Guo Qian, Zhao Zexin, Wang Wenzheng, Hu Xiaonan, Hu Hao, Hu Yao, Xu Lihua, Liu Xu, Liu Xiaohua, Li Guanjun, Shi Zhongying, Wang Jijun
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, PR China.
Schizophr Res Cogn. 2025 Jan 9;40:100344. doi: 10.1016/j.scog.2025.100344. eCollection 2025 Jun.
Evidence suggests that attenuated mismatch negative (MMN) waves have a close link to auditory verbal hallucinations (AVH) and their clinical outcomes, especially impaired neural oscillations such as θ, β representing attentional control. In current study, thirty patients with schizophrenia and AVH (SZ) and twenty-nine healthy controls (HC) underwent multi-feature MMN paradigm measurements including frequency and duration deviant stimuli (fMMN and dMMN). Clinical symptoms and MMN paradigm were followed up among SZ group after 8-week treatment. Results demonstrated that hallucinating patients exhibited attenuated dMMN amplitudes across Fz (p = 0.010), F1 (p = 0.020) and F2 (p = 0.014) electrodes, which were trendily recovered after treatment. Meanwhile, θ band and TBR at frontal fMMN and right temporal dMMN were significantly reduced in SZs. After treatment, SZs showed reduced scores of Hoffman's Auditory Hallucinations Rating Scale (AHRS), with a remarkable recovery in right temporal TBR of dMMN (p = 0.042) and a trending change in frontal TBR of fMMN (p = 0.090). The β band was decreased in dMMN (p = 0.035) by time. Additionally, P3 scores of Positive and Negative Syndrome Scale (PANSS) were negatively correlated with θ band of fMMN at baseline. Baseline scores of AHRS negatively predicted changes of dMMN amplitude after treatment, and changes of β band in left temporal dMMN predicted the reduction in scores of PANSS negative scale. These findings supported that deficits in θ oscillation and TBR during auditory attention process were crucial to clinical progression of schizophrenia with AVH.
有证据表明，失匹配负波（MMN）减弱与幻听（AVH）及其临床结果密切相关，尤其是与诸如代表注意力控制的θ、β等神经振荡受损有关。在本研究中，30例伴有幻听的精神分裂症患者（SZ）和29名健康对照者（HC）接受了多特征MMN范式测量，包括频率和时长偏差刺激（fMMN和dMMN）。对SZ组患者进行8周治疗后，随访其临床症状和MMN范式。结果表明，有幻听的患者在Fz（p = 0.010）、F1（p = 0.020）和F2（p = 0.014）电极处的dMMN波幅减弱，治疗后有逐渐恢复的趋势。同时，SZ患者额叶fMMN处的θ频段和时间基率（TBR）以及右侧颞叶dMMN处的θ频段和TBR显著降低。治疗后，SZ患者的霍夫曼幻听评定量表（AHRS）评分降低，dMMN右侧颞叶TBR有显著恢复（p = 0.042），fMMN额叶TBR有趋势性变化（p = 0.090）。随着时间推移，dMMN中的β频段降低（p = 0.035）。此外，阳性和阴性症状量表（PANSS）的P3评分在基线时与fMMN的θ频段呈负相关。AHRS的基线评分可负向预测治疗后dMMN波幅的变化，左侧颞叶dMMN中β频段的变化可预测PANSS阴性量表评分的降低。这些发现支持，听觉注意力过程中θ振荡和TBR的缺陷对伴有幻听的精神分裂症的临床进展至关重要。
