Accumulating evidence points to neurophysiological abnormalities of the motor cortex in Schizophrenia (SCZ). However, whether these abnormalities represent a core biological feature of psychosis rather than a superimposed neurodegenerative process is yet to be defined, as it is their putative relationship with clinical symptoms. in this study, we used Transcranial Magnetic Stimulation coupled with electroencephalography (TMS-EEG) to probe the intrinsic oscillatory properties of motor (Brodmann Area 4, BA4) and non-motor (posterior parietal, BA7) cortical areas in twenty-three first-episode psychosis (FEP) patients and thirteen age and gender-matched healthy comparison (HC) subjects. Patients underwent clinical evaluation at baseline and six-months after the TMS-EEG session. We found that FEP patients had reduced EEG activity evoked by TMS of the motor cortex in the beta-2 (25-34 Hz) frequency band in a cluster of electrodes overlying BA4, relative to HC participants. Beta-2 deficits in the TMS-evoked EEG response correlated with worse positive psychotic symptoms at baseline and also predicted positive symptoms severity at six-month follow-up assessments. Altogether, these findings indicate that reduced TMS-evoked fast oscillatory activity in the motor cortex is an early neural abnormality that: 1) is present at illness onset; 2) may represent a state marker of psychosis; and 3) could play a role in the development of new tools of outcome prediction in psychotic patients.

越来越多的证据表明精神分裂症（SCZ）运动皮层存在神经生理学异常。然而，这些异常是否代表精神病的核心生物学特征而不是叠加的神经退行性过程尚待确定，因为这是它们与临床症状的假定关系。在这项研究中，我们使用经颅磁刺激结合脑电图 (TMS-EEG) 来探测 23 个前皮质区的运动皮质区（布罗德曼区 4，BA4）和非运动皮质区（后顶叶区，BA7）的固有振荡特性。精神病发作 (FEP) 患者和 13 名年龄和性别匹配的健康对照 (HC) 受试者。患者在基线和 TMS-EEG 疗程后六个月接受临床评估。我们发现，相对于 HC 参与者，FEP 患者在 BA4 上的一组电极中，运动皮层 TMS 在 β-2（25-34 Hz）频带内诱发的 EEG 活动减少。 TMS 诱发的脑电图反应中的 Beta-2 缺陷与基线时更严重的阳性精神病症状相关，并且还可以预测六个月随访评估中阳性症状的严重程度。总而言之，这些研究结果表明，TMS 诱发的运动皮层快速振荡活动减少是一种早期神经异常：1）在疾病发作时出现； 2) 可能代表精神病的状态标志； 3）可以在精神病患者结果预测新工具的开发中发挥作用。