Association between Mismatch Negativity and Functional Status in Patients with Schizophrenia

Min Ah Kim; Sung Nyun Kim; Min Hee Lee; Suji Lee; Jun Soo Kwon

doi:10.16946/kjsr.2013.16.2.98

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Kim, Kim, Lee, Lee, and Kwon: Association between Mismatch Negativity and Functional Status in Patients with Schizophrenia

Original Article

Korean J Schizophr Res 2013;16(2):98-106.

Published online: 17 January 2013

DOI: https://doi.org/10.16946/kjsr.2013.16.2.98

Association between Mismatch Negativity and Functional Status in Patients with Schizophrenia

Min Ah Kim, MD¹, Sung Nyun Kim, MD^1,², Min Hee Lee, RN², Suji Lee, MS³, Jun Soo Kwon, MD^1,^2,^3,

¹Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea

²Institute of Human Behavioral Sciences, Seoul National University-Medical Research Center, Seoul, Korea

³Department of Brain and Cognitive Science-World Class University Program, Seoul National University College of Natural Science, Seoul, Korea

Address for correspondence: Jun Soo Kwon, Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul 110-744, Korea Tel: 02-2072-2450, Fax: 02-747-7405 E-mail: kwonjs@snu.ac.kr

이 연구는 대한민국 보건복지부 보건의료연구개발사업(중점기술 중개연구, A120476) 의 지원으로 수행되었습니다.

Revised 4 September 201325 September 2013 Accepted 27 September 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

It has been constantly reported that mismatch negativity (MMN) is impaired in patients with schizophrenia. However, the mechanism which relates impaired MMN and schizophrenia is not clear yet. The aim of this study is to investigate the association between MMN and clinical variables including functional status in patients with schizophrenia.

Methods

The present study assessed MMN using passive auditory oddball task in 26 patients with schizophrenia and 48 healthy controls. Repeated measures Analysis of Variance with age as a covariate was carried out for comparing peak amplitude and latency of MMN at 8 central line electrodes (FPz, Fz, FCz, Cz, CPz, Pz, POz, Oz) across groups. Pearson's correlation was performed to reveal the relationship between MMN and clinical variables including neurocognitive test results and the Global Assessment of Functioning score.

Results

MMN amplitude was significantly reduced in patients with schizophrenia compared with healthy controls. Pearson's correlation showed that subsets of short form of Korean Wechsler Adult Intelligence Scale scores and GAF scores were associated with MMN amplitude in patients with schizophrenia.

Conclusion

These findings suggest that MMN amplitude is associated with current functional status including cognitive function in patients with schizophrenia.

Keywords: Event related potential, Mismatch negativity, Schizophrenia, Cognitive function, Functional status

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Fig. 1.

The grand averaged Mismatch negativity waveforms at Fz. A : Patients with schizophrenia. B : Healthy controls.

Fig. 2.

Mismatch negativity amplitude across group at Fz and Cz. Horizontal lines in the group indicate mean value and vertical lines in the group indicate 95% confidence interval.

Fig. 3.

Correlation between Mismatch negativity amplitudes and subsets of short form of Korean Wechsler Adult Intelligence Scale in patients with schizophrenia.

Fig. 4.

Correlation between Mismatch negativity amplitudes and Global Assessment of Functioning scores in patients with schizophrenia.

Table 1.

Demographic, neurocognitive and clinical characteristics of subjects

	Schizophrenia (N=26)		Healthy controls (N=48)		Analysis^†	p value
	Mean	SD	Mean	SD	χ² or t	p value
Demographic characteristics
Male/Female	18/8		26/22		1.59	0.227
Age (y)	27.42	4.69	23.94	5.40	2.77	0.007∗
Education (y)	13.96	2.16	14.23^∥	1.68	-0.60	0.552
Handedness (R/L)	23/2^‡		47/1			0.269
Neurocognitive performances
WCST
Correct response	65.21^§	15.85	70.08	6.77	-1.44	0.161
Errors	40.29^§	30.00	16.15	7.57	3.88	0.001∗
Perseverative response	22.33^§	19.74	8.54	4.27	3.38	0.002∗
Non-perseverative response	20.50^§	16.84	8.08	4.44	3.55	0.002∗
Perseverative error	19.79^§	16.03	8.10	3.78	3.52	0.002∗
Categories achieved	4.54^§	2.15	5.92	0.58	-3.08	0.005∗
TMT-A
Time (sec)/error	32.71/0.08^§	12.15/0.28	21.81/0.15	6.22/0.36	4.13/-0.75	＜0.001∗/0.422
TMT-B
Time (sec)/error	93.29/0.46^§	34.75/0.83	52.83/0.21	15.46/0.46	5.44/1.37	＜0.001∗/0.181
COWA
Letters	29.25^§	8.89	44.44	10.09	-6.26	＜0.001∗
Categories	29.00^§	7.09	42.71	9.54	-6.86	＜0.001∗
K-WAIS (short form)
Vocabulary	11.08^§	2.65	12.54	2.01	-2.37	0.023∗
Digit span	10.70^‡	1.92	12.52	1.70	-4.06	＜0.001∗
Picture arrangement	9.92^§	2.39	11.63	1.84	-3.35	0.001∗
Block design	11.21^§	2.60	14.46	1.95	-5.95	＜0.001∗
Arithmatic	10.17^§	2.53	13.73	2.86	-5.18	＜0.001∗
Full scale iq	100.50^§	14.27	113.90	13.58	-3.88	＜0.001∗
Clinical characteristics
PANSS total	57.08^§	14.04
PANSS positive	12.42^§	4.12
PANSS negative	16.25^§	5.79
PANSS general	28.42^§	6.46
BPRS	40.21^§	8.31
GAF	50.87^§	10.69

^∗ : The mean difference is significant at the 0.05 level,

^† : Independent t test or Welch's t test if the variances were not equal, χ² analysis or Fisher's exact test for categorical data,

^‡ : N=25, the number of missing data was 1,

^§ : N=24, the number of missing data was 2,

^∥ : N=47, the number of missing data was 1. WCST : Wisconsin Card Sorting Test, TMT-A : Trail Making Test-A, TMT-B : Trail Making Test-B, COWA : Controlled Oral Word Association Test, K-WAIS : Korean Wechsler Adult Intelligence Scale, IQ : Intelligence Quotient, PANSS : Positive and Negative Syndrome Scale, BPRS : Brief Psychiatric Rating Scale, GAF : Global Assessment of Functioning, N : number of patients

Table 2.

Means and standard deviations of peak MMN amplitudes and latencies at central electrode sites

	Schizophrenia (N=26)		Healthy controls (N=48)		t	p value
	Mean	SD	Mean	SD	t	p value
Amplitude
FPZ	-3.75	2.00	-4.69	2.10	1.86	0.067
FZ	-3.61	1.95	-5.70	2.29	3.92	＜0.001∗
FCZ	-3.51	2.43	-5.61	2.39	3.60	＜0.001∗
CZ	-3.04	1.76	-4.75	2.13	3.50	0.001∗
CPZ	-2.30	1.28	-3.71	1.76	3.57	0.001∗
PZ	-1.68	1.08	-2.61	1.27	3.20	0.002∗
POZ	-1.28	1.12	-1.57	1.03	1.11	0.271
OZ	-0.90	0.91	-1.14	1.54	0.73	0.469
Latency
FPZ	170.69	29.06	177.23	23.19	-1.06	0.294
FZ	179.23	27.22	178.10	20.19	0.20	0.840
FCZ	174.42	30.90	177.10	18.58	-0.41	0.688
CZ	175.92	31.17	176.06	19.09	-0.02	0.984
CPZ	181.31	31.13	175.35	17.96	0.90	0.376
PZ	177.81	29.63	181.69	22.66	-0.63	0.531
POZ	190.46	35.33	189.35	27.47	0.15	0.882
OZ	202.42	29.01	193.67	30.34	1.20	0.233

^∗ : The mean difference is significant at the 0.05 level. SD : Standard Deviation, N : Number of patients

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