Duration Mismatch Negativity Predicts Remission in First-Episode Schizophrenia Patients

Abstract

Objective: Remission in schizophrenia patients is associated with neurocognitive, social, and role functioning during both the early and chronic stages of schizophrenia. It is well-established that the amplitudes of duration mismatch negativity (dMMN) and frequency MMN (fMMN) are reduced in schizophrenia patients. However, the potential link between MMN and remission has not been established. In this study, we investigated the relationship between MMNs and remission in first-episode schizophrenia (FES) and their association with neurocognitive and social functioning.Method: dMMN and fMMN were measured in 30 patients with FES and 22 healthy controls at baseline and after a mean of 3 years. Clinical symptoms and cognitive and social functioning in the patients were assessed at the time of MMN measurements by using the Positive and Negative Syndrome Scale (PANSS), modified Global Assessment of Functioning (mGAF), Schizophrenia Cognition Rating Scale (SCoRS), and the Brief Assessment of Cognition in Schizophrenia (BACS). Remission of the patients was defined using the criteria by the Remission in Schizophrenia Working Group; of the 30 patients with FES, 14 achieved remission and 16 did not.Results: Baseline dMMN amplitude was reduced in FES compared to healthy controls. Further, baseline dMMN in the non-remitters had decreased amplitude and prolonged latency compared to the remitters. MMN did not change during follow-up period regardless of parameters, diagnosis, or remission status. Baseline dMMN amplitude in FES was correlated with future SCoRS and PANSS total scores. Logistic regression analysis revealed that dMMN amplitude at baseline was a significant predictor of remission.Conclusions: Our findings suggest that dMMN amplitude may be a useful biomarker for predicting symptomatic remission and improvement of cognitive and social functions in FES.

Markers of muscarinic deficit for individualized treatment in schizophrenia

“…Measures of MMN are correlated to the magnitude of these sensory processing deficits ( 38 ). Consistent with that, recent studies revealed that reduced MMN is particularly present in a subgroup of patients with marked cognitive deficits and poor social functioning ( 34 , 39 , 40 ) and predicts poor response to therapy with common antipsychotics ( 41 , 42 ). Studies on the neurophysiological substrate of MMN reductions have demonstrated associations to hypofunction of the glutamatergic NMDA receptor ( 43 ).…”

Analysis of polyunsaturated fatty acids in antipsychotic-free individuals with at-risk mental state and patients with first-episode schizophrenia

“…Patients diagnosed with schizophrenia underwent diagnostic interviews using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) Patient Edition ( 35 ). FES was defined as an illness duration of fewer than 2 years and a single psychotic episode, following previous studies ( 36 , 37 ). Recent-onset patients who had multiple psychotic episodes within 2 years were excluded.…”

Mismatch negativity as an early biomarker of cognitive impairment in schizophrenia

“…Relations between MMN amplitude to duration deviants and measures of visual attention [94] and social cognition [95] have also been documented previously. More recently, Nakajima 2021 [44] shed light on the potential value of MMN amplitude as a biomarker for predicting symptomatic remission and upgrading of both cognitive and social abilities in first episode schizophrenia. However, the later-mentioned issues were not evaluated in our study.…”

“…Another point of controversy is related to the relation of MMN deficits to neuropsychological tests. It has become increasingly obvious over recent years that MMN deficits correlate significantly with impaired cognitive performance in schizophrenia, which, in turn, forecast limited functional outcomes [38,43,44]. On the other hand, Li and colleagues [39] pointed out the lack of close association between MMN indices and neuropsychological parameters.…”