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Mismatch negativity and clinical trajectories in psychotic disorders: Five-year stability and predictive utility

Published online by Cambridge University Press:  13 October 2022

Kayla R. Donaldson Open the ORCID record for Kayla R. Donaldson [Opens in a new window] ,
Katherine Jonas ,
Dan Foti ,
Emmett M. Larsen ,
Aprajita Mohanty  and
Roman Kotov
Kayla R. Donaldson*
Affiliation:
Department of Psychology, Stony Brook University, Stony Brook, NY, USA
Katherine Jonas
Affiliation:
Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY, USA
Dan Foti
Affiliation:
Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
Emmett M. Larsen
Affiliation:
Department of Psychology, Stony Brook University, Stony Brook, NY, USA
Aprajita Mohanty
Affiliation:
Department of Psychology, Stony Brook University, Stony Brook, NY, USA
Roman Kotov*
Affiliation:
Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY, USA
*
Authors for correspondence: Kayla R. Donaldson, E-mail: kayla.donaldson@stonybrook.edu; Roman Kotov, E-mail: roman.kotov@stonybrookmedicine.edu
Authors for correspondence: Kayla R. Donaldson, E-mail: kayla.donaldson@stonybrook.edu; Roman Kotov, E-mail: roman.kotov@stonybrookmedicine.edu
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Abstract

Background

Mismatch negativity (MMN) amplitude is reduced in psychotic disorders and associated with symptoms and functioning. Due to these robust associations, it is often considered a biomarker for psychotic illness. The relationship between MMN and clinical outcomes has been examined well in early onset psychotic illness; however, its stability and predictive utility in chronic samples are not clear.

Method

We examined the five-year stability of MMN amplitude over two timepoints in individuals with established psychotic disorders (cases; N = 132) and never-psychotic participants (NP; N = 170), as well as longitudinal associations with clinical symptoms and functioning.

Results

MMN amplitude exhibited good temporal stability (cases, r = 0.53; never-psychotic, r = 0.52). In cases, structural equation models revealed MMN amplitude to be a significant predictor of worsening auditory hallucinations (β = 0.19), everyday functioning (β = −0.13), and illness severity (β = −0.12) at follow-up. Meanwhile, initial IQ (β = −0.24), negative symptoms (β = 0.23), and illness severity (β = −0.16) were significant predictors of worsening MMN amplitude five years later.

Conclusions

These results imply that MMN measures a neural deficit that is reasonably stable up to five years. Results support disordered cognition and negative symptoms as preceding reduced MMN, which then may operate as a mechanism driving reductions in everyday functioning and the worsening of auditory hallucinations in chronic psychotic disorders. This pattern may inform models of illness course, clarifying the relationships amongst biological mechanisms of predictive processing and clinical deficits in chronic psychosis and allowing us to better understand the mechanisms driving such impairments over time.

Keywords

BiomarkersEEG/ERPslongitudinal cohort studymismatch negativity (MMN)psychotic disordersschizophrenia
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 12 , September 2023 , pp. 5818 - 5828
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

Indicates joint senior authorship.

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