Differing Pattern of Mismatch Negativity Responses in Clinical and Nonclinical Voice Hearers Challenge Predictive Coding Accounts of Psychosis

Molly A. Erickson , Sonia Bansal , Charlotte Li , James Waltz , Philip Corlett , James Gold
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Abstract

Background

Among people with schizophrenia (PSZ), reduced mismatch negativity (MMN) is conceptualized as evidence of disrupted prediction error signaling that underlies positive symptoms. However, this conceptualization has been challenged by observations that MMN and positive symptoms are often uncorrelated. In the current study, we tested the hypothesis that reduced MMN is associated with the presence of hallucinations and delusions specifically rather than the presence of a psychiatric illness. A second aim was to determine whether the strength of the association with positive symptoms increases for indices that reflect predictions at higher levels of abstraction.

Methods

Fifty-six PSZ, 34 nonclinical voice hearers, and 48 healthy comparison subjects (HCs) completed 2 MMN paradigms: one with a simple duration deviant type, and one with a higher-level, pattern-violation deviant type. We also measured the repetition positivity, which reflects the formation of auditory memory traces.

Results

We observed that although PSZ exhibited the expected pattern of significantly reduced duration MMN and reduced pattern-violation MMN at the trend level compared with HCs, nonclinical voice hearers exhibited a pattern of duration MMN and pattern-violation MMN amplitude that was statistically similar to that of HCs (ps > .64). Similarly, PSZ exhibited a significantly reduced repetition positivity slope compared with HCs in the duration condition and a trend-level reduction compared with HCs in the pattern-violation condition. Nonclinical voice hearers did not differ from either group in repetition positivity slope in either condition.

Conclusions

These results indicate that the MMN as a prediction error signal does not reflect processes relevant for the manifestation of hallucinations and delusions.
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临床和非临床听声辩位者的错配负性反应模式不同,这对精神病的预测编码描述提出了挑战
背景在精神分裂症(PSZ)患者中,错配负性(MMN)的降低被认为是预测错误信号传递中断的证据,而预测错误信号传递中断是阳性症状的基础。然而,MMN与阳性症状往往不相关的观察结果却对这一概念提出了质疑。在本研究中,我们检验了这样一个假设,即 MMN 的降低与幻觉和妄想的出现相关,而不是与精神疾病的出现相关。研究方法:56 名 PSZ、34 名非临床语音倾听者和 48 名健康对比受试者(HCs)完成了 2 个 MMN 范例:一个是简单的持续时间偏差类型,另一个是更高层次的模式违反偏差类型。我们还测量了反映听觉记忆痕迹形成的重复积极性。结果我们观察到,虽然 PSZ 与 HCs 相比,在趋势水平上表现出预期的持续时间 MMN 显著减少和模式违反 MMN 减少的模式,但非临床语音听者表现出的持续时间 MMN 和模式违反 MMN 振幅模式在统计学上与 HCs 相似(ps >.64)。同样,在持续时间条件下,PSZ 的重复阳性斜率与 HC 相比明显降低;在模式违反条件下,PSZ 的重复阳性斜率与 HC 相比呈下降趋势。这些结果表明,MMN 作为一种预测错误信号,并不能反映与幻觉和妄想表现相关的过程。
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来源期刊
Biological psychiatry global open science
Biological psychiatry global open science Psychiatry and Mental Health
CiteScore
4.00
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审稿时长
91 days
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