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Auditory Oddball Responses Across the Schizophrenia-Bipolar Spectrum and Their Relationship to Cognitive and Clinical Features
American Journal of Psychiatry ( IF 17.7 ) Pub Date : 2021-08-19 , DOI: 10.1176/appi.ajp.2021.20071043
David A Parker 1 , Rebekah L Trotti 1 , Jennifer E McDowell 1 , Sarah K Keedy 1 , S Kristian Hill 1 , Elliot S Gershon 1 , Elena I Ivleva 1 , Godfrey D Pearlson 1 , Matcheri S Keshavan 1 , Carol A Tamminga 1 , Brett A Clementz 1
Affiliation  

Objective:

Neural activations during auditory oddball tasks may be endophenotypes for psychosis and bipolar disorder. The authors investigated oddball neural deviations that discriminate multiple diagnostic groups across the schizophrenia-bipolar spectrum (schizophrenia, schizoaffective disorder, psychotic bipolar disorder, and nonpsychotic bipolar disorder) and clarified their relationship to clinical and cognitive features.

Methods:

Auditory oddball responses to standard and target tones from 64 sensor EEG recordings were compared across patients with psychosis (total N=597; schizophrenia, N=225; schizoaffective disorder, N=201; bipolar disorder with psychosis, N=171), patients with bipolar disorder without psychosis (N=66), and healthy comparison subjects (N=415) from the second iteration of the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP2) study. EEG activity was analyzed in voltage and in the time-frequency domain (low, beta, and gamma bands). Event-related potentials (ERPs) were compared with those from an independent sample collected during the first iteration of B-SNIP (B-SNIP1; healthy subjects, N=211; psychosis group, N=526) to establish the repeatability of complex oddball ERPs across multiple psychosis syndromes (r values >0.94 between B-SNIP1 and B-SNIP2).

Results:

Twenty-six EEG features differentiated the groups; they were used in discriminant and correlational analyses. EEG variables from the N100, P300, and low-frequency ranges separated the groups along a diagnostic continuum from healthy to bipolar disorder with psychosis/bipolar disorder without psychosis to schizoaffective disorder/schizophrenia and were strongly related to general cognitive function (r=0.91). P50 responses to standard trials and early beta/gamma frequency responses separated the bipolar disorder without psychosis group from the bipolar disorder with psychosis group. P200, N200, and late beta/gamma frequency responses separated the two bipolar disorder groups from the other groups.

Conclusions:

Neural deviations during auditory processing are related to psychosis history and bipolar disorder. There is a powerful transdiagnostic relationship between severity of these neural deviations and general cognitive performance. These results have implications for understanding the neurobiology of clinical syndromes across the schizophrenia-bipolar spectrum that may have an impact on future biomarker research.



中文翻译:

精神分裂症-双极谱的听觉异常反应及其与认知和临床特征的关系

客观的:

听觉古怪任务期间的神经激活可能是精神病和双相情感障碍的内表型。作者调查了在精神分裂症-双相情感障碍(精神分裂症、分裂情感性障碍、精神病性双相情感障碍和非精神病性双相情感障碍)中区分多个诊断组的奇怪神经偏差,并阐明了它们与临床和认知特征的关系。

方法:

比较精神病患者(总 N=597;精神分裂症,N=225;分裂情感性障碍,N=201;伴有精神病的双相情感障碍,N=171),对来自 64 个传感器 EEG 记录的标准音和目标音的听觉古怪反应无精神病的双相情感障碍 (N=66) 和来自双相精神分裂症中间表型网络 (B-SNIP2) 研究的第二次迭代的健康对照受试者 (N=415)。在电压和时频域(低、β 和伽马波段)中分析 EEG 活动。将事件相关电位 (ERP) 与 B-SNIP 第一次迭代期间收集的独立样本(B-SNIP1;健康受试者,N=211;精神病组,N=526)进行比较,以确定复杂古怪的可重复性跨多种精神病综合征的 ERP(r 值 > 0。

结果:

26 个脑电图特征区分了这些群体;它们被用于判别分析和相关分析。来自 N100、P300 和低频范围的 EEG 变量沿着诊断连续性将各组从健康到双相情感障碍与精神病/无精神病的双相情感障碍到分裂情感性障碍/精神分裂症分开,并且与一般认知功能密切相关 (r=0.91) . 对标准试验的 P50 响应和早期 β/γ 频率响应将没有精神病的双相情感障碍与有精神病的双相情感障碍分开。P200、N200 和晚期 beta/gamma 频率响应将两个双相情感障碍组与其他组分开。

结论:

听觉处理过程中的神经偏差与精神病史和双相情感障碍有关。这些神经偏差的严重程度与一般认知能力之间存在强大的跨诊断关系。这些结果对于理解精神分裂症-双相障碍谱中临床综合征的神经生物学具有重要意义,这可能会对未来的生物标志物研究产生影响。

更新日期:2021-08-31
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