Erickson Molly A, Ruffle Abigail, Gold James M
Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.
Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.
Biol Psychiatry. 2016 Jun 15;79(12):980-7. doi: 10.1016/j.biopsych.2015.08.025. Epub 2015 Aug 31.
The observation that mismatch negativity (MMN) is consistently impaired in schizophrenia has generated considerable interest in the use of this biomarker as an index of disease risk and progression. Despite such enthusiasm, a number of issues remain unresolved regarding the nature of MMN impairment. The present study expands upon an earlier meta-analysis of MMN impairment in schizophrenia by examining impairment across a range of clinical presentations, as well as across experimental parameters.
One hundred one samples of schizophrenia patients were included in the present study, including first-episode (n = 13), chronic (n = 13), and mixed-stage (n = 75) samples. Additionally, MMN was examined in three related conditions: bipolar disorder (n = 9), unaffected first-degree relatives (n = 8), and clinical high risk (n = 16).
We found that MMN impairment 1) likely reflects a vulnerability to disease progression in clinical high-risk populations rather than a genetic risk for the condition; 2) is largely unrelated to duration of illness after the first few years of illness, indicating that impairment is not progressive throughout the life span; 3) is present in bipolar disorder, albeit to a lesser degree than in schizophrenia; and 4) is not modulated by experimental parameters such as magnitude of change between standard and deviant tones or frequency of deviant tones but may be modulated by attentional demands.
Such findings lay the foundation for a better understanding of the nature of MMN impairment in schizophrenia, as well as its potential as a clinically useful biomarker.
错配负波（MMN）在精神分裂症中持续受损这一观察结果引发了人们对将该生物标志物用作疾病风险和进展指标的浓厚兴趣。尽管有这种热情，但关于MMN受损的性质仍有一些问题尚未解决。本研究通过检查一系列临床表现以及实验参数中的损伤情况，对早期关于精神分裂症中MMN损伤的荟萃分析进行了扩展。
本研究纳入了101个精神分裂症患者样本，包括首发（n = 13）、慢性（n = 13）和混合阶段（n = 75）样本。此外，在三种相关情况下检查了MMN：双相情感障碍（n = 9）、未受影响的一级亲属（n = 8）和临床高危人群（n = 16）。
我们发现MMN损伤1）可能反映了临床高危人群中疾病进展的易感性，而非该疾病的遗传风险；2）在疾病最初几年后，很大程度上与病程无关，表明损伤并非在整个生命周期中持续进展；3）在双相情感障碍中也存在，尽管程度低于精神分裂症；4）不受诸如标准音与偏差音之间的变化幅度或偏差音频率等实验参数的调节，但可能受注意力需求的调节。
这些发现为更好地理解精神分裂症中MMN损伤的性质及其作为临床有用生物标志物的潜力奠定了基础。
