Salisbury Dean F, Coffman Brian A, Haigh Sarah M
Clinical Neurophysiology Research Laboratory, Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
Front Psychiatry. 2020 Jun 8;11:505. doi: 10.3389/fpsyt.2020.00505. eCollection 2020.
Although "simple" mismatch negativity (sMMN) to stimulus parameter changes is robustly reduced in long-term schizophrenia (Sz), it is much less reduced in individuals at their first psychotic episode in the schizophrenia-spectrum (FESz). "Complex" MMN (cMMN) reflecting pre-attentive acoustic pattern analysis is also markedly reduced in Sz, but is little studied in FESz. The computational complexity of pattern analysis reflected in cMMN may more greatly stress auditory processing, providing a more sensitive measure of auditory processing deficits at first break. If so, cMMN would provide information about the underlying pathophysiology early in disease course, and may serve as a biomarker for pathology in the Sz prodrome. Twenty-two FESz individuals were compared to 22 volunteer healthy controls (HC) on sMMN and cMMN tasks. For sMMN, pitch- and duration-deviants were presented among standard repetitive tones. For cMMN, repeated groups of 3 identical tones were presented with occasional (14%) groups including an extra identical 4th tone deviant. FESz did not show reductions of pitch-deviant (Cohen's d = 0.08) or duration-deviant MMNs (d =-0.02), but showed large reduction in extra-tone cMMN (d = 0.83). Reduced cMMN was associated with poor social functioning. Reduction in cMMN but not in sMMNs in FESz suggests impairments in late perceptual pattern processing. cMMN is sensitive to subtle pathology and functioning early in disease course which may, in turn, impact social functioning. Future studies in clinical high risk individuals are needed to determine whether this putative biomarker of disease presence is sensitive to the prodromal stage of schizophrenia.
尽管长期精神分裂症（Sz）患者对刺激参数变化的“简单”失配负波（sMMN）明显降低，但处于精神分裂症谱系首次精神病发作阶段（FESz）的个体降低程度要小得多。反映前注意听觉模式分析的“复杂”MMN（cMMN）在Sz患者中也明显降低，但在FESz患者中的研究较少。cMMN所反映的模式分析计算复杂性可能会给听觉处理带来更大压力，从而在首次发作时提供更敏感的听觉处理缺陷测量指标。如果是这样，cMMN将在疾病进程早期提供有关潜在病理生理学的信息，并可能作为精神分裂症前驱期病理的生物标志物。将22名FESz个体与22名志愿者健康对照者（HC）进行sMMN和cMMN任务比较。对于sMMN，在标准重复音调中呈现音高和时长偏差。对于cMMN，呈现由3个相同音调组成的重复组，偶尔（14%）会出现包含额外第4个相同音调偏差的组。FESz患者的音高偏差MMN（Cohen's d = 0.08）或时长偏差MMN（d = -0.02）没有降低，但额外音调cMMN大幅降低（d = 0.83）。cMMN降低与社会功能差有关。FESz患者中cMMN降低而sMMN未降低表明后期感知模式处理存在损伤。cMMN对疾病进程早期的细微病理和功能敏感，这反过来可能会影响社会功能。需要对临床高危个体进行进一步研究，以确定这种假定的疾病存在生物标志物是否对精神分裂症前驱期敏感。
