P50 changes with visual interference in normal subjects: a sensory distraction model for schizophrenia

Sensory gating disturbances in the spectrum: similarities and differences in schizotypal personality disorder and schizophrenia

BACKGROUND

DSM-5 places schizophrenia on a continuum from severe, chronic schizophrenia to the attenuated schizophrenia-like traits of schizotypal personality disorder (SPD), the prototypic schizophrenia-related personality disorder. SPD shares common genetic and neurobiological substrates with schizophrenia, including information processing abnormalities, although they are less marked. This is the first study to directly compare the P50 evoked electroencephalographic response-a measure of sensory gating and a neurophysiological endophenotype-between schizophrenia-spectrum groups. Two hypotheses were tested: (1) Compared with healthy controls (HCs), schizophrenia patients show reduced P50 suppression and SPD patients resemble schizophrenia but exhibit less marked deficits; and (2) Deficient P50 suppression in SPD is associated with greater clinical symptom severity.

METHODS

P50 was assessed in 32 schizophrenia-spectrum disorder patients (12 SPD, 20 schizophrenia patients) and 25 demographically-matched HCs. The standard conditioning (C)-testing (T) paradigm was used and P50 suppression was quantified using the T-C difference and the T/C ratio.

RESULTS

All P50 measures showed a linear, stepwise pattern with the SPD group intermediate between the HC and schizophrenia groups. Compared with HCs, both patient groups had lower conditioning and T-C difference values. Among the SPD group, greater clinical symptom severity was associated with greater conditioning-response amplitude deficits.

CONCLUSION

These findings: (1) are novel in showing that P50 deficits in SPD resemble those observed in schizophrenia, albeit less marked; (2) support the concept that the phenomenological link between SPD and schizophrenia lies in shared neurocognitive/neurophysiological pathologies; and (3) provide evidence that P50 is a neurophysiological endophenotype for schizophrenia-spectrum disorders.

Sensory gating deficits in the attenuated psychosis syndrome

BACKGROUND

Individuals with an "Attenuated Psychosis Syndrome" (APS) have a 20-40% chance of developing a psychotic disorder within two years; however it is difficult to predict which of them will become ill on the basis of their clinical symptoms alone. We examined whether P50 gating deficits could help to discriminate individuals with APS and also those who are particularly likely to make a transition to psychosis.

METHOD

36 cases meeting PACE (Personal Assessment and Crisis Evaluation) criteria for the APS, all free of antipsychotics, and 60 controls performed an auditory conditioning-testing experiment while their electroencephalogram was recorded. The P50 ratio and its C-T difference were compared between groups. Subjects received follow-up for up to 2 years to determine their clinical outcome.

RESULTS

The P50 ratio was significantly higher and C-T difference lower in the APS group compared to controls. Of the individuals with APS who completed the follow-up (n=36), nine (25%) developed psychosis. P50 ratio and the C-T difference did not significantly differ between those individuals who developed psychosis and those who did not within the APS group.

CONCLUSION

P50 deficits appear to be associated with the pre-clinical phase of psychosis. However, due to the limitations of the study and its sample size, replication in an independent cohort is necessary, to clarify the role of P50 deficits in illness progression and whether this inexpensive and non-invasive EEG marker could be of clinical value in the prediction of psychosis outcomes amongst populations at risk.

Spectral decomposition of P50 suppression in schizophrenia during concurrent visual processing

Reduced suppression of the auditory P50 event-related potential has long been associated with schizophrenia, but the mechanisms associated with the generation and suppression of the P50 are not well understood. Recent investigations have used spectral decomposition of the electroencephalograph (EEG) signal to gain additional insight into the ongoing electrophysiological activity that may be reflected by the P50 suppression deficit. The present investigation extended this line of study by examining how both a traditional measure of sensory gating and the ongoing EEG from which it is extracted might be modified by the presence of concurrent visual stimulation - perhaps better characterizing gating deficits as they occur in a real-world, complex sensory environment. The EEG was obtained from 18 patients with schizophrenia and 17 healthy control subjects during the P50 suppression paradigm and while identical auditory paired-stimuli were presented concurrently with affectively neutral pictures. Consistent with prior research, schizophrenia patients differed from healthy subjects in gating of power in the theta range; theta activity also was modulated by visual stimulation. In addition, schizophrenia patients showed intact gating but overall increased power in the gamma range, consistent with a model of NMDA receptor dysfunction in the disorder. These results are in line with a model of schizophrenia in which impairments in neural synchrony are related to sensory demands and the processing of multimodal information.

Ketamine Modulates Theta and Gamma Oscillations

Ketamine, an N-methyl-d-aspartate (NMDA) receptor glutamatergic antagonist, has been studied as a model of schizophrenia when applied in subanesthetic doses. In EEG studies, ketamine affects sensory gating and alters the oscillatory characteristics of neuronal signals in a complex manner. We investigated the effects of ketamine on in vivo recordings from the CA3 region of mouse hippocampus referenced to the ipsilateral frontal sinus using a paired-click auditory gating paradigm. One issue of particular interest was elucidating the effect of ketamine on background network activity, poststimulus evoked and induced activity. We find that ketamine attenuates the theta frequency band in both background activity and in poststimulus evoked activity. Ketamine also disrupts a late, poststimulus theta power reduction seen in control recordings. In the gamma frequency range, ketamine enhances both background and evoked power, but decreases relative induced power. These findings support a role for NMDA receptors in mediating the balance between theta and gamma responses to sensory stimuli, with possible implications for dysfunction in schizophrenia.

Electroencephalographic evidence of sensory gating in the occipital visual cortex

Sensory gating refers to the suppression of the neuronal response to a repeating stimulus and is considered a protection mechanism in the brain. In this study, we assessed gating of the mid-latency components of the visual evoked potentials (N75, P100, N150) in 11 healthy individuals using a paired-flash paradigm. A significant decrease of P100 and N150 amplitudes was shown; additionally, a significant increase in the latency of N75 and P100 for the second stimulus of the pair compared with the first one was also observed. Absolute power of the stimulus 2 signal at theta frequency was significantly suppressed as compared with the stimulus 1 signal. These results indicate a gating effect in the visual modality, reflected in both time-domain and frequency-domain measures.

The P50 auditory evoked potential in violent and non-violent patients with schizophrenia

BACKGROUND

Emotionally driven violence is facilitated by increased arousal. It may be a consequence of an information-processing deficit and the cognitive attributions for the stimuli given by the subject. The aim of this study was to compare the P50 evoked potential responses of violent patients with schizophrenia with non-violent patients with schizophrenia and healthy controls.

METHOD

Patients were classified into violent and non-violent in accordance to the Overt Aggression Scale. P50 auditory evoked potentials of 32 unmedicated patients with schizophrenia (violent=14, non-violent=18) and 17 healthy controls were recorded during five runs of 30 click pairs.

RESULTS

Healthy controls exhibited a lower S2/S1 ratio when compared to violent (p<0.001) and non-violent (p=0.04) patients. Using a cutoff point of 0.50 for S2/S1 ratio to define abnormal gating a significant proportion of violent patients did not show P50 suppression (71.4%) in comparison to non-violent patients (38.9%) and healthy controls (23.5%) (p=0.02).

CONCLUSIONS

Violent behavior in patients with schizophrenia could be associated with a disturbed information sensory gating. Violence in patients with schizophrenia may be facilitated by an increased arousal which may in turn be the result of an information-processing deficit.

Effects of nicotine vary across two auditory evoked potentials in the mouse

BACKGROUND

Schizophrenia patients display sensory processing deficits, reduced alpha7-nicotine receptor expression, and increased incidence of smoking, prompting investigation of nicotine receptor agonists as possible treatments. We evaluated the effects of acute and chronic nicotine, using an animal model that incorporates genetic variation for sensory processing and nicotine sensitivity.

METHODS

C57BL/6J and DBA/2Hsd mice received 2 weeks of 4.2 mg/kg chronic nicotine or saline. Auditory evoked potentials were recorded before and after acute nicotine injection of 1.05 mg/kg on day 14, with a paired-click paradigm (S1/S2). Amplitude and gating of the P20 and N40 were compared between conditions.

RESULTS

Acute nicotine increased the amplitude and gating of the P20 and decreased the amplitude and gating of the N40 across all groups, primarily by acting on S1. Chronic nicotine attenuated the effects of acute nicotine on the N40.

CONCLUSIONS

Our data support the notion that the mouse P20 shares pharmacological response properties with the human P50. In addition, findings suggest that nicotine might increase the initial sensory response (S1), with a resulting improvement in gating of some components.

Mecamylamine blocks nicotine-induced enhancement of the P20 auditory event-related potential and evoked gamma

Cigarette smoking is significantly more prevalent in individuals with schizophrenia than in non-affected populations. Certain neurocognitive deficits and disruptions common in schizophrenia may be altered by smoking, leading to the hypothesis that schizophrenics engage in smoking behavior to alleviate specific neurocognitive symptoms of the disorder. Additionally, research suggests that individuals with schizophrenia have altered auditory event-related potentials (ERPs) and abnormalities in evoked gamma oscillations which are both indices of sensory information processing. This study was conducted to examine the effect of acute administration of nicotine and the non-specific nicotinic antagonist mecamylamine on the P20 and N40 components of the ERP and evoked gamma oscillations in mice. Acute nicotine (1 mg/kg) significantly increased P20 amplitude, an effect that was blocked by pretreatment with mecamylamine (2 mg/kg). Additionally, acute nicotine increased the normal burst of evoked gamma following an auditory stimulus. The increase in evoked gamma was also blocked by mecamylamine pretreatment. Although acute nicotine decreased amplitude of the N40 component, this decrease was not attenuated by mecamylamine. These results replicate findings that nicotine may enhance early sensory information processing through the nicotinic acetylcholinergic receptor system in an established model (ERPs) and extend these findings in an emerging, novel model (evoked gamma oscillations) of sensory information processing. The results also support the hypothesis that nicotine may be beneficial to individuals with deficits in neurocognitive functions, such as those suffering from schizophrenia.

Exploration of auditory P50 gating in schizophrenia by way of difference waves

Electroencephalographic measures of information processing encompass both mid-latency evoked potentials like the pre-attentive auditory P50 potential and a host of later more cognitive components like P300 and N400.Difference waves have mostly been employed in studies of later event related potentials but here this method along with low frequency filtering is applied exploratory on auditory P50 gating data, previously analyzed in the standard format (reported in Am J Psychiatry 2003, 160:2236-8). The exploration was motivated by the observation during visual peak detection that the AEP waveform was different in the patient group, although this was not reflected by the peak measures. The sample included un-medicated schizophrenia spectrum patients (n = 17) and healthy controls (n = 24). The patients had an attenuated difference P50. This attenuation was primarily seen in the sub-sample of patients with severe negative symptoms. The difference attenuation was due to low amplitude at the first stimulus. This suggests an abnormality in readiness more than an abnormality in gating in the patient group.

Contributions of subtype and spectral frequency analyses to the study of P50 ERP amplitude and suppression in schizophrenia

BACKGROUND

Poor suppression of P50 event-related potential (ERP) amplitudes to paired-click stimuli may indicate genetic liability for schizophrenia and weak "sensory gating." Evidence suggests, however, that P50 amplitude is selectively impaired in nonparanoid, but not paranoid, schizophrenia subtypes. Furthermore, paired-click suppression can appear deficient in schizophrenia due to smaller evoked responses to the first stimulus (S1), rather than larger, less effectively "gated" responses to the second (S2). Finally, the P50 ERP is comprised of activity from at least two frequency components that may be distinctly impaired: the gamma band, associated with sensory registration, and the low frequency response, associated with attention/encoding processes. P50 and related frequency subcomponents were examined as a function of illness subtype to further integrate these concepts.

METHOD

The standard paired-click paradigm was administered to 38 schizophrenia (27 paranoid, 11 nonparanoid) and 38 age-matched healthy control participants. P50 amplitudes and spectral power of gamma band (GBR; 20-50 Hz) and low frequency (LFR; 1-20 Hz) responses were analyzed.

RESULTS

P50 analyses revealed smaller S1 amplitude and normal S2 in schizophrenia participants collectively, but no differentiation of schizophrenia subtypes. Spectral analyses revealed smaller magnitude S1 and normal S2 responses in schizophrenia across both the GBR and LFR. The LFR, but not GBR, was found to distinguish nonparanoid from control groups, while paranoid participants evidenced no impairment in either frequency domain. LFR amplitude values correlated with clinical ratings of cognitive symptomatology.

CONCLUSIONS

ERP deficits in the dual-click paradigm were specific to S1 amplitudes and most prominent in the low frequency response. These results replicate previous findings and extend their relevance to schizophrenia subtype distinctions. Implications for the recurrent inhibition model of sensory gating are discussed.

Exploration of somatosensory P50 gating in schizophrenia spectrum patients: reduced P50 amplitude correlates to social anhedonia

Originally, the hypothesis of a sensory gating defect in schizophrenia evolved from studies of somatosensory evoked potentials (SEP), although the idea has primarily been pursued in the auditory modality. Gating is the relative attenuation of amplitude following the second stimulus in a stimulus pair. Recently, SEP P50 gating was seen when recording the SEP P50 in a paradigm similar to the one used for auditory P50 gating. Hypothetically, abnormality of somatosensory information processing could be related to anhedonia, which is considered a core feature of schizophrenia. Twelve unmedicated, male, schizophrenia spectrum patients (seven schizophrenic and five schizotypal personality disorder patients) and 14 age-matched healthy men participated in recordings of pair-wise presented auditory and median nerve stimuli. The patients had smaller amplitudes of the SEP P50 at the first stimulus, but no gating defect. The reduced amplitude was particularly evident in subjects with high scores on the Revised Social Anhedonia Scale. Early somatosensory information processing seems abnormal in schizophrenia spectrum patients. This could be in agreement with the theory of loss of the benefit of regularity in schizophrenia, while the results are in-conclusive regarding sensory gating theory.

A mixed modality paradigm for recording somatosensory and auditory P50 gating

Significant somatosensory evoked potential (SEP) P50 gating has previously been found in young healthy men by the use of identical paired stimuli. In this study, the exploration of the gating paradigm was extended with the addition of a mixed modality paradigm where three different pairs of identical stimuli (clicks, right median nerve electric stimulations and proprioceptive stimuli of changing load on a handheld weight) were presented over a 12-s cycle. In both modalities repeated measures analyses of variance demonstrated no effect of paradigm. This mixed-modality recording paradigm could be used in further experiments to examine gating deficits across modalities.

Is P50 suppression a measure of sensory gating in schizophrenia?

BACKGROUND

Abnormal P50 response has been hypothesized to reflect the sensory gating deficit in schizophrenia. Despite the extensive literature concerning the sensory filtering or gating deficit in schizophrenia, no evidence has been provided to test the relationship of the P50 phenomenon with patients' experiences of perceptual anomalies.

METHODS

Sixteen drug-free DSM-IV diagnosed schizophrenic patients who reported moderate to severe perceptual anomalies in the auditory or visual modality were examined as compared to 16 schizophrenic patients who did not report perceptual anomalies, and 16 normal subjects. Both control groups were age- and gender-matched with the study group.

RESULTS

Patients reporting perceptual anomalies exhibited P50 patterns that did not differ from normal subjects. In contrast, patients who did not report perceptual anomalies showed the abnormal P50 ratios previously found to be associated with schizophrenia.

CONCLUSIONS

These paradoxical findings do not support the hypothetical relationship between the P50 and behavioral measures of sensory gating, suggesting that additional studies are needed to further explore the clinical correlates of the P50.

Effects of P50 temporal variability on sensory gating in schizophrenia

The conditioning-testing (S1-S2) P50 auditory evoked potential (EP) has been well-documented and accepted as an important tool for measuring sensory gating in schizophrenia research. However, the physiological mechanism of the phenomenon is not known. In this study a single-trial analysis was used to determine the influence of the latency variability of the responses in the formation of the averaged P50. Ten schizophrenic patients and 10 normal controls were tested in the dual-click EP paradigm. Using ensemble averaging analysis, we replicated the previous finding of a lower S1 P50 amplitude and higher S2/S1 ratio in schizophrenics compared with normal controls. The single-trial analysis revealed that patients had significantly higher trial-to-trial latency variability in S1 responses than normal subjects, while the S2 showed the same variability as in controls. Measured by the single-trial procedure, the arithmetic mean amplitudes of P50 responses to S1 and S2 were similar between normal and schizophrenic subjects. The same measure also eliminated the difference in averaged P50 amplitude between S1 and S2 for both groups. Temporal variability appears to be an important factor in the assessment of averaged EPs and thus contribute to the change of P50 amplitude observed in schizophrenia.