Erickson Molly A, Bansal Sonia, Li Charlotte, Waltz James, Corlett Philip, Gold James
Department of Psychiatry & Behavioral Neuroscience, University of Chicago Medical Center, Chicago, Illinois.
Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.
Biol Psychiatry Glob Open Sci. 2024 Sep 17;5(1):100394. doi: 10.1016/j.bpsgos.2024.100394. eCollection 2025 Jan.
Among people with schizophrenia (PSZ), reduced mismatch negativity (MMN) is conceptualized as evidence of disrupted prediction error signaling that underlies positive symptoms. However, this conceptualization has been challenged by observations that MMN and positive symptoms are often uncorrelated. In the current study, we tested the hypothesis that reduced MMN is associated with the presence of hallucinations and delusions specifically rather than the presence of a psychiatric illness. A second aim was to determine whether the strength of the association with positive symptoms increases for indices that reflect predictions at higher levels of abstraction.
Fifty-six PSZ, 34 nonclinical voice hearers, and 48 healthy comparison subjects (HCs) completed 2 MMN paradigms: one with a simple duration deviant type, and one with a higher-level, pattern-violation deviant type. We also measured the repetition positivity, which reflects the formation of auditory memory traces.
We observed that although PSZ exhibited the expected pattern of significantly reduced duration MMN and reduced pattern-violation MMN at the trend level compared with HCs, nonclinical voice hearers exhibited a pattern of duration MMN and pattern-violation MMN amplitude that was statistically similar to that of HCs (s > .64). Similarly, PSZ exhibited a significantly reduced repetition positivity slope compared with HCs in the duration condition and a trend-level reduction compared with HCs in the pattern-violation condition. Nonclinical voice hearers did not differ from either group in repetition positivity slope in either condition.
These results indicate that the MMN as a prediction error signal does not reflect processes relevant for the manifestation of hallucinations and delusions.
在精神分裂症患者（PSZ）中，失匹配负波（MMN）降低被认为是预测误差信号中断的证据，而这种中断是阳性症状的基础。然而，MMN与阳性症状往往不相关这一观察结果对这一概念提出了挑战。在本研究中，我们检验了以下假设：MMN降低与幻觉和妄想的存在相关，而非与精神疾病的存在相关。第二个目的是确定对于反映更高抽象水平预测的指标，其与阳性症状的关联强度是否会增加。
56名精神分裂症患者、34名非临床幻听者和48名健康对照受试者（HCs）完成了2种MMN范式：一种是简单持续时间偏差类型，另一种是更高层次的模式违反偏差类型。我们还测量了重复正波，它反映了听觉记忆痕迹的形成。
我们观察到，尽管与HCs相比，PSZ表现出预期的模式，即持续时间MMN显著降低，且在趋势水平上模式违反MMN降低，但非临床幻听者表现出的持续时间MMN和模式违反MMN幅度模式在统计学上与HCs相似（s>.64）。同样，与HCs相比，PSZ在持续时间条件下的重复正波斜率显著降低，在模式违反条件下与HCs相比有趋势水平的降低。在任何一种条件下，非临床幻听者在重复正波斜率上与两组均无差异。
这些结果表明，作为预测误差信号的MMN并不反映与幻觉和妄想表现相关的过程。
