Mismatch Negativity Predicts Remission and Neurocognitive Function in Individuals at Ultra-High Risk for Psychosis
Mismatch Negativity Predicts Remission and Neurocognitive Function in Individuals at Ultra-High Risk for Psychosis
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DOI：
10.3389/fpsyt.2020.00770
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发表时间：
2020-08-03
影响因子：
4.7
通讯作者：
Kasai, Kiyoto
中科院分区：
文献类型：
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作者：
Fujioka, Mao;Kirihara, Kenji;Kasai, Kiyoto
背景 在精神病的早期干预中，超高风险（UHR）标准已被用来识别容易患精神病的个体。尽管 UHR 患者在几年内转变为精神病的比率为 10% 至 30%，但一些 UHR 患者即使没有发生转变，预后也很差。因此，无论过渡如何，识别生物标志物来预测 UHR 个体的预后非常重要。我们研究了对持续时间偏差刺激 (dMMN) 和频率偏差刺激 (fMMN) 的错配负性 (MMN) 是否可以预测 UHR 个体的预后，包括缓解和神经认知功能。材料和方法 UHR 个体（n = 24）和健康对照者（HC；n = 18）参与了本研究。在一个奇怪的听觉范式中，dMMN 和 fMMN 都是在基线时测量的。在 UHR 组中检查 > 180 天后的缓解和神经认知功能。 UHR 缓解被定义为使用整体功能评估 (GAF) 评分和前驱症状量表 (SOPS) 阳性子量表的功能和症状改善。使用精神分裂症认知简要评估（BACS）来测量神经认知功能。我们检查了缓解者（缓解者）和未缓解者（非缓解者）之间基线 MMN 振幅的差异。进行多元回归分析以确定功能、阳性症状和神经认知功能的预测因素。结果与HC组相比，UHR组的dMMN振幅显着减弱（p=0.003）。在UHR组中，GAF评分在随访期间显着改善（平均值47.1至55.5，p=0.004）。汇款人 (n = 6) 的基线 dMMN 振幅显着大于非汇款人组 (n = 18) (p = 0.039)。基线时的总 SOPS 阳性子量表分数和 fMMN 幅度可以预测随访点的 BACS 注意力子分数（SOPS 阳性子量表，p= 0.030；fMMN，p= 0.041）。结论 我们的研究结果表明，dMMN 和 fMMN 分别预测 UHR 个体的缓解和神经认知功能，这表明这两种候选生物标志物都可用于预测 UHR 个体的预后。
Background In the early intervention in psychosis, ultra-high risk (UHR) criteria have been used to identify individuals who are prone to develop psychosis. Although the transition rate to psychosis in individuals at UHR is 10% to 30% within several years, some individuals at UHR present with poor prognoses even without transition occurring. Therefore, it is important to identify biomarkers for predicting the prognosis of individuals at UHR, regardless of transition. We investigated whether mismatch negativity (MMN) in response to both duration deviant stimuli (dMMN) and frequency deviant stimuli (fMMN) could predict prognosis, including remission and neurocognitive function in individuals at UHR. Materials and Methods Individuals at UHR (n = 24) and healthy controls (HC; n = 18) participated in this study. In an auditory oddball paradigm, both dMMN and fMMN were measured at baseline. Remission and neurocognitive function after > 180 days were examined in the UHR group. Remission from UHR was defined as functional and symptomatic improvement using the Global Assessment of Functioning (GAF) score and Scale of Prodromal Symptoms (SOPS) positive subscales. Neurocognitive function was measured using the Brief Assessment of Cognition in Schizophrenia (BACS). We examined differences in MMN amplitude at baseline between those who achieved remission (remitters) and those who did not (non-remitters). Multiple regression analyses were performed to identify predictors for functioning, positive symptoms, and neurocognitive function. Results Compared with the HC group, the UHR group had a significantly attenuated dMMN amplitude (p= 0.003). In the UHR group, GAF scores significantly improved during the follow-up period (mean value 47.1 to 55.5,p= 0.004). The dMMN amplitude at baseline was significantly larger in the remitter (n = 6) than in the non-remitter group (n = 18) (p= 0.039). The total SOPS positive subscale scores and fMMN amplitude at baseline could predict BACS attention subscore at the follow-up point (SOPS positive subscales,p= 0.030; fMMN,p= 0.041). Conclusion Our findings indicate that dMMN and fMMN predicted remission and neurocognitive function, respectively, in individuals at UHR, which suggests that there are both promising biomarker candidates for predicting prognosis in individuals at UHR.