EEG microstates are a candidate endophenotype for schizophrenia

Cruz, Janir Ramos da; Favrod, Ophélie; Roinishvili, Maya; Chkonia, Eka; Brand, Andreas; Möhr, Christine; Figueiredo, Patrícia; Herzog, Michael H.

doi:10.1038/s41467-020-16914-1

Cited by 176 publications

(174 citation statements)

References 53 publications

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“…Microstate C was suggested to predominantly occur during activation of the salience network 22 , and would have therefore been expected to be abnormal in patients with psychotic disorders based on the aberrant salience account of psychosis 50 . On the other hand, although both aforementioned meta-analyses 30 , 31 reported microstate C to be increased (coverage and occurrence) in schizophrenia patients, this effect is not very consistent across single studies, with approximately half of existing studies reporting differences in this microstate between unmedicated schizophrenia patients and healthy controls 25 , 27 , 28 , while the other half failed to observe significant differences 24 , 26 , 29 . This inconsistency may be explained by a recent observation that the optimal number of microstate maps to describe resting-state EEG data may be higher than the original four (A–D).…”

Section: Discussionmentioning

confidence: 94%

“…Microstate D coverage was also found to be decreased in unmedicated schizophrenia patients compared to healthy controls 25 – 27 , which was confirmed by two recent meta-analysis, including medicated and unmedicated patients with psychotic disorders 31 . Dynamics of microstate D were further suggested as candidate endophenotype by a study that compared medicated schizophrenia patients and their siblings to healthy controls and found decreased microstate D in both the patient group, as well as their siblings 30 . Our results expand upon these previous findings, indicating that decreased microstate D could be a selective trait marker that potentially predicts later transition to psychosis in UHR patients.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has identified several differences in these temporal parameters between medication-naïve patients with schizophrenia and healthy controls 24 – 29 . While these studies have reported changes across all microstate classes, recent meta-analyses only reported increased occurrence of microstate C and decreased duration of microstate D in patients with psychotic disorders 30 , 31 . Although less pronounced, some of these changes are already present in individuals with a clinical or genetic high risk for schizophrenia 32 , 33 , indicating that microstate alterations already occur at an early stage of psychotic disorders.…”

Section: Introductionmentioning

confidence: 99%

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EEG microstates as biomarker for psychosis in ultra-high-risk patients

et al. 2020

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Resting-state EEG microstates are brief (50–100 ms) periods, in which the spatial configuration of scalp global field power remains quasi-stable before rapidly shifting to another configuration. Changes in microstate parameters have been described in patients with psychotic disorders. These changes have also been observed in individuals with a clinical or genetic high risk, suggesting potential usefulness of EEG microstates as a biomarker for psychotic disorders. The present study aimed to investigate the potential of EEG microstates as biomarkers for psychotic disorders and future transition to psychosis in patients at ultra-high-risk (UHR). We used 19-channel clinical EEG recordings and orthogonal contrasts to compare temporal parameters of four normative microstate classes (A–D) between patients with first-episode psychosis (FEP; n = 29), UHR patients with (UHR-T; n = 20) and without (UHR-NT; n = 34) later transition to psychosis, and healthy controls (HC; n = 25). Microstate A was increased in patients (FEP & UHR-T & UHR-NT) compared to HC, suggesting an unspecific state biomarker of general psychopathology. Microstate B displayed a decrease in FEP compared to both UHR patient groups, and thus may represent a state biomarker specific to psychotic illness progression. Microstate D was significantly decreased in UHR-T compared to UHR-NT, suggesting its potential as a selective biomarker of future transition in UHR patients.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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EEG microstates as biomarker for psychosis in ultra-high-risk patients

et al. 2020

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“…While certain biomarkers can serve both functions, some are best suited for one of these purposes. Endophenotypes are conventionally regarded as biological measures that are thought to be closely related to the genetic variation responsible for causing upstream changes, and thus can help understand the molecular mechanisms underlying pathophysiology ( 45 , 46 ), where recently proposed endophenotypes in schizophrenia have included EEG markers ( 47 , 48 ). Predictive biomarkers, on the other hand, are those identified using a different set of criteria, as specified by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative, to aid in the development and selection of interventions, with an emphasis on association with a functional outcome and/or pharmacological response ( 49 ).…”

Section: Introductionmentioning

confidence: 99%

Neurophysiological Biomarkers in Schizophrenia—P50, Mismatch Negativity, and TMS-EMG and TMS-EEG

2020

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Impaired early auditory processing is a well characterized finding in schizophrenia that is theorized to contribute to clinical symptoms, cognitive impairment, and social dysfunction in patients. Two neurophysiological measures of early auditory processing, P50 gating ("P50") and mismatch negativity (MMN), which measure sensory gating and detection of change in auditory stimuli, respectively, are consistently shown to be impaired in patients with schizophrenia. Transcranial magnetic stimulation (TMS) may also be a potential method by which sensory processing can be assessed, since TMS paradigms can be used to measure GABA B-mediated cortical inhibition that is linked with sensory gating. In this review, we examine the potential of P50, MMN and two TMS paradigms, cortical silent period (CSP) and long-interval intracortical inhibition (LICI), as endophenotypes as well as their ability to be used as predictive markers for interventions targeted at cognitive and psychosocial functioning. Studies consistently support a link between MMN, P50, and cognitive dysfunction, with robust evidence for a link between MMN and psychosocial functioning in schizophrenia as well. Importantly, studies have demonstrated that MMN can be used to predict performance in social and cognitive training tasks. A growing body of studies also supports the potential of MMN to be used as an endophenotype, and future studies are needed to determine if MMN can be used as an endophenotype specifically in schizophrenia. P50, however, has weaker evidence supporting its use as an endophenotype. While CSP and LICI are not as extensively investigated, growing evidence is supporting their potential to be used as an endophenotype in schizophrenia. Future studies that assess the ability of P50, MMN, and TMS neurophysiological measures to predict performance in cognitive and social training programs may identify markers that inform clinical decisions in the treatment of neurocognitive impairments in schizophrenia.

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“…Furthermore, abnormal patterns have been described in various mental conditions (27)(28)(29)(30), most notably in psychotic disorders: Microstate differences across all classes were found for medicated (31)(32)(33)(34)(35), as well as medication-naïve patients with psychotic disorders (30,(36)(37)(38) compared to healthy controls, as well as patients in the high-risk state of psychosis (31,36,39). Two recent meta-analyses found increased occurrence of microstate C and decreased duration of microstate D to be consistently reported across studies in medicated as well as medication-naïve patients with psychotic disorders (40,41).…”

Section: Introductionmentioning

confidence: 98%

EEG Microstate Differences in Medicated vs. Medication-Naïve First-Episode Psychosis Patients

et al. 2020

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There has been considerable interest in the role of synchronous brain activity abnormalities in the pathophysiology of psychotic disorders and their relevance for treatment; one index of such activity are EEG resting-state microstates. These reflect electric field configurations of the brain that persist over 60–120 ms time periods. A set of quasi-stable microstates classes A, B, C, and D have been repeatedly identified across healthy participants. Changes in microstate parameters coverage, duration and occurrence have been found in medication-naïve as well as medicated patients with psychotic disorders compared to healthy controls. However, to date, only two studies have directly compared antipsychotic medication effects on EEG microstates either pre- vs. post-treatment or between medicated and unmedicated chronic schizophrenia patients. The aim of this study was therefore to directly compare EEG resting-state microstates between medicated and medication-naïve (untreated) first-episode (FEP) psychosis patients (mFEP vs. uFEP). We used 19-channel clinical EEG recordings to compare temporal parameters of four prototypical microstate classes (A–D) within an overall sample of 47 patients (mFEP n = 17; uFEP n = 30). The results demonstrated significant decreases of microstate class A and significant increases of microstate class B in mFEP compared to uFEP. No significant differences between groups were found for microstate classes C and D. Further studies are needed to replicate these results in longitudinal designs that assess antipsychotic medication effects on neural networks at the onset of the disorder and over time during illness progression. As treatment response and compliance in FEP patients are relatively low, such studies could contribute to better understand treatment outcomes and ultimately improve treatment strategies.

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EEG microstates are a candidate endophenotype for schizophrenia

Cited by 176 publications

References 53 publications

EEG microstates as biomarker for psychosis in ultra-high-risk patients

EEG microstates as biomarker for psychosis in ultra-high-risk patients

Neurophysiological Biomarkers in Schizophrenia—P50, Mismatch Negativity, and TMS-EMG and TMS-EEG

EEG Microstate Differences in Medicated vs. Medication-Naïve First-Episode Psychosis Patients

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