Ricardo E Carrión1, Barbara A Cornblatt2, Danielle McLaughlin3, Jeremy Chang3, Andrea M Auther4, Ruth H Olsen3, Daniel C Javitt5. 1. Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY 11030, USA; Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. Electronic address: RCarrion@NSHS.edu. 2. Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY 11030, USA; Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA; Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. 3. Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA. 4. Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA; Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. 5. Division of Experimental Therapeutics, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; Division of Schizophrenia Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA.
Abstract
BACKGROUND: There is a growing recognition that individuals at clinical high risk need intervention for functional impairments, along with emerging psychosis, as the majority of clinical high risk (CHR) individuals show persistent deficits in social and role functioning regardless of transition to psychosis. Recent studies have demonstrated reduced reading ability as a potential cause of functional disability in schizophrenia, related to underlying deficits in generation of mismatch negativity (MMN). The present study extends these findings to subjects at CHR. METHODS: The sample consisted of 34 CHR individuals and 33 healthy comparison subjects (CNTLs) from the Recognition and Prevention (RAP) Program at the Zucker Hillside Hospital in New York. At baseline, reading measures were collected, along with MMN to pitch, duration, and intensity deviants, and measures of neurocognition, and social and role (academic/work) functioning. RESULTS: CHR subjects showed impairments in reading ability, neurocognition, and MMN generation, relative to CNTLs. Lower-amplitude MMN responses were correlated with worse reading ability, slower processing speed, and poorer social and role functioning. However, when entered into a simultaneous regression, only reduced responses to deviance in sound duration and volume predicted poor social and role functioning, respectively. CONCLUSIONS: Deficits in reading ability exist even prior to illness onset in schizophrenia and may represent a decline in performance from prior abilities. As in schizophrenia, deficits are related to impaired MMN generation, suggesting specific contributions of sensory-level impairment to neurocognitive processes related to social and role function.
BACKGROUND: There is a growing recognition that individuals at clinical high risk need intervention for functional impairments, along with emerging psychosis, as the majority of clinical high risk (CHR) individuals show persistent deficits in social and role functioning regardless of transition to psychosis. Recent studies have demonstrated reduced reading ability as a potential cause of functional disability in schizophrenia, related to underlying deficits in generation of mismatch negativity (MMN). The present study extends these findings to subjects at CHR. METHODS: The sample consisted of 34 CHR individuals and 33 healthy comparison subjects (CNTLs) from the Recognition and Prevention (RAP) Program at the Zucker Hillside Hospital in New York. At baseline, reading measures were collected, along with MMN to pitch, duration, and intensity deviants, and measures of neurocognition, and social and role (academic/work) functioning. RESULTS: CHR subjects showed impairments in reading ability, neurocognition, and MMN generation, relative to CNTLs. Lower-amplitude MMN responses were correlated with worse reading ability, slower processing speed, and poorer social and role functioning. However, when entered into a simultaneous regression, only reduced responses to deviance in sound duration and volume predicted poor social and role functioning, respectively. CONCLUSIONS: Deficits in reading ability exist even prior to illness onset in schizophrenia and may represent a decline in performance from prior abilities. As in schizophrenia, deficits are related to impaired MMN generation, suggesting specific contributions of sensory-level impairment to neurocognitive processes related to social and role function.
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