
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Cambridge and Peterborough NHS Foundation Trust, United Kingdom
| | - Rashid Zaman
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- South Essex Partnership NHS Foundation Trust, United Kingdom
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Cambridge and Peterborough NHS Foundation Trust, United Kingdom
| | - Ulrich Müller
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Cambridge and Peterborough NHS Foundation Trust, United Kingdom
| | - Anna Dean
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Edward T. Bullmore
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- GlaxoSmithKline, Clinical Unit Cambridge, Medicines Discovery and Development, Cambridge, United Kingdom
- Cambridge and Peterborough NHS Foundation Trust, United Kingdom
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Pradeep J. Nathan
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- School of Psychology and Psychiatry, Monash University, Melbourne, Australia
- Neuroscience Discovery Medicine, UCB Pharma, Brussels, Belgium
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Nagai T, Tada M, Kirihara K, Araki T, Jinde S, Kasai K. Mismatch negativity as a "translatable" brain marker toward early intervention for psychosis: a review. Front Psychiatry 2013; 4:115. [PMID: 24069006 PMCID: PMC3779867 DOI: 10.3389/fpsyt.2013.00115] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/09/2013] [Indexed: 01/30/2023] Open
Abstract
Recent reviews and meta-analyses suggest that reducing the duration of untreated psychosis leads to better symptomatic and functional outcome in patients with psychotic disorder. Early intervention attenuates the symptoms of individuals at clinical high-risk (HR) for psychosis and may delay or prevent their transition to psychosis. Identifying biological markers in the early stages of psychotic disorder is an important step toward elucidating the pathophysiology, improving prediction of the transition to psychosis, and introducing targeted early intervention for help-seeking individuals aiming for better outcome. Mismatch negativity (MMN) is a component of event-related potentials that reflects preattentive auditory sensory memory and is a promising biomarker candidate for schizophrenia. Reduced MMN amplitude is a robust finding in patients with chronic schizophrenia. Recent reports have shown that people in the early stages of psychotic disorder exhibit attenuation of MMN amplitude. MMN in response to duration deviants and in response to frequency deviants reveals different patterns of deficits. These findings suggest that MMN may be useful for identifying clinical stages of psychosis and for predicting the risk of development. MMN may also be a "translatable" biomarker since it reflects N-methyl-d-aspartte receptor function, which plays a fundamental role in schizophrenia pathophysiology. Furthermore, MMN-like responses can be recorded in animals such as mice and rats. This article reviews MMN studies conducted on individuals with HR for psychosis, first-episode psychosis, recent-onset psychosis, and on animals. Based on the findings, the authors discuss the potential of MMN as a clinical biomarker for early intervention for help-seeking individuals in the early stages of psychotic disorder, and as a translatable neurophysiological marker for the preclinical assessment of pharmacological agents used in animal models that mimic early stages of the disorder.
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Affiliation(s)
- Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo , Tokyo , Japan
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Mondragón-Maya A, Solís-Vivanco R, León-Ortiz P, Rodríguez-Agudelo Y, Yáñez-Téllez G, Bernal-Hernández J, Cadenhead KS, de la Fuente-Sandoval C. Reduced P3a amplitudes in antipsychotic naïve first-episode psychosis patients and individuals at clinical high-risk for psychosis. J Psychiatr Res 2013; 47:755-61. [PMID: 23507048 DOI: 10.1016/j.jpsychires.2012.12.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/03/2012] [Accepted: 12/14/2012] [Indexed: 11/27/2022]
Abstract
Event related potentials (ERP) associated with early sensory information processing have been proposed as possible vulnerability markers for psychosis. Compared to other ERPs reported in schizophrenia research, like Mismatch Negativity (MMN), little is known about P3a, an ERP related to novelty detection. The aim of this study was to analyze the MMN-P3a complex in 20 antipsychotic naïve first-episode psychosis patients (FEP), 23 antipsychotic naïve individuals at clinical high-risk for psychosis (CHR) and 24 healthy controls. The MMN-P3a amplitudes and latencies were obtained during a passive auditory mismatch frequency deviant ERP paradigm and analyzed in frontal and central scalp regions. There were no significant differences in MMN amplitude between groups. There was a significant group difference in P3a due to reduced amplitude (F[2,64] = 3.7, p = 0.03) in both CHR and FEP groups (Mean difference (MD) = 0.39, p = 0.04 and MD = 0.49, p = 0.02, respectively) compared to the control group and this effect was most prominent on the right side (Group × laterality effect: MD = 0.57, p < 0.01 and MD = 0.58, p < 0.01, respectively). No significant differences were observed for MMN or P3a latencies between groups. Although a P3a decrement in chronic schizophrenia and FEP has been previously reported, our results suggest that this novelty detection impairment is present even in pre-psychosis stages in antipsychotic naïve subjects. This study supports the evidence that P3a could represent a neurophysiological vulnerability marker for the development of psychosis.
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Affiliation(s)
- Alejandra Mondragón-Maya
- Neuropsychology Department, Instituto Nacional de Neurología y Neurocirugía, Insurgentes Sur 3877, La Fama, Tlalpan, 14269, Mexico City, Mexico
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Shin KS, Kim JS, Kim SN, Koh Y, Jang JH, An SK, O’Donnell BF, Chung CK, Kwon JS. Aberrant auditory processing in schizophrenia and in subjects at ultra-high-risk for psychosis. Schizophr Bull 2012; 38:1258-67. [PMID: 22021663 PMCID: PMC3494059 DOI: 10.1093/schbul/sbr138] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The N1 and the mismatch negativity (MMN) responses observed in electroencephalographic and magnetoencephalographic (MEG) recordings reflect sensory processing, sensory memory, and adaptation and are usually abnormal in patients with schizophrenia. However, their differential sensitivity to ultra-high-risk (UHR) status is controversial. The current study evaluated the sensitivity of MEG N1m, N1m adaptation, and magnetic counterpart of MMN (MMNm) in 16 UHR subjects, 15 schizophrenia patients, and 18 healthy controls (HCs) during a passive auditory oddball task. N1m adaptation was assessed using the difference in N1m dipole moment between the first and last standard tones in a standard stimulus sequence. N1m adaptation occurred in HCs, whereas neither the UHR nor the schizophrenia groups showed adaptation to the standard tone on repeated presentations. The UHR group had values between those for HCs and schizophrenia patients. Additionally, MMNm dipole moment was reduced in both the UHR and patient groups compared with HCs, whereas the UHR and schizophrenia groups did not differ from each other. These findings indicated that both N1m adaptation and MMNm were altered in UHR subjects and in schizophrenia patients, despite unaffected N1m dipole moment to the first standard tones. Moreover, both UHR and schizophrenia groups failed to show adaptation of the N1m to repeated standard tones. This failure in adaptation was more severe in patients than UHR subjects, suggesting that auditory adaptation may be sensitive to the progression of the illness and be an early biomarker of UHR for psychosis. Deficits in auditory sensory memory, on the other hand, may be similarly impaired in both groups.
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Affiliation(s)
- Kyung Soon Shin
- Clinical Cognitive Neuroscience Center, Neuroscience Institute, Seoul National University - Medical Research Center, Seoul, Korea
| | - June Sic Kim
- Magnetoencephalography Center, Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Yuri Koh
- Clinical Cognitive Neuroscience Center, Neuroscience Institute, Seoul National University - Medical Research Center, Seoul, Korea
| | - Joon Hwan Jang
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Brian F. O’Donnell
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN
| | - Chun Kee Chung
- Magnetoencephalography Center, Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Soo Kwon
- Clinical Cognitive Neuroscience Center, Neuroscience Institute, Seoul National University - Medical Research Center, Seoul, Korea,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea,Department of Brain and Cognitive Science-World Class University Program, Seoul National University College of Natural Science, Seoul, Korea,To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, 101 Daehakno, Chongno-gu, Seoul 110-744, Republic of Korea; tel: +82-2-2072-2972, fax: +82-2-747-9063, e-mail:
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Rissling AJ, Braff DL, Swerdlow NR, Hellemann G, Rassovsky Y, Sprock J, Pela M, Light GA. Disentangling early sensory information processing deficits in schizophrenia. Clin Neurophysiol 2012; 123:1942-9. [PMID: 22608970 DOI: 10.1016/j.clinph.2012.02.079] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Revised: 02/02/2012] [Accepted: 02/28/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The disentangling of early sensory information processing deficits and examination of their relationships to demographic and clinical factors are important steps for the validation of potential biomarkers and/or endophenotypes of schizophrenia. The aims of the present study were to characterize commonly used sensory event-related potential deficits, to determine whether they are (1) distinct from one another and (2) independently associated with important clinical characteristics. METHODS MMN, P3a and RON event-related potentials (ERP) were recorded from schizophrenia patients (SZ; n=429) and nonpsychiatric comparison subjects (NCS; n=286). Subgroup analyses on demographic and clinical variables were performed. RESULTS Schizophrenia patients exhibited robust ERP deficits at frontocentral electrodes (MMN: d=1.10; P3a: d=0.87; RON: d=0.77), consistent with previous studies. Each ERP component uniquely accounted for variance in amplitude and schizophrenia deficits. Amplitude reductions occurred with increasing age in both NCS and SZ patients. A small subset of patients prescribed combinations of 1st and 2nd generation antipsychotics exhibited significantly reduced MMN amplitude relative to other medication-defined subgroups. CONCLUSIONS MMN, P3a, and RON are dissociable deficits with distinct relationships to age and medication status in schizophrenia patients, potentially reflecting divergent pathophysiological processes. Reduced MMN in patients taking multiple antipsychotic medications appear to be attributable to greater severity of symptoms and functional impairments, rather than a medication effect. SIGNIFICANCE Independent information processing deficits in schizophrenia patients may differentially contribute to the commonly observed deficits in neurocognitive and psychosocial functioning.
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Affiliation(s)
- Anthony J Rissling
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093-0804, USA
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Suzuki M, Takahashi S, Matsushima E, Tsunoda M, Kurachi M, Okada T, Hayashi T, Ishii Y, Morita K, Maeda H, Katayama S, Otsuka T, Hirayasu Y, Sekine M, Okubo Y, Motoshita M, Ohta K, Uchiyama M, Kojima T. Relationships between exploratory eye movement dysfunction and clinical symptoms in schizophrenia. Psychiatry Clin Neurosci 2012; 66:187-94. [PMID: 22369367 DOI: 10.1111/j.1440-1819.2011.02314.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Many psychophysiological tests have been widely researched in the search for a biological marker of schizophrenia. The exploratory eye movement (EEM) test involves the monitoring of eye movements while subjects freely view geometric figures. Suzuki et al. (2009) performed discriminant analysis between schizophrenia and non-schizophrenia subjects using EEM test data; consequently, clinically diagnosed schizophrenia patients were identified as having schizophrenia with high probability (73.3%). The aim of the present study was to investigate the characteristics of schizophrenia patients who were identified as having schizophrenia on EEM discriminant analysis (SPDSE) or schizophrenia patients who were identified as not having schizophrenia on EEM discriminant analysis (SPDNSE). METHODS The data for the 251 schizophrenia subjects used in the previous discriminant-analytic study were analyzed, and the demographic or symptomatic characteristics of SPDSE and SPDNSE were investigated. As for the symptomatic features, a factor analysis of the Brief Psychiatric Rating Scale (BPRS) rating from the schizophrenia subjects was carried out. RESULTS Five factors were found for schizophrenia symptoms: excitement/hostility; negative symptoms; depression/anxiety; positive symptoms; and disorganization. SPDSE had significantly higher factor scores for excitement/hostility, negative symptoms and disorganization than SPDNSE. Furthermore, the BPRS total score for the SPDSE was significantly higher than that for the SPDNSE. CONCLUSION SPDSE may be a disease subtype of schizophrenia with severe symptoms related to excitement/hostility, negative symptoms and disorganization, and EEM parameters may detect this subtype. Therefore, the EEM test may be one of the contributors to the simplification of the heterogeneity of schizophrenia.
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Affiliation(s)
- Masahiro Suzuki
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
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Jahshan C, Cadenhead KS, Rissling AJ, Kirihara K, Braff DL, Light GA. Automatic sensory information processing abnormalities across the illness course of schizophrenia. Psychol Med 2012; 42:85-97. [PMID: 21740622 PMCID: PMC3193558 DOI: 10.1017/s0033291711001061] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Deficits in automatic sensory discrimination, as indexed by a reduction in the mismatch negativity (MMN) and P3a event-related potential amplitudes, are well documented in chronic schizophrenia. However, MMN and P3a have not been sufficiently studied early in the course of psychotic illness. The present study aimed to investigate MMN, P3a and reorienting negativity (RON) across the course of schizophrenia. METHOD MMN, P3a, and RON were assessed in 118 subjects across four groups: (1) individuals at risk for psychosis (n=26); (2) recent-onset patients (n=31); (3) chronic patients (n=33); and (4) normal controls (n=28) using a duration-deviant auditory oddball paradigm. RESULTS Frontocentral deficits in MMN and P3a were present in all patient groups. The at-risk group's MMN and P3a amplitudes were intermediate to those of the control and recent-onset groups. The recent-onset and chronic patients, but not the at-risk subjects, showed significant RON amplitude reductions, relative to the control group. Associations between MMN, P3a, RON and psychosocial functioning were present in the chronic patients. In the at-risk subjects, P3a and RON deficits were significantly associated with higher levels of negative symptoms. CONCLUSIONS Abnormalities in the automatic processes of sensory discrimination, orienting and reorienting of attention are evident in the early phases of schizophrenia and raise the possibility of progressive worsening across stages of the illness. The finding that MMN and P3a, but not RON, were reduced before psychosis onset supports the continued examination of these components as potential early biomarkers of schizophrenia.
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Affiliation(s)
- Carol Jahshan
- Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
| | - Kristin S. Cadenhead
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Anthony J. Rissling
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Kenji Kirihara
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - David L. Braff
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Gregory A. Light
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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The mismatch negativity (MMN)--a unique window to disturbed central auditory processing in ageing and different clinical conditions. Clin Neurophysiol 2011; 123:424-58. [PMID: 22169062 DOI: 10.1016/j.clinph.2011.09.020] [Citation(s) in RCA: 268] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 09/16/2011] [Accepted: 09/20/2011] [Indexed: 12/14/2022]
Abstract
In this article, we review clinical research using the mismatch negativity (MMN), a change-detection response of the brain elicited even in the absence of attention or behavioural task. In these studies, the MMN was usually elicited by employing occasional frequency, duration or speech-sound changes in repetitive background stimulation while the patient was reading or watching videos. It was found that in a large number of different neuropsychiatric, neurological and neurodevelopmental disorders, as well as in normal ageing, the MMN amplitude was attenuated and peak latency prolonged. Besides indexing decreased discrimination accuracy, these effects may also reflect, depending on the specific stimulus paradigm used, decreased sensory-memory duration, abnormal perception or attention control or, most importantly, cognitive decline. In fact, MMN deficiency appears to index cognitive decline irrespective of the specific symptomatologies and aetiologies of the different disorders involved.
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Yao S, Liu X, Yang W, Wang X. Preattentive Processing Abnormalities in Chronic Pain: Neurophysiological Evidence from Mismatch Negativity. PAIN MEDICINE 2011; 12:773-81. [DOI: 10.1111/j.1526-4637.2011.01097.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Karayiorgou M, Simon TJ, Gogos JA. 22q11.2 microdeletions: linking DNA structural variation to brain dysfunction and schizophrenia. Nat Rev Neurosci 2010; 11:402-16. [PMID: 20485365 DOI: 10.1038/nrn2841] [Citation(s) in RCA: 341] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recent studies are beginning to paint a clear and consistent picture of the impairments in psychological and cognitive competencies that are associated with microdeletions in chromosome 22q11.2. These studies have highlighted a strong link between this genetic lesion and schizophrenia. Parallel studies in humans and animal models are starting to uncover the complex genetic and neural substrates altered by the microdeletion. In addition to offering a deeper understanding of the effects of this genetic lesion, these findings may guide analysis of other copy-number variants associated with cognitive dysfunction and psychiatric disorders.
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Affiliation(s)
- Maria Karayiorgou
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, New York 10032, USA.
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Suzuki M, Takahashi S, Matsushima E, Tsunoda M, Kurachi M, Okada T, Hayashi T, Ishii Y, Morita K, Maeda H, Katayama S, Kawahara R, Otsuka T, Hirayasu Y, Sekine M, Okubo Y, Motoshita M, Ohta K, Uchiyama M, Kojima T. Exploratory eye movement dysfunction as a discriminator for schizophrenia : a large sample study using a newly developed digital computerized system. Eur Arch Psychiatry Clin Neurosci 2009; 259:186-94. [PMID: 19165524 DOI: 10.1007/s00406-008-0850-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 08/28/2008] [Indexed: 11/29/2022]
Abstract
In our previous studies, we identified that exploratory eye movement (EEM) dysfunction appears to be specific to schizophrenia. The availability of a biological marker specific to schizophrenia would be useful for clinical diagnosis of schizophrenia. Consequently, we performed the discriminant analysis between schizophrenics and non-schizophrenics on a large sample using the EEM test data and examined an application of the EEM for clinical diagnosis of schizophrenia. EEM performances were recorded in 251 schizophrenics and 389 non-schizophrenics (111 patients with mood disorders, 28 patients with neurotic disorders and 250 normal controls). The patients were recruited from eight university hospitals and three affiliated hospitals. For this study with a large sample, we developed a new digital computerized version of the EEM test, which automatically handled large amounts of data. We measured four parameters: number of eye fixations (NEF), total eye scanning length (TESL), mean eye scanning length (MESL) and responsive search score (RSS). These parameters of schizophrenics differed significantly from those of the other three groups. The stepwise regression analysis selected the TESL and the RSS as the valid parameters for discriminating between schizophrenics and non-schizophrenics. In the discriminant analysis using the RSS and TESL as prediction parameters, 184 of the 251 clinically diagnosed schizophrenics were discriminated as having schizophrenia (sensitivity 73.3%); and 308 of the 389 clinically diagnosed non-schizophrenic subjects were discriminated as non-schizophrenics (specificity 79.2%). Based on our findings we believe that the EEM measures may be useful for the clinical diagnosis of schizophrenia.
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Affiliation(s)
- Masahiro Suzuki
- Dept. of Neuropsychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
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Central auditory dysfunction in schizophrenia as revealed by the mismatch negativity (MMN) and its magnetic equivalent MMNm: a review. Int J Neuropsychopharmacol 2009; 12:125-35. [PMID: 18771603 DOI: 10.1017/s1461145708009322] [Citation(s) in RCA: 179] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Since the early 1990s, the auditory change-detection response, mismatch negativity (MMN) and its magnetoencephalographic (MEG) equivalent MMNm have been applied in a large number of studies on schizophrenia. These studies have enhanced our understanding of the central auditory dysfunction underlying schizophrenia. The attenuation of the MMN amplitude is a systematic and robust neurophysiological finding in these patients. The gradual attenuation of the MMN amplitude resulting from frequency change reflects the progress of the disease, particularly the impairment occurring as a function of illness duration, whereas the MMN deficiency for duration change may be more closely linked to the genetic aspect of the illness. Electroencephalographic (EEG) and magnetoencephalographic (MEG) studies, together, suggest that both the temporal and frontal cortices contributing to MMN generation are affected in schizophrenia patients. Furthermore, abnormalities in auditory perception and discrimination revealed by a deficient temporal MMN generator process might be associated with patients' positive symptoms, whereas the dampened frontal attention-switching function, suggested by the attenuated responses of the frontal MMN generator, might contribute to the negative symptoms such as social withdrawal. In addition, gradual MMN amplitude reduction, in particular that for frequency change, reflects cognitive and functional impairment occurring as a function of illness duration. Finally, as MMN can be detected even in animals such as the mouse, it might provide a useful biomarker for assessing the effects of the drugs developed to fight the cognitive and functional impairments in schizophrenia patients.
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