Predicting Remission in Subjects at Clinical High Risk for Psychosis Using Mismatch Negativity
Predicting Remission in Subjects at Clinical High Risk for Psychosis Using Mismatch Negativity
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DOI：
10.1093/schbul/sbx102
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发表时间：
2018-05-01
影响因子：
6.6
通讯作者：
Kwon, Jun Soo
中科院分区：
文献类型：
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作者：
Kim, Minah;Lee, Tak Hyung;Kwon, Jun Soo
在精神病临床高风险（CHR）受试者中，向精神病过渡率的下降和非精神病性不良结局的增加增加了对生物标志物的需求，无论是否过渡，都可以预测缓解。本研究探讨失配阴性（MMN）是否能预测CHR患者6年随访期间的预后。共有47名健康对照（HC）受试者和48名精神病CHR受试者参加了MMN评估。在基线和长达6年的定期检查CHR受试者的临床状况。将CHR受试者分为发送者组和非发送者组，比较发送者组、非发送者组和HC组的基线MMN振幅和潜伏期。进行回归分析以确定缓解、减弱阳性症状改善和功能恢复的预测因素。与CHR缓解者和HC受试者相比，CHR未缓解者在基线时MMN振幅降低。逻辑回归分析显示，额叶电极处的基线MMN振幅是缓解的唯一显著预测因子。在多元回归分析中，MMN的振幅、抗精神病药物的使用和受教育年限预测了阳性症状减弱的改善。基线时MMN振幅预测功能恢复。这些结果表明，MMN是一个假定的预后预测因子，无论在CHR受试者是否过渡到精神障碍。MMN可能有助于基于初始CHR状态的早期预后预测和提供适当的干预措施。
The declining transition rate to psychotic disorder and the increasing rate of nonpsychotic poor outcomes among subjects at clinical high risk (CHR) for psychosis have increased the need for biomarkers to predict remission regardless of transition. This study investigated whether mismatch negativity (MMN) predicts the prognosis of CHR individuals during a 6-year follow-up period.A total of 47 healthy control (HC) subjects and 48 subjects at CHR for psychosis participated in the MMN assessment. The clinical statuses of the CHR subjects were examined at baseline and regularly for up to 6 years. The CHR subjects were divided into remitter and nonremitter groups, and the baseline MMN amplitudes and latencies were compared across the remitter, nonremitter, and HC groups. Regression analyses were performed to identify the predictive factors of remission, the improvement of attenuated positive symptoms, and functional recovery.CHR nonremitters showed reduced MMN amplitudes at baseline compared to CHR remitters and HC subjects. A logistic regression analysis revealed that the baseline MMN amplitude at the frontal electrode site was the only significant predictor of remission. In a multiple regression analysis, the MMN amplitude, antipsychotic use, and years of education predicted an improvement in attenuated positive symptoms. The MMN amplitude at baseline predicted functional recovery.These results suggest that MMN is a putative predictor of prognosis regardless of the transition to psychotic disorder in subjects at CHR. Early prognosis prediction and the provision of appropriate interventions based on the initial CHR status might be aided using MMN.