Is source-resolved magnetoencephalographic mismatch negativity a viable biomarker for early psychosis?
Is source-resolved magnetoencephalographic mismatch negativity a viable biomarker for early psychosis?
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DOI：
10.1111/ejn.16107
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发表时间：
2023-08-03
影响因子：
3.4
通讯作者：
Salisbury，Dean F. F.
中科院分区：
文献类型：
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作者：
Lopez-Caballero，Fran;Curtis，Mark;Salisbury，Dean F. F.
错配负波（MMN）是一种听觉事件相关反应，反映了对新刺激的前注意检测，是精神分裂症（SZ）皮质功能障碍的生物标志物。MMN音高（pMMN）和持续时间（dMMN）偏离刺激在慢性SZ中受损，但尚不清楚首次发作SZ中MMN是否减少，头皮水平EEG研究的结果不一致。在这里，我们研究了26例首发精神分裂症谱系（FEsz）和26例匹配的健康对照（C）的pMMN和dMMN的神经发生器和MEG记录。我们将MEG逆解投射到精确的功能上有意义的听觉皮层区域。MEG衍生的MMN源位于双侧初级听觉皮层（A1）和带状区域。在A1中，pMMN FEsz降低显示出统计学显著性趋势（F（1，50）= 3.31;p= .07），FEsz中dMMN降低（F（1，50）= 4.11;p= .04）。在每个半球进行的假设驱动比较显示，FEz的dMMN降低发生在左半球（t（56）= 2.23;p= 0.03;d= 0.61），而不是右半球（t（56）= 1.02;p= 0.31;d= 0.28），具有中等效应量。MEG源溶液与高分辨率MRI和A1分组的额外精度可能是检测新出现的病理生理学所必需的，并表明精神病发作时左半球病理学的关键作用。然而，左侧A1的中等效应量，尽管大于头皮MMN Meta分析中报告的效应量，但对MMN用于鉴别诊断的临床效用提出了质疑，因为大多数患者将与健康个体的分布重叠。
Mismatch negativity (MMN) is an auditory event‐related response reflecting the pre‐attentive detection of novel stimuli and is a biomarker of cortical dysfunction in schizophrenia (SZ). MMN to pitch (pMMN) and to duration (dMMN) deviant stimuli are impaired in chronic SZ, but it is less clear if MMN is reduced in first‐episode SZ, with inconsistent findings in scalp‐level EEG studies. Here, we investigated the neural generators of pMMN and dMMN with MEG recordings in 26 first‐episode schizophrenia spectrum (FEsz) and 26 matched healthy controls (C). We projected MEG inverse solutions into precise functionally meaningful auditory cortex areas. MEG‐derived MMN sources were in bilateral primary auditory cortex (A1) and belt areas. In A1, pMMN FEszreduction showed a trend towards statistical significance (F(1,50)= 3.31;p= .07), and dMMN was reduced in FEsz(F(1,50)= 4.11;p= .04). Hypothesis‐driven comparisons at each hemisphere revealed dMMN reduction in FEszoccurred in the left (t(56)= 2.23;p= .03;d= .61) but not right (t(56)= 1.02;p= .31;d= .28) hemisphere, with a moderate effect size. The added precision of MEG source solution with high‐resolution MRI and parcellation of A1 may be requisite to detect the emerging pathophysiology and indicates a critical role for left hemisphere pathology at psychosis onset. However, the moderate effect size in left A1, albeit larger than reported in scalp MMN meta‐analyses, casts doubt on the clinical utility of MMN for differential diagnosis, as a majority of patients will overlap with the healthy individual's distribution.