Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens (Parker, Trotti, McDowell, Clementz); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (Keedy, Gershon); Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago (Hill); Department of Psychiatry, UT Southwestern Medical Center, Dallas (Ivleva, Tamminga); Departments of Psychiatry and Neuroscience, Yale School of Medicine, New Haven, Conn. (Pearlson); Olin Center, Institute of Living, Hartford Healthcare Corporation, Hartford, Conn. (Pearlson); and Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Cambridge, Mass. (Keshavan).
Am J Psychiatry. 2021 Oct 1;178(10):952-964. doi: 10.1176/appi.ajp.2021.20071043. Epub 2021 Aug 19.
Neural activations during auditory oddball tasks may be endophenotypes for psychosis and bipolar disorder. The authors investigated oddball neural deviations that discriminate multiple diagnostic groups across the schizophrenia-bipolar spectrum (schizophrenia, schizoaffective disorder, psychotic bipolar disorder, and nonpsychotic bipolar disorder) and clarified their relationship to clinical and cognitive features.
Auditory oddball responses to standard and target tones from 64 sensor EEG recordings were compared across patients with psychosis (total N=597; schizophrenia, N=225; schizoaffective disorder, N=201; bipolar disorder with psychosis, N=171), patients with bipolar disorder without psychosis (N=66), and healthy comparison subjects (N=415) from the second iteration of the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP2) study. EEG activity was analyzed in voltage and in the time-frequency domain (low, beta, and gamma bands). Event-related potentials (ERPs) were compared with those from an independent sample collected during the first iteration of B-SNIP (B-SNIP1; healthy subjects, N=211; psychosis group, N=526) to establish the repeatability of complex oddball ERPs across multiple psychosis syndromes (r values >0.94 between B-SNIP1 and B-SNIP2).
Twenty-six EEG features differentiated the groups; they were used in discriminant and correlational analyses. EEG variables from the N100, P300, and low-frequency ranges separated the groups along a diagnostic continuum from healthy to bipolar disorder with psychosis/bipolar disorder without psychosis to schizoaffective disorder/schizophrenia and were strongly related to general cognitive function (r=0.91). P50 responses to standard trials and early beta/gamma frequency responses separated the bipolar disorder without psychosis group from the bipolar disorder with psychosis group. P200, N200, and late beta/gamma frequency responses separated the two bipolar disorder groups from the other groups.
Neural deviations during auditory processing are related to psychosis history and bipolar disorder. There is a powerful transdiagnostic relationship between severity of these neural deviations and general cognitive performance. These results have implications for understanding the neurobiology of clinical syndromes across the schizophrenia-bipolar spectrum that may have an impact on future biomarker research.
听觉Oddball 任务期间的神经激活可能是精神分裂症和双相障碍的内表型。作者研究了区分精神分裂症-双相谱系（精神分裂症、分裂情感障碍、伴有精神病性的双相障碍和无精神病性的双相障碍）中多个诊断组的Oddball 神经偏差，并阐明了它们与临床和认知特征的关系。
来自双相-精神分裂症网络中间表型研究（B-SNIP2）第二次迭代的 64 个传感器脑电图记录中，对患有精神疾病的患者（总 N=597；精神分裂症，N=225；分裂情感障碍，N=201；伴有精神病性的双相障碍，N=171）、患有双相障碍但无精神病性的患者（N=66）和健康对照者（N=415）进行听觉Oddball 对标准音和靶音的反应。脑电图活动在电压和时频域（低频、β频和γ频带）中进行分析。比较事件相关电位（ERPs）与来自 B-SNIP 第一次迭代（B-SNIP1；健康对照者，N=211；精神病组，N=526）中收集的独立样本，以建立跨多种精神病综合征的复杂 Oddball ERPs 的可重复性（B-SNIP1 和 B-SNIP2 之间 r 值>0.94）。
26 个 EEG 特征区分了这些组；它们被用于判别和相关分析。N100、P300 和低频范围的 EEG 变量沿着从健康到伴有精神病性的双相障碍/无精神病性的双相障碍到分裂情感障碍的诊断连续体分离组，并与一般认知功能密切相关（r=0.91）。标准试验的 P50 反应和早期β/γ频率反应将无精神病性的双相障碍组与伴有精神病性的双相障碍组分开。P200、N200 和晚期β/γ频率反应将两组双相障碍与其他组分开。
听觉处理过程中的神经偏差与精神病史和双相障碍有关。这些神经偏差的严重程度与一般认知表现之间存在强大的跨诊断关系。这些结果对于理解精神分裂症-双相谱系中的临床综合征的神经生物学具有重要意义，可能对未来的生物标志物研究产生影响。
