Department of Psychiatry, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
Schizophr Res. 2019 Aug;210:228-238. doi: 10.1016/j.schres.2018.12.029. Epub 2019 Jan 23.
Little research has investigated the use of electrophysiological biomarkers in childhood and adolescence to distinguish early onset psychosis and the clinical high risk state. The P300 evoked potential is a robust neurophysiological marker of schizophrenia that is dampened in patients with schizophrenia and, less consistently, in those with affective psychoses and those at clinical high risk for psychosis (CHR). How it may differ between patients with psychotic disorders (PS) and CHR is less studied, especially in youth. The current study compared P300 activity among children and adolescents, aged 5-18 years, at CHR (n = 43), with PS (n = 28), and healthy controls (HC; n = 24). Participants engaged in an auditory event-related potential (ERP) task to elicit a P300 response and completed clinical interviews to verify symptoms and diagnoses. Linear regression analyses revealed a decrease in P300 amplitude with increased severity of psychotic symptoms. PS participants showed a diminished P300 response compared to those at CHR and HC, particularly among adolescents aged 13-18. This response was most evident at centroparietal and parietal locations in the right hemisphere. The findings suggest that high risk and psychotic symptomatology is linked to attenuated parietal P300 activity in youth as young as 13 years. Further exploration of the P300 as a biomarker for psychosis in very young patients could inform tailored, appropriate interventions at early stages of disease progression. Future research should evaluate whether specific phenotypic and genotypic characteristics are differentially associated with neurophysiological biomarkers and whether P300 attenuation in CHR youth can predict later symptom severity.
针对儿童和青少年时期使用电生理生物标志物来区分早期精神病和临床高危状态的研究甚少。P300 诱发电位是精神分裂症的一种强大神经生理标志物，在精神分裂症患者中会减弱，在情感性精神病患者中和处于精神病临床高危状态（CHR）的患者中则不太一致。其在精神病患者（PS）和 CHR 患者之间的差异研究较少，尤其是在年轻人中。本研究比较了 CHR（n=43）、PS（n=28）和健康对照组（HC；n=24）的儿童和青少年（5-18 岁）的 P300 活动。参与者进行听觉事件相关电位（ERP）任务以引出 P300 反应，并完成临床访谈以验证症状和诊断。线性回归分析显示，随着精神病症状严重程度的增加，P300 幅度降低。与 CHR 和 HC 相比，PS 参与者的 P300 反应减弱，尤其是在 13-18 岁的青少年中。这种反应在右半球的中央顶和顶区最为明显。研究结果表明，高危和精神病症状与年轻人（年仅 13 岁）的顶叶 P300 活动减弱有关。进一步探索 P300 作为精神病的生物标志物，可能为疾病进展的早期阶段提供针对性的适当干预措施。未来的研究应评估特定的表型和基因型特征是否与神经生理生物标志物有差异相关，以及 CHR 青少年的 P300 衰减是否可以预测以后的症状严重程度。
