Mismatch Negativity and P3a/Reorienting Complex in Subjects with Schizophrenia or At-Risk Mental State

Introduction: Shorter duration of untreated psychosis has been associated with better prognosis in patients with schizophrenia. In Introduction: In this study, we measured duration mismatch negativity (dMMN), P3a and reorienting negativity (RON) in subjects with at-risk mental state (ARMS), patients with first-episode or chronic schizophrenia, and healthy volunteers. The main interest was to determine if these event-related potentials provide a biomarker associated with progression to overt schizophrenia in ARMS subjects. Methods: Seventeen ARMS subjects meeting the criteria of the Comprehensive Assessment of At-Risk Mental State, 38 patients with schizophrenia (19 first-episode and 19 chronic), and 19 healthy controls participated in the study. dMMN, P3a and RON were measured with an auditory odd-ball paradigm at baseline. Results: During the follow-up period (2.2 years), 4 out of the 19 ARMS subjects transitioned to schizophrenia (Converters) while 15 did not (non-Converters). dMMN amplitudes of Converters were significantly smaller than those of non-Converters at frontal and central electrodes before onset of illness. dMMN amplitudes of non-Converters did not differ from those of healthy controls, while Converters showed significantly smaller dMMN amplitudes compared to control subjects. RON amplitudes were also reduced at frontal and central electrodes in subjects with schizophrenia, but not ARMS. Converter subjects tended to show smaller RON amplitudes compared to non-Converters. Conclusions: Our data confirm that diminished dMMN amplitudes provide a biomarker which is present before and after the development of psychosis. In this respect, RON amplitudes may also be useful, as suggested for the first time in this study.