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Hamilton HK, Mathalon DH, Ford JM. P300 in schizophrenia: Then and now. Biol Psychol 2024; 187:108757. [PMID: 38316196 DOI: 10.1016/j.biopsycho.2024.108757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
The 1965 discovery of the P300 component of the electroencephalography (EEG)-based event-related potential (ERP), along with the subsequent identification of its alteration in people with schizophrenia, initiated over 50 years of P300 research in schizophrenia. Here, we review what we now know about P300 in schizophrenia after nearly six decades of research. We describe recent efforts to expand our understanding of P300 beyond its sensitivity to schizophrenia itself to its potential role as a biomarker of risk for psychosis or a heritable endophenotype that bridges genetic risk and psychosis phenomenology. We also highlight efforts to move beyond a syndrome-based approach to understand P300 within the context of the clinical, cognitive, and presumed pathophysiological heterogeneity among people diagnosed with schizophrenia. Finally, we describe several recent approaches that extend beyond measuring the traditional P300 ERP component in people with schizophrenia, including time-frequency analyses and pharmacological challenge studies, that may help to clarify specific cognitive mechanisms that are disrupted in schizophrenia. Moreover, we discuss several promising areas for future research, including studies of animal models that can be used for treatment development.
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Affiliation(s)
- Holly K Hamilton
- University of Minnesota, Department of Psychiatry & Behavioral Sciences, Minneapolis, MN, USA; Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Daniel H Mathalon
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Judith M Ford
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
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2
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Devrim-Üçok M, Keskin-Ergen HY, Üçok A. Visual P3 abnormalities in patients with first-episode schizophrenia, unaffected siblings of schizophrenia patients and individuals at ultra-high risk for psychosis. Prog Neuropsychopharmacol Biol Psychiatry 2023; 122:110678. [PMID: 36427549 DOI: 10.1016/j.pnpbp.2022.110678] [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] [Received: 03/14/2022] [Revised: 11/11/2022] [Accepted: 11/12/2022] [Indexed: 11/24/2022]
Abstract
Cued version of the continuous performance test (AX-CPT) assesses sustained attention, working memory and cognitive control processes, which have been reported as impaired in schizophrenia. This study investigated visual P3 event-related potential elicited during cued CPT in patients with schizophrenia and in individuals who were at clinical or genetic high risk for psychosis to determine whether any abnormality may provide a marker of vulnerability for psychosis. Visual P3 elicited during cued CPT have not been reported in individuals at high risk for psychosis. Visual Go and NoGo P3 potentials were assessed in 34 antipsychotic-naive patients with first-episode schizophrenia (FES), 25 clinically unaffected siblings of these patients (familial high-risk for psychosis, FHR), 49 antipsychotic-naive individuals at ultra-high risk for psychosis (UHR) and 37 healthy control (HC) participants. FES patients had overall smaller P3 amplitudes than all other groups. P3 amplitude of the UHR participants was in-between the HC participants and FES patients. The anteroposterior P3 topography differed between the groups, with FES patients and FHR participants showing a more frontally distributed P3 compared with the HC participants. These findings suggest that the reduction in visual P3 amplitude may provide a vulnerability marker for psychosis in individuals who are at clinical high risk for psychosis and that a more frontally distributed visual P3 may be a marker of genetic liability for psychosis.
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Affiliation(s)
- Müge Devrim-Üçok
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - H Yasemin Keskin-Ergen
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alp Üçok
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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3
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Strauss GP, Bartolomeo LA, Luther L. Reduced willingness to expend effort for rewards is associated with risk for conversion and negative symptom severity in youth at clinical high-risk for psychosis. Psychol Med 2023; 53:714-721. [PMID: 34120660 DOI: 10.1017/s003329172100204x] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and predictive of conversion to illness. Mechanisms underlying negative symptoms are unclear in the CHR population. METHODS The current study evaluated whether CHR participants demonstrated deficits in the willingness to expend effort for rewards and whether these impairments are associated with negative symptoms and greater risk for conversion. Participants included 44 CHR participants and 32 healthy controls (CN) who completed the Effort Expenditure for Reward Task (EEfRT). RESULTS Compared to CN, CHR participants displayed reduced likelihood of exerting high effort for high probability and magnitude rewards. Among CHR participants, reduced effort expenditure was associated with greater negative symptom severity and greater probability of conversion to a psychotic disorder on a cross-sectional risk calculator. CONCLUSIONS Findings suggest that effort-cost computation is a marker of illness liability and a transphasic mechanism underlying negative symptoms in the SZ spectrum.
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Affiliation(s)
| | | | - Lauren Luther
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Wang B, Zartaloudi E, Linden JF, Bramon E. Neurophysiology in psychosis: The quest for disease biomarkers. Transl Psychiatry 2022; 12:100. [PMID: 35277479 PMCID: PMC8917164 DOI: 10.1038/s41398-022-01860-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 01/11/2023] Open
Abstract
Psychotic disorders affect 3% of the population at some stage in life, are a leading cause of disability, and impose a great economic burden on society. Major breakthroughs in the genetics of psychosis have not yet been matched by an understanding of its neurobiology. Biomarkers of perception and cognition obtained through non-invasive neurophysiological tools, especially EEG, offer a unique opportunity to gain mechanistic insights. Techniques for measuring neurophysiological markers are inexpensive and ubiquitous, thus having the potential as an accessible tool for patient stratification towards early treatments leading to better outcomes. In this paper, we review the literature on neurophysiological markers for psychosis and their relevant disease mechanisms, mainly covering event-related potentials including P50/N100 sensory gating, mismatch negativity, and the N100 and P300 waveforms. While several neurophysiological deficits are well established in patients with psychosis, more research is needed to study neurophysiological markers in their unaffected relatives and individuals at clinical high risk. We need to harness EEG to investigate markers of disease risk as key steps to elucidate the aetiology of psychosis and facilitate earlier detection and treatment.
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Affiliation(s)
- Baihan Wang
- Division of Psychiatry, University College London, London, UK.
| | - Eirini Zartaloudi
- Division of Psychiatry, University College London, London, UK.
- Institute of Clinical Trials and Methodology, University College London, London, UK.
| | - Jennifer F Linden
- Ear Institute, University College London, London, UK
- Department of Neuroscience, Physiology & Pharmacology, University College London, London, UK
| | - Elvira Bramon
- Division of Psychiatry, University College London, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
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Mamah D, Mutiso VN, Ndetei DM. Longitudinal and cross-sectional validation of the WERCAP screen for assessing psychosis risk and conversion. Schizophr Res 2022; 241:201-209. [PMID: 35144059 PMCID: PMC10448956 DOI: 10.1016/j.schres.2022.01.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/05/2022] [Accepted: 01/16/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen was developed to assess risk for developing psychosis. Its validity has not been investigated in a large population-based study or with longitudinal analyses. METHODS 825 participants, aged 14-25, were recruited from Kenya. Symptoms were assessed using the WERCAP Screen, as experienced over the prior 3-months (3MO), 12-months (12MO) or lifetime (LIF). ROC curve analysis was used to determine the validity of the WERCAP Screen against the Structured Interview of Psychosis-Risk Syndromes. Longitudinal validity was assessed by comparing baseline p-WERCAP scores in psychotic disorder converters and non-converters, and using ROC curve analysis. Relationship of the p-WERCAP was examined against clinical variables. RESULTS ROC curve analyses against SIPS showed an AUC of 0.83 for 3MO, 0.79 for 12MO and 0.65 for LIF psychosis scores. The optimal cut-point on 3MO was a score of >12 (sens: 0.78; spec: 0.77; ppv: 0.41), and >32 for 12MO (sens: 0.71; spec: 0.74; ppv: 0.24). Baseline 3MO scores (but not LIF scores) were higher in converters compared to high-risk non-converters (p = 0.02). 3MO scores against conversion status had an AUC of 0.75, with an optimal cutoff point of >16 (sens: 1.0; spec: 0.53). All p-WERCAP scores significantly correlated with substance use and stress severity. 12 MO scores were most related to cognitive impairment. CONCLUSIONS The WERCAP Screen is a valid instrument for assessing psychosis severity and conversion risk. It can be used in the community to identify those who may require clinical assessment and care, and for recruitment in psychosis-risk research.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, United States of America.
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Kenya
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Hamilton HK, Roach BJ, Mathalon DH. Forecasting Remission From the Psychosis Risk Syndrome With Mismatch Negativity and P300: Potentials and Pitfalls. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:178-187. [PMID: 33431345 PMCID: PMC8128162 DOI: 10.1016/j.bpsc.2020.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022]
Abstract
Clinical outcomes vary for individuals at clinical high risk (CHR) for psychosis, ranging from conversion to a psychotic disorder to full remission from the risk syndrome. Given that most CHR individuals do not convert to psychosis, recent research efforts have turned toward identifying specific predictors of CHR remission, a task that is conceptually and empirically dissociable from the identification of predictors of conversion to psychosis, and one that may reveal specific biological characteristics that confer resilience to psychosis and provide further insights into the mechanisms associated with the pathogenesis of schizophrenia and those underlying a transient CHR syndrome. Such biomarkers may ultimately facilitate the development of novel early interventions and support the optimization of individualized care. In this review, we focus on two event-related brain potential measures, mismatch negativity and P300, that have attracted interest as predictors of future psychosis among CHR individuals. We describe several recent studies examining whether mismatch negativity and P300 predict subsequent CHR remission and suggest that intact mismatch negativity and P300 may reflect the integrity of specific neurocognitive processes that confer resilience against the persistence of the CHR syndrome and its associated risk for future transition to psychosis. We also highlight several major methodological concerns associated with these studies that apply to the broader literature examining predictors of CHR remission. Among them is the concern that studies that predict dichotomous remission versus nonremission and/or dichotomous conversion versus nonconversion outcomes potentially confound remission and conversion effects, a phenomenon we demonstrate with a data simulation.
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Affiliation(s)
- Holly K Hamilton
- San Francisco VA Health Care System, University of California San Francisco, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California.
| | - Brian J Roach
- San Francisco VA Health Care System, University of California San Francisco, San Francisco, California; Northern California Institute for Research and Education, San Francisco, California
| | - Daniel H Mathalon
- San Francisco VA Health Care System, University of California San Francisco, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California.
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P300 as an index of transition to psychosis and of remission: Data from a clinical high risk for psychosis study and review of literature. Schizophr Res 2020; 226:74-83. [PMID: 30819593 PMCID: PMC6708777 DOI: 10.1016/j.schres.2019.02.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 01/10/2023]
Abstract
Auditory P300 oddball and novel components index working memory operations and salience processing, respectively, and are regarded as biomarkers of neurocognitive changes in both chronic and first-episode schizophrenia. Much less is known about whether P300 abnormalities exist in individuals at clinical high risk for psychosis (CHR) and if they are predictors of both transition to psychosis and remission from symptoms. One hundred and four CHR and 69 healthy control individuals (HC) completed P300 oddball paradigm, and 131 CHR and 69 HC subjects completed P300 novel paradigm. All CHR subjects were followed up for one year and stratified into CHR converters (CHRC) and non-converters (CHR-NC), with CHR-NC further stratified into remitted and non-remitted subgroups. Between-group comparisons of P300 oddball and novel amplitude and latency were performed among CHRC, CHR-NC and HC, as well as among CHRC, non-remitted CHR, remitted CHR and HC. CHR converters had lower fronto-central P300 novel amplitude as well as marginally lower P300 oddball amplitude relative to HC. When CHR non-converters were stratified into remitted and non-remitted subgroups, P300 novel amplitude in remitted CHR subjects was comparable to HC, and it was higher than that in CHR subjects who converted to psychosis or who did not remit. Thus, reduced P300 novel amplitude indexing impaired salience processing marked both conversion to psychosis and remission from psychotic symptoms.
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Progression from being at-risk to psychosis: next steps. NPJ SCHIZOPHRENIA 2020; 6:27. [PMID: 33020486 PMCID: PMC7536226 DOI: 10.1038/s41537-020-00117-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022]
Abstract
Over the past 20 years there has been a great deal of research into those considered to be at risk for developing psychosis. Much has been learned and studies have been encouraging. The aim of this paper is to offer an update of the current status of research on risk for psychosis, and what the next steps might be in examining the progression from CHR to psychosis. Advances have been made in accurate prediction, yet there are some methodological issues in ascertainment, diagnosis, the use of data-driven selection methods and lack of external validation. Although there have been several high-quality treatment trials the heterogeneity of this clinical high-risk population has to be addressed so that their treatment needs can be properly met. Recommendations for the future include more collaborative research programmes, and ensuring they are accessible and harmonized with respect to criteria and outcomes so that the field can continue to move forward with the development of large collaborative consortiums as well as increased funding for multisite projects.
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Oribe N, Hirano Y, Del Re E, Mesholam-Gately RI, Woodberry KA, Ueno T, Kanba S, Onitsuka T, Shenton ME, Spencer KM, Niznikiewicz MA. Longitudinal evaluation of visual P300 amplitude in clinical high-risk subjects: An event-related potential study. Psychiatry Clin Neurosci 2020; 74:527-534. [PMID: 32519778 DOI: 10.1111/pcn.13083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 12/11/2022]
Abstract
AIM We previously reported abnormal P300 and N200 in a visual oddball task, and progressive P300 amplitude reduction at 1-year follow-up in patients with first-episode schizophrenia. P300 reduction as well as intact P1/N1 were also observed in clinical high-risk subjects (CHR), but whether or not these components change over time is unknown. This study evaluates, longitudinally, the visual P300, as well as P1, N1, and N200, in CHR. METHODS Visual event-related potentials (ERP) were recorded twice, once at baseline and once at 1-year follow-up in CHR (n = 19) and healthy comparison subjects (HC; n = 28). Participants silently counted infrequent target stimuli ('x') among standard stimuli ('y') presented on the screen while the 64-channel electroencephalogram was recorded. RESULTS No CHR converted to psychosis from baseline to 1-year follow-up in this study. Visual P300 amplitude was reduced and the latency was delayed significantly in CHR at both time points compared with HC. Furthermore, CHR subjects who had more positive symptoms showed more amplitude reduction at both time points. P1, N1, and N200 did not differ between groups. CONCLUSION Visual P300 amplitude was found to be reduced in CHR individuals compared with HC. We note that this finding is in subjects who did not convert to psychosis at 1-year follow-up. The association between visual P300 amplitude and symptoms suggests that for CHR who often experience clinical symptoms and seek medical care, visual P300 may be an important index that reflects the pathophysiological impairment underlying such clinical states.
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Affiliation(s)
- Naoya Oribe
- Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, USA
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
- Department of Clinical Research, National Hospital Organization, Hizen Psychiatric Medical Center, Yoshinogari, Japan
| | - Yoji Hirano
- Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, USA
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - Elisabetta Del Re
- Departments of Psychiatry and Radiology, Veterans Affairs Boston Healthcare System, and Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
- Cognitive Neuroscience Laboratory, VA Boston Healthcare System, Department of Psychiatry, Harvard Medical School, Brockton, USA
| | - Raquelle I Mesholam-Gately
- Massachusetts Mental Health Center, Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, USA
| | - Kristen A Woodberry
- Massachusetts Mental Health Center, Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, USA
- Center for Psychiatric Research, Maine Medical Center Research Institute, Portland, USA
| | - Takefumi Ueno
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
- Department of Clinical Research, National Hospital Organization, Hizen Psychiatric Medical Center, Yoshinogari, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
- Japan Depression Center, Tokyo, Japan
| | - Toshiaki Onitsuka
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - Martha E Shenton
- Departments of Psychiatry and Radiology, Veterans Affairs Boston Healthcare System, and Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Kevin M Spencer
- Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Margaret A Niznikiewicz
- Cognitive Neuroscience Laboratory, VA Boston Healthcare System, Department of Psychiatry, Harvard Medical School, Brockton, USA
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Hamilton HK, Boos AK, Mathalon DH. Electroencephalography and Event-Related Potential Biomarkers in Individuals at Clinical High Risk for Psychosis. Biol Psychiatry 2020; 88:294-303. [PMID: 32507388 PMCID: PMC8300573 DOI: 10.1016/j.biopsych.2020.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 01/17/2023]
Abstract
Clinical outcomes vary among youths at clinical high risk for psychosis (CHR-P), with approximately 20% progressing to full-blown psychosis over 2 to 3 years and 30% achieving remission. Recent research efforts have focused on identifying biomarkers that precede psychosis onset and enhance the accuracy of clinical outcome prediction in CHR-P individuals, with the ultimate goal of developing staged treatment approaches based on the individual's level of risk. Identifying such biomarkers may also facilitate progress toward understanding pathogenic mechanisms underlying psychosis onset, which may support the development of mechanistically informed early interventions for psychosis. In recent years, electroencephalography-based event-related potential measures with established sensitivity to schizophrenia have gained traction in the study of CHR-P and its clinical outcomes. In this review, we describe the evidence for event-related potential abnormalities in CHR-P and discuss how they inform our understanding of information processing deficits as vulnerability markers for emerging psychosis and as indicators of future outcomes. Among the measures studied, P300 and mismatch negativity are notable because deficits predict conversion to psychosis and/or CHR-P remission. However, the accuracy with which these and other measures predict outcomes in CHR-P has been obscured in the prior literature by the tendency to only report group-level differences, underscoring the need for inclusion of individual predictive accuracy metrics in future studies. Nevertheless, both P300 and mismatch negativity show promise as electrophysiological markers of risk for psychosis, as target engagement measures for clinical trials, and as potential translational bridges between human studies and animal models focused on novel drug development for early psychosis.
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Affiliation(s)
- Holly K Hamilton
- San Francisco Veterans Affairs Health Care System, San Francisco, California; Department of Psychiatry, University of California, San Francisco, California
| | - Alison K Boos
- San Francisco Veterans Affairs Health Care System, San Francisco, California; Northern California Institute for Research and Education, San Francisco, California
| | - Daniel H Mathalon
- San Francisco Veterans Affairs Health Care System, San Francisco, California; Department of Psychiatry, University of California, San Francisco, California.
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Salisbury DF, Kohler J, Shenton ME, McCarley RW. Deficit Effect Sizes and Correlations of Auditory Event-Related Potentials at First Hospitalization in the Schizophrenia Spectrum. Clin EEG Neurosci 2020; 51:198-206. [PMID: 31390901 PMCID: PMC9494547 DOI: 10.1177/1550059419868115] [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: 12/16/2022]
Abstract
The N1, P2, and P3 event-related potentials (ERPs) are impaired in first-episode schizophrenia (FESz). Reduced pitch-deviant mismatch negativity (MMN) is present in chronic schizophrenia but not FESz. We examined effect sizes of, and correlations between, N1, P2, P3, and MMN in 106 FESz and 114 matched psychiatrically well controls to determine which ERPs maximally differentiated groups, and whether late sensory/perceptual deficits (N1, P2) affected preattentive memory (MMN) and conscious attention (P3). Furthermore, we compared hallucinators and nonhallucinators within FESz. Participants completed 1 of 3 oddball tasks, silently counting target tones among standard tones. Sixty-seven FESz and 72 matched participants also completed pitch-deviant MMN testing. Measures were z-scored from task appropriate controls before merging samples. Mean z-scores for N1, P2, and P3 were significantly abnormal in FESz, while pitch-deviant MMN was not. N1 showed the largest deficit (z = 0.53), and only N1 was smaller in hallucinators (n = 71) than nonhallucinators (n = 27). Among all participants, early sensory processing (N1, P2) correlated with later cognitive processing (P3), and P2 and P3 also correlated with automatic preattentive memory (pitch-deviant MMN). In well individuals, N1 was associated with MMN. These data are consistent with bottom-up sensory/perceptual processes affecting more cognitive processes. However, N1 and MMN were not associated in FESz, suggesting different auditory cortex physiology underlie these ERPs, which is differentially affected in FESz. Larger P2 and P3 with greater estimated premorbid intellect in patients indicate a possible neuroprotective effect of intellect in FESz.
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Affiliation(s)
- Dean F Salisbury
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,McLean Hospital, Cognitive Neuroscience Laboratory, Belmont, MA, USA.,UPMC Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Justine Kohler
- UPMC Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martha E Shenton
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Brigham & Women's Hospital, Psychiatry Neuroimaging Laboratory, Boston, MA, USA
| | - Robert W McCarley
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Boston VA Healthcare System, Brockton Division, Laboratory of Neuroscience, Brockton, MA, USA
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12
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Pinheiro AP, Schwartze M, Amorim M, Coentre R, Levy P, Kotz SA. Changes in motor preparation affect the sensory consequences of voice production in voice hearers. Neuropsychologia 2020; 146:107531. [PMID: 32553846 DOI: 10.1016/j.neuropsychologia.2020.107531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/11/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) are a cardinal symptom of psychosis but are also present in 6-13% of the general population. Alterations in sensory feedback processing are a likely cause of AVH, indicative of changes in the forward model. However, it is unknown whether such alterations are related to anomalies in forming an efference copy during action preparation, selective for voices, and similar along the psychosis continuum. By directly comparing psychotic and nonclinical voice hearers (NCVH), the current study specifies whether and how AVH proneness modulates both the efference copy (Readiness Potential) and sensory feedback processing for voices and tones (N1, P2) with event-related brain potentials (ERPs). METHODS Controls with low AVH proneness (n = 15), NCVH (n = 16) and first-episode psychotic patients with AVH (n = 16) engaged in a button-press task with two types of stimuli: self-initiated and externally generated self-voices or tones during EEG recordings. RESULTS Groups differed in sensory feedback processing of expected and actual feedback: NCVH displayed an atypically enhanced N1 to self-initiated voices, while N1 suppression was reduced in psychotic patients. P2 suppression for voices and tones was strongest in NCVH, but absent for voices in patients. Motor activity preceding the button press was reduced in NCVH and patients, specifically for sensory feedback to self-voice in NCVH. CONCLUSIONS These findings suggest that selective changes in sensory feedback to voice are core to AVH. These changes already show in preparatory motor activity, potentially reflecting changes in forming an efference copy. The results provide partial support for continuum models of psychosis.
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Affiliation(s)
- Ana P Pinheiro
- Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal.
| | - Michael Schwartze
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Maria Amorim
- Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Ricardo Coentre
- Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro Levy
- Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal
| | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Hamilton HK, Woods SW, Roach BJ, Llerena K, McGlashan TH, Srihari VH, Ford JM, Mathalon DH. Auditory and Visual Oddball Stimulus Processing Deficits in Schizophrenia and the Psychosis Risk Syndrome: Forecasting Psychosis Risk With P300. Schizophr Bull 2019; 45:1068-1080. [PMID: 30753731 PMCID: PMC6737543 DOI: 10.1093/schbul/sby167] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Identification of neurophysiological abnormalities associated with schizophrenia that predate and predict psychosis onset may improve clinical prediction in the psychosis risk syndrome (PRS) and help elucidate the pathogenesis of schizophrenia. Amplitude reduction of the P300 event-related potential component reflects attention-mediated processing deficits and is among the most replicated biological findings in schizophrenia, making it a candidate biomarker of psychosis risk. The relative extent to which deficits in P300 amplitudes elicited by auditory and visual oddball stimuli precede psychosis onset during the PRS and predict transition to psychosis, however, remains unclear. Forty-three individuals meeting PRS criteria, 19 schizophrenia patients, and 43 healthy control (HC) participants completed baseline electroencephalography recording during separate auditory and visual oddball tasks. Two subcomponents of P300 were measured: P3b, elicited by infrequent target stimuli, and P3a, elicited by infrequent nontarget novel stimuli. Auditory and visual target P3b and novel P3a amplitudes were reduced in PRS and schizophrenia participants relative to HC participants. In addition, baseline auditory and visual target P3b, but not novel P3a, amplitudes were reduced in 15 PRS participants who later converted to psychosis, relative to 18 PRS non-converters who were followed for at least 22 months. Furthermore, target P3b amplitudes predicted time to psychosis onset among PRS participants. These results suggest that P300 amplitude deficits across auditory and visual modalities emerge early in the schizophrenia illness course and precede onset of full psychosis. Moreover, target P3b may represent an important neurophysiological vulnerability marker of the imminence of risk for psychosis.
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Affiliation(s)
- Holly K Hamilton
- Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT
| | - Brian J Roach
- Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA
- Northern California Institute for Research and Education, San Francisco, CA
| | - Katiah Llerena
- Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | | | | | - Judith M Ford
- Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Daniel H Mathalon
- Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA
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14
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Monaghan CK, Brickman S, Huynh P, Öngür D, Hall MH. A longitudinal study of event related potentials and correlations with psychosocial functioning and clinical features in first episode psychosis patients. Int J Psychophysiol 2019; 145:48-56. [PMID: 31108121 DOI: 10.1016/j.ijpsycho.2019.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Deficits in auditory event-related potentials (ERPs), brain responses to stimuli indexing different cognitive processes, have been demonstrated widely in chronic schizophrenia (SZ) patients though much less is known about these responses across the early course of psychosis. The present study examined multiple ERP components in first episode psychosis (FEP) patients longitudinally and investigated the relationships between ERPs, psychosocial functioning, and clinical features over time. METHODS N1, P2, P3a, and P3b ERPs were elicited using a three-stimulus (novelty) auditory oddball paradigm. FEP patients included SZ-spectrum and psychotic bipolar disorder (BD) diagnoses. Data were collected from 41 patients at baseline, 20 patients at 12-month follow-up, 14 at 24-month follow-up, and 29 healthy control subjects. RESULTS N1 and P2 ERPs were intact across the early stages of psychosis. Baseline P2 was significantly larger in BD than SZ patients. Reduced P3a and P3b ERPs were found in patients followed longitudinally and are stable over time. ERPs tracked distinct aspects of symptomology and medication, though specific associations were inconsistent across time. Baseline P3a amplitude predicted later psychosocial functioning. The pattern of correlations between ERP components in patients differed from controls. DISCUSSION Baseline P3a ERP, and PANSS general score were significant and independent predictors of later MCAS functioning at 12-month. Overall, individuals with worse functioning and greater symptomology produced smaller amplitudes. Our results highlight the heterogeneity within the FEP population. Correlation patterns among ERPs are similar between patients and controls. P3a and P3b amplitudes appear to link with higher-order cognitive and psychosocial functioning.
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Affiliation(s)
- Caitlin K Monaghan
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Sophie Brickman
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Polly Huynh
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Mei-Hua Hall
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA.
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15
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Addington J, Farris M, Stowkowy J, Santesteban-Echarri O, Metzak P, Kalathil MS. Predictors of Transition to Psychosis in Individuals at Clinical High Risk. Curr Psychiatry Rep 2019; 21:39. [PMID: 31037392 DOI: 10.1007/s11920-019-1027-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Current research is examining predictors of the transition to psychosis in youth who are at clinical high risk based on attenuated psychotic symptoms (APS). Determining predictors of the development of psychosis is important for an improved understanding of mechanisms as well as the development of preventative strategies. The purpose is to review the most recent literature identifying predictors of the transition to psychosis in those who are already assessed as being at risk. RECENT FINDINGS Multidomain models, in particular, integrated models of symptoms, social functioning, and cognition variables, achieve better predictive performance than individual factors. There are many methodological issues; however, several solutions have now been described in the literature. For youth who already have APS, predicting who may go on to later develop psychosis is possible. Several studies are underway in large consortiums that may overcome some of the methodological concerns and develop improved means of prediction.
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Affiliation(s)
- Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
| | - Megan Farris
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Jacqueline Stowkowy
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Olga Santesteban-Echarri
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Paul Metzak
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Mohammed Shakeel Kalathil
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
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16
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Lepock JR, Mizrahi R, Korostil M, Bagby RM, Pang EW, Kiang M. Event-Related Potentials in the Clinical High-Risk (CHR) State for Psychosis: A Systematic Review. Clin EEG Neurosci 2018; 49:215-225. [PMID: 29382210 DOI: 10.1177/1550059418755212] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is emerging evidence that identification and treatment of individuals in the prodromal or clinical high-risk (CHR) state for psychosis can reduce the probability that they will develop a psychotic disorder. Event-related brain potentials (ERPs) are a noninvasive neurophysiological technique that holds promise for improving our understanding of neurocognitive processes underlying the CHR state. We aimed to systematically review the current literature on cognitive ERP studies of the CHR population, in order to summarize and synthesize the results, and their implications for our understanding of the CHR state. Across studies, amplitudes of the auditory P300 and duration mismatch negativity (MMN) ERPs appear reliably reduced in CHR individuals, suggesting that underlying impairments in detecting changes in auditory stimuli are a sensitive early marker of the psychotic disease process. There are more limited data indicating that an earlier-latency auditory ERP response, the N100, is also reduced in amplitude, and in the degree to which it is modulated by stimulus characteristics, in the CHR population. There is also evidence that a number of auditory ERP measures (including P300, MMN and N100 amplitudes, and N100 gating in response to repeated stimuli) can further refine our ability to detect which CHR individuals are most at risk for developing psychosis. Thus, further research is warranted to optimize the predictive power of algorithms incorporating these measures, which could help efforts to target psychosis prevention interventions toward those most in need.
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Affiliation(s)
- Jennifer R Lepock
- 1 Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Romina Mizrahi
- 1 Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,2 Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Michele Korostil
- 1 Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,2 Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,4 Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - R Michael Bagby
- 1 Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,2 Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,5 Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth W Pang
- 1 Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,6 Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada.,7 Neuroscience and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada
| | - Michael Kiang
- 1 Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,2 Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Alterations of complex mismatch negativity (cMMN) elicited by a two-tone pattern paradigm in early-phase psychosis. Biol Psychol 2018; 135:128-135. [DOI: 10.1016/j.biopsycho.2018.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/19/2018] [Accepted: 03/25/2018] [Indexed: 11/17/2022]
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18
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Mikanmaa E, Grent-'t-Jong T, Hua L, Recasens M, Thune H, Uhlhaas PJ. Towards a neurodynamical understanding of the prodrome in schizophrenia. Neuroimage 2017; 190:144-153. [PMID: 29175199 DOI: 10.1016/j.neuroimage.2017.11.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/23/2017] [Accepted: 11/15/2017] [Indexed: 12/12/2022] Open
Abstract
The identification of biomarkers for the early diagnosis of schizophrenia that could inform novel treatment developments is an important objective of current research. This paper will summarize recent work that has investigated changes in oscillatory activity and event-related potentials with Electro/Magnetoencephalography (EEG/MEG) in participants at high-risk for the development of schizophrenia, highlighting disruptions in sensory and cognitive operations prior to the onset of the syndrome. Changes in EEG/MEG-data are consistent with evidence for alterations in Glutamatergic and GABAergic neurotransmission as disclosed by Magnetic Resonance Spectroscopy and brain stimulation, indicating changes in Excitation/Inhibition balance parameters prior to the onset of psychosis. Together these data emphasize the importance of research into neuronal dynamics as a crucial approach to establish functional relationships between impairments in neural circuits and emerging psychopathology that together could be fundamental for early intervention and the identification of novel treatments for emerging psychosis.
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Affiliation(s)
- Emmi Mikanmaa
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | | | - Lingling Hua
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Marc Recasens
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Hanna Thune
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK.
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19
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Prediction of conversion to psychosis in individuals with an at-risk mental state: a brief update on recent developments. Curr Opin Psychiatry 2017; 30:209-219. [PMID: 28212173 DOI: 10.1097/yco.0000000000000320] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW So far, only little more than one-third of individuals classified as being at-risk for psychosis have been shown to actually convert to frank psychosis during follow-up. There have therefore been enormous efforts to improve the accuracy of predicting this transition. We reviewed the most recent studies in the field with the aim to clarify whether accuracy of prediction has been improved by the different research endeavors and what could be done to further improve it, and/or what alternative goals research should pursue. RECENT FINDINGS A total of 56 studies published between May 2015 and December 2016 were included, of which eight were meta-analyses. New meta-analytical evidence confirms that established instruments for checking clinical risk criteria have an excellent clinical utility in individuals referred to high-risk services. Within a such identified group of ultra-high-risk (UHR) individuals, especially Brief Limited Intermittent Psychotic Symptoms and Attenuated Psychotic Symptoms seem to predict transition. Further assessments should be performed within the UHR individuals, as risk of transition seems particularly high in those with an even higher severity of certain symptoms such as suspiciousness or anhedonia, in those with lower global or social functioning, poor neurocognitive performance or cannabis abuse. Also, electroencephalography, neuroimaging and blood biomarkers might contribute to improving individual prediction. The most promising approach certainly is a staged multidomain assessment. Risk calculators to integrate all data for an individualized prediction are being developed. SUMMARY Prediction of psychosis is already possible with an excellent prognostic performance based on clinical assessments. Recent studies show that this accuracy can be further improved by using multidomain approaches and modern statistics for individualized prediction. The challenge now is the translation into the clinic with a broad clinical implementation.
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20
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Bodatsch M, Brockhaus-Dumke A, Klosterkötter J, Ruhrmann S. Forecasting psychosis by event-related potentials-systematic review and specific meta-analysis. Biol Psychiatry 2015; 77:951-8. [PMID: 25636178 DOI: 10.1016/j.biopsych.2014.09.025] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 09/18/2014] [Accepted: 09/19/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Prediction and prevention of psychosis have become major research topics. Clinical approaches warrant objective biological parameters to enhance validity in prediction of psychosis onset. In this regard, event-related potentials (ERPs) have been identified as promising tools for improving psychosis prediction. METHODS Herein, the focus is on sensory gating, mismatch negativity (MMN) and P300, thereby discussing which parameters allow for a timely and valid detection of future converters to psychosis. In a first step, we systematically reviewed the studies that resulted from a search of the MEDLINE database. In a second step, we performed a meta-analysis of those investigations reporting transitions that statistically compared ERPs in converting versus nonconverting subjects. RESULTS Sensory gating, MMN, and P300 have been demonstrated to be impaired in subjects clinically at risk of developing a psychotic disorder. In the meta-analysis, duration MMN achieved the highest effect size measures. CONCLUSIONS In summary, MMN studies have produced the most convincing results until now, including independent replication of the predictive validity. However, a synopsis of the literature revealed a relative paucity of ERP studies addressing the psychosis risk state. Considering the high clinical relevance of valid psychosis prediction, future research should question for the most informative paradigms and should allow for meta-analytic evaluation with regard to specificity and sensitivity of the most appropriate parameters.
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Affiliation(s)
- Mitja Bodatsch
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne.
| | - Anke Brockhaus-Dumke
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Rheinhessen-Fachklinik Alzey, Alzey, Germany
| | | | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne
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21
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Shendyapina MV, Omelchenko MA, Lebedeva IS, Kanonovich PS, Semenova NA, Ublinsky MV, Dmitrienko DM, Akhadov TA, Simonova OA, Kaleda VG. [Information processing and brain metabolic characteristics in patients at ultra-high risk for endogenous psychosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:24-29. [PMID: 25909785 DOI: 10.17116/jnevro20151151124-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Functional and structural brain abnormalities in people at high risk for psychosis is a subject of intensive studies in biological psychiatry over the last decades. We studied correlations between neurophysiological and neuroimaging parameters in ultra-high risk patients. MATERIAL AND METHODS Fifty-six patients, aged 17-25 years, with nonpsychotic mental disorders were examined. The control group included 30 age- and sex-matched healthy people. Neurophysiological study measured sensory gating. Proton MR-spectroscopy was used to study metabolic processes in the brain (index for glutamate/glutamine, N-acetylaspartate and choline containing compounds in the dorsolateral prefrontal cortex and thalamus of both hemispheres as well as in the genu and splenium of the corpus callosum). RESULTS AND CONCLUSION We found the abnormality of sensory gating in patients at ultra-high risk for endogenous psychosis that was not correlated with the metabolic parameters. The latter were normal or were normalized during treatment.
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22
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del Re EC, Spencer KM, Oribe N, Mesholam-Gately RI, Goldstein J, Shenton ME, Petryshen T, Seidman LJ, McCarley RW, Niznikiewicz MA. Clinical high risk and first episode schizophrenia: auditory event-related potentials. Psychiatry Res 2015; 231:126-33. [PMID: 25557063 PMCID: PMC4314407 DOI: 10.1016/j.pscychresns.2014.11.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 11/07/2014] [Accepted: 11/19/2014] [Indexed: 01/15/2023]
Abstract
The clinical high risk (CHR) period is a phase denoting a risk for overt psychosis during which subacute symptoms often appear, and cognitive functions may deteriorate. To compare biological indices during this phase with those during first episode schizophrenia, we cross-sectionally examined sex- and age-matched clinical high risk (CHR, n=21), first episode schizophrenia patients (FESZ, n=20) and matched healthy controls (HC, n=25) on oddball and novelty paradigms and assessed the N100, P200, P3a and P3b as indices of perceptual, attentional and working memory processes. To our knowledge, this is the only such comparison using all of these event-related potentials (ERPs) in two paradigms. We hypothesized that the ERPs would differentiate between the three groups and allow prediction of a diagnostic group. The majority of ERPs were significantly affected in CHR and FESZ compared with controls, with similar effect sizes. Nonetheless, in logistic regression, only the P3a and N100 distinguished CHR and FESZ from healthy controls, suggesting that ERPs not associated with an overt task might be more sensitive to prediction of group membership.
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Affiliation(s)
- Elisabetta C del Re
- VA Boston Healthcare System, Brockton, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry and Department of Radiology, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA.
| | - Kevin M Spencer
- VA Boston Healthcare System, Brockton, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Naoya Oribe
- VA Boston Healthcare System, Brockton, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jill Goldstein
- Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Brigham and Women׳s Hospital, Connors Center for Women׳s Health and Gender Biology, Boston, MA, USA; Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- VA Boston Healthcare System, Brockton, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry and Department of Radiology, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA
| | - Tracey Petryshen
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Larry J Seidman
- Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Robert W McCarley
- VA Boston Healthcare System, Brockton, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Margaret A Niznikiewicz
- VA Boston Healthcare System, Brockton, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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23
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Du Z. Predisposition to Schizophrenia: An Update of Current Understanding. Cell Biochem Biophys 2015; 73:187-90. [PMID: 25711187 DOI: 10.1007/s12013-015-0614-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Within the field of mental health, the concept of predisposition or that of being "at risk" has been properly addressed by Mrazek and Haggarty. This period prior to clear diagnosis of psychosis has been referred by several names like 'premorbid' phase, at-risk individuals, predisposed individuals, prodromal phase, etc. The premorbid phase is perhaps the most debated term in this list because this term suggests that the morbidity arises only in the overt illness phase. However, evidences arising from several different lines of observations suggest that this may not be the case. In spite of the fact that it has been generally accepted that the prodromal phase precedes the clinical phase, identification of this phase remains a challenge. The real challenge in identifying the onset of the prepsychotic phase is the differentiation of 'normal' experiences from these 'abnormal' experiences. Much fewer studies have been conducted for the assessment of cognitive functions in prodromal phase or predisposed phases of schizophrenia. Cognitive deficits, particularly in memory and attentional functions, are among the most extensively documented aspects of psychosis. Regarding the somatosensory abnormalities in the high-risk individuals, so far there has been only one study conducted which involved somatosensory evoked potentials in these patients.
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Affiliation(s)
- Zhongxiang Du
- Department of Psychiatry, The First Hospital of Xuzhou, Xuzhou, Jiangsu, China.
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24
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Event-related potential and time-frequency endophenotypes for schizophrenia and psychotic bipolar disorder. Biol Psychiatry 2015; 77:127-36. [PMID: 24923619 PMCID: PMC5314434 DOI: 10.1016/j.biopsych.2014.03.032] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 02/20/2014] [Accepted: 03/19/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND The investigators compared event-related potential (ERP) amplitudes and event-related oscillations across a broad frequency range during an auditory oddball task using a comprehensive analysis approach to describe shared and unique neural auditory processing characteristics among healthy subjects (HP), schizophrenia probands (SZ) and their first-degree relatives, and bipolar disorder I with psychosis probands (BDP) and their first-degree relatives. METHODS This Bipolar-Schizophrenia Network on Intermediate Phenotypes sample consisted of clinically stable SZ (n = 229) and BDP (n = 188), HP (n = 284), first-degree relatives of schizophrenia probands (n = 264), and first-degree relatives of bipolar disorder I with psychosis probands (n = 239). They were administered an auditory oddball task in the electroencephalography environment. Principal components analysis derived data-driven frequency bands evoked power. Spatial principal components analysis reduced ERP and frequency data to component waveforms for each subject. Clusters of time bins with significant group differences on response magnitude were assessed for proband/relative differences from HP and familiality. RESULTS Nine variables survived a linear discriminant analysis between HP, SZ, and BDP. Of those, two showed evidence (deficit in relatives and familiality) as genetic risk markers more specific to SZ (N1, P3b), one was specific to BDP (P2) and one for psychosis in general (N2). CONCLUSIONS This study supports for both shared and unique deficits in early sensory and late cognitive processing across psychotic diagnostic groups. Additional ERP and time-frequency component alterations (frontal N2/P2, late high, early, mid, and low frequency) may provide insight into deficits in underlying neural architecture and potential protective/compensatory mechanisms in unaffected relatives.
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25
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van Tricht MJ, Bour LJ, Koelman JHTM, Derks EM, Braff DL, de Wilde OM, Boerée T, Linszen DH, de Haan L, Nieman DH. Qualitative and quantitative aspects of information processing in first psychosis: latent class analyses in patients, at-risk subjects, and controls. Psychophysiology 2014; 52:585-93. [PMID: 25376718 DOI: 10.1111/psyp.12379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 09/18/2014] [Indexed: 11/28/2022]
Abstract
We aimed to determine profiles of information processing deficits in the pathway to first psychosis. Sixty-one subjects at ultrahigh risk (UHR) for psychosis were assessed, of whom 18 converted to a first episode of psychosis (FEP) within the follow-up period. Additionally, 47 FEP and 30 control subjects were included. Using 10 neurophysiological parameters associated with information processing, latent class analyses yielded three classes at baseline. Class membership was related to group status. Within the UHR sample, two classes were found. Transition to psychosis was nominally associated with class membership. Neurophysiological profiles were unstable over time, but associations between specific neurophysiological components at baseline and follow-up were found. We conclude that certain constellations of neurophysiological variables aid in the differentiation between controls and patients in the prodrome and after first psychosis.
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Affiliation(s)
- Mirjam J van Tricht
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Neurology and Clinical Neurophysiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Mamah D, Owoso A, Sheffield JM, Bayer C. The WERCAP Screen and the WERC Stress Screen: psychometrics of self-rated instruments for assessing bipolar and psychotic disorder risk and perceived stress burden. Compr Psychiatry 2014; 55:1757-71. [PMID: 25128205 DOI: 10.1016/j.comppsych.2014.07.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Identification of individuals in the prodromal phase of bipolar disorder and schizophrenia facilitates early intervention and promises an improved prognosis. There are no current assessment tools for clinical risk symptoms of bipolar disorder, and psychosis-risk assessment generally involves semi-structured interviews, which are time consuming and rater dependent. We present psychometric data on two novel quantitative questionnaires: the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen for assessing bipolar and psychotic disorder risk traits, and the accompanying WERC Stress Screen for assessing individual and total psychosocial stressor severities. METHODS Prevalence rates of the WERCAP Screen were evaluated among 171 community youth (aged 13-24 years); internal consistency was assessed and k-means cluster analysis was used to identify symptom groups. In 33 participants, test-retest reliability coefficients were assessed, and ROC curve analysis was used to determine the validity of the psychosis section of the WERCAP Screen (pWERCAP) against the Structured Interview of Psychosis-Risk Symptoms (SIPS). Correlations of the pWERCAP, the affectivity section of the WERCAP Screen (aWERCAP) and the WERC Stress Screen were examined to determine the relatedness of scores with cognition and clinical measures. RESULTS Cluster analysis identified three groups of participants: a normative (47%), a psychosis-affectivity (18%) and an affectivity only (35%) group. Internal consistency of the aWERCAP and pWERCAP resulted in alphas of 0.87 and 0.92, and test-retest reliabilities resulted in intraclass correlation coefficients of 0.76 and 0.86 respectively. ROC curve analysis showed the optimal cut-point on the pWERCAP as a score of >30 (sensitivity: 0.89; specificity: 1.0). There was a significant negative correlation between aWERCAP scores and total cognition (R=-0.42), and between pWERCAP scores and sensorimotor processing speed. Total stress scores correlated significantly with scores on the aWERCAP (R=0.88), pWERCAP (R=0.62) and total cognition (R=-0.44). CONCLUSIONS Our results show that the WERCAP Screen and the WERC Stress Screen are easy to administer and derived scores are related to cognitive and clinical traits. This suggests that their use could have particular benefits for epidemiologic studies and in busy clinical settings. Longitudinal studies would be required to evaluate clinical outcomes with high questionnaire scores.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University, St. Louis, Missouri.
| | - Akinkunle Owoso
- Department of Psychiatry, Washington University, St. Louis, Missouri
| | - Julia M Sheffield
- Department of Psychology, Washington University, St. Louis, Missouri
| | - Chelsea Bayer
- Department of Psychiatry, Washington University, St. Louis, Missouri
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Correlations of Parameters of Cerebral Evoked Potentials with Age, Clinical, and Social Characteristics of Patients with the First Episode of Psychosis. NEUROPHYSIOLOGY+ 2014. [DOI: 10.1007/s11062-014-9437-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Abstract
Psychotic disorders continue to be among the most disabling and scientifically challenging of all mental illnesses. Accumulating research findings suggest that the etiologic processes underlying the development of these disorders are more complex than had previously been assumed. At the same time, this complexity has revealed a wider range of potential options for preventive intervention, both psychosocial and biological. In part, these opportunities result from our increased understanding of the dynamic and multifaceted nature of the neurodevelopmental mechanisms involved in the disease process, as well as the evidence that many of these entail processes that are malleable. In this article, we review the burgeoning research literature on the prodrome to psychosis, based on studies of individuals who meet clinical high risk criteria. This literature has examined a range of factors, including cognitive, genetic, psychosocial, and neurobiological. We then turn to a discussion of some contemporary models of the etiology of psychosis that emphasize the prodromal period. These models encompass the origins of vulnerability in fetal development, as well as postnatal stress, the immune response, and neuromaturational processes in adolescent brain development that appear to go awry during the prodrome to psychosis. Then, informed by these neurodevelopmental models of etiology, we turn to the application of new research paradigms that will address critical issues in future investigations. It is expected that these studies will play a major role in setting the stage for clinical trials aimed at preventive intervention.
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29
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Chen KC, Lee IH, Yang YK, Landau S, Chang WH, Chen PS, Lu RB, David AS, Bramon E. P300 waveform and dopamine transporter availability: a controlled EEG and SPECT study in medication-naive patients with schizophrenia and a meta-analysis. Psychol Med 2014; 44:2151-2162. [PMID: 24238542 DOI: 10.1017/s0033291713002808] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Reduced P300 event-related potential (ERP) amplitude and latency prolongation have been reported in patients with schizophrenia compared to healthy controls. However, the influence of antipsychotics (and dopamine) on ERP measures are poorly understood and medication confounding remains a possibility. METHOD We explored ERP differences between 36 drug-naive patients with schizophrenia and 138 healthy controls and examined whether P300 performance was related to dopamine transporter (DAT) availability, both without the confounding effects of medication. We also conducted a random effects meta-analysis of the available literature, synthesizing the results of three comparable published articles and our local study. RESULTS No overall significant difference was found in mean P300 ERP between patients and controls in latency or in amplitude. There was a significant gender effect, with females showing greater P300 amplitude than males. A difference between patients and controls in P300 latency was evident with ageing, with latency increasing faster in patients. No effect of DAT availability on P300 latency or amplitude was detected. The meta-analysis computed the latency pooled standardized effect size (PSES; Cohen's d) of -0.13 and the amplitude PSES (Cohen's d) of 0.48, with patients showing a significant reduction in amplitude. CONCLUSIONS Our findings suggest the P300 ERP is not altered in the early stages of schizophrenia before medication is introduced, and the DAT availability does not influence the P300 ERP amplitude or latency. P300 ERP amplitude reduction could be an indicator of the progression of illness and chronicity.
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Affiliation(s)
- K C Chen
- Department of Psychiatry,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - I H Lee
- Department of Psychiatry,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - Y K Yang
- Department of Psychiatry,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - S Landau
- Department of Biostatistics, Institute of Psychiatry,King's College London,UK
| | - W H Chang
- Department of Psychiatry,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - P S Chen
- Department of Psychiatry,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - R B Lu
- Department of Psychiatry,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - A S David
- Department of Psychosis Studies, Institute of Psychiatry,King's College London,UK
| | - E Bramon
- Department of Psychosis Studies, Institute of Psychiatry,King's College London,UK
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30
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Goulding SM, Holtzman CW, Trotman HD, Ryan AT, Macdonald AN, Shapiro DI, Brasfield JL, Walker EF. The prodrome and clinical risk for psychotic disorders. Child Adolesc Psychiatr Clin N Am 2013; 22:557-67. [PMID: 24012073 PMCID: PMC4140174 DOI: 10.1016/j.chc.2013.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The psychosis prodrome offers great promise for identifying neural mechanisms involved in psychotic disorders and offers an opportunity to implement empirical interventions to delay, and ultimately ameliorate, illness onset. This article summarizes the literature on individuals in the putatively prodromal phase of psychosis/deemed at clinical high risk (CHR) for psychosis onset. Standardized measurement and manifestation of the CHR syndromes are discussed, followed by empirical findings that highlight the psychological deficits and biological abnormalities seen in CHR syndromes and psychotic disorders. Current controversies surrounding the diagnosis of CHR syndromes and issues related to the treatment of CHR individuals are also presented.
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Affiliation(s)
- Sandra M Goulding
- Mental Health and Development Program, Department of Psychology, Emory University, 36 Eagle Row, Room 270, Atlanta, GA 30322, USA.
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Fusar-Poli P, Borgwardt S, Bechdolf A, Addington J, Riecher-Rössler A, Schultze-Lutter F, Keshavan M, Wood S, Ruhrmann S, Seidman LJ, Valmaggia L, Cannon T, Velthorst E, De Haan L, Cornblatt B, Bonoldi I, Birchwood M, McGlashan T, Carpenter W, McGorry P, Klosterkötter J, McGuire P, Yung A. The psychosis high-risk state: a comprehensive state-of-the-art review. JAMA Psychiatry 2013; 70:107-20. [PMID: 23165428 PMCID: PMC4356506 DOI: 10.1001/jamapsychiatry.2013.269] [Citation(s) in RCA: 975] [Impact Index Per Article: 88.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. OBJECTIVE To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. DATA SOURCES Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. STUDY SELECTION AND DATA EXTRACTION Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. DATA SYNTHESIS Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. CONCLUSIONS The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.
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Affiliation(s)
- Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK.
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | | | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Stephen Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia; School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Larry J. Seidman
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston
| | - Lucia Valmaggia
- Departments of Psychosis Studies and Psychology, King's College London, London, United Kingdom; OASIS team for prodromal psychosis, NHSSLAM Foundation Trust, London
| | - Tyrone Cannon
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Eva Velthorst
- Department of Early Psychosis, Academic Medical Center, Amsterdam, the Netherlands
| | - Lieuwe De Haan
- Department of Early Psychosis, Academic Medical Center, Amsterdam, the Netherlands
| | - Barbara Cornblatt
- Department of Psychiatry Research, The Zucker Hillside Hospital, New York, New York
| | - Ilaria Bonoldi
- OASIS team for prodromal psychosis, NHSSLAM Foundation Trust, London; Department of Psychosis Studies King's College London, London, United Kingdom
| | - Max Birchwood
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | | | - William Carpenter
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore
| | - Patrick McGorry
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne
| | | | - Philip McGuire
- Department of Psychosis Studies King's College London, London, United Kingdom; OASIS team for prodromal psychosis, NHSSLAM Foundation Trust, London
| | - Alison Yung
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne
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32
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Ziermans TB, Schothorst PF, Sprong M, Magnée MJCM, van Engeland H, Kemner C. Reduced prepulse inhibition as an early vulnerability marker of the psychosis prodrome in adolescence. Schizophr Res 2012; 134:10-5. [PMID: 22085828 DOI: 10.1016/j.schres.2011.10.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 10/04/2011] [Accepted: 10/20/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND The onset of psychosis is thought to be preceded by neurodevelopmental changes in the brain. However, the timing and nature of these changes have not been established. The aim of the present study was to determine whether three "classic" neurophysiological markers of schizophrenia are also characteristic of young adolescents (12-18 years) at ultra-high risk for psychosis (UHR). METHODS 63 young UHR individuals and 68 typically developing, age-, sex- and IQ-matched controls were recruited for neurophysiological assessment. Data for P50 suppression, prepulse inhibition (PPI) and smooth pursuit eye movements (SPEM) were gathered and compared. RESULTS UHR individuals showed reduced PPI compared to controls, which became more pronounced when controls were directly compared to medication-naive UHR individuals (N=39). There were no group differences in P50 or SPEM measures. CONCLUSIONS These results suggest that PPI is a relatively early vulnerability marker, while changes in other neurophysiological measures may only be detected or affected later during the illness course. Antipsychotic and antidepressant medication may aid in elevating PPI levels and potentially have a neuroprotective effect.
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Affiliation(s)
- Tim B Ziermans
- Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
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