Decrease in gamma-band auditory steady-state response in patients with treatment-resistant schizophrenia.

Jan 16, 2023

Experts: Kamiyu Ogyu,Karin Matsushita,Shiori Honda,Masataka Wada,Shunsuke Tamura,Kazumasa Takenouchi,Yui Tobari,Keisuke Kusudo,Hideo Kato,Teruki Koizumi,Naohiro Arai,Akihiro Koreki,Mie Matsui,Hiroyuki Uchida,Shinya Fujii,Mitsumoto Onaya,Yoji Hirano,Masaru Mimura,Shinichiro Nakajima,Yoshihiro Noda

Thirty percent of patients with schizophrenia do not respond to non-clozapine antipsychotics and are termed treatment-resistant schizophrenia (TRS). The 40-Hz auditory steady-state response (ASSR) is a well-known to be reduced in patients with schizophrenia compared to healthy controls (HCs), suggesting impaired gamma oscillation in schizophrenia. Given no ASSR study on TRS, we aimed to examine the neurophysiological basis of TRS employing 40-Hz ASSR paradigm.
We compared ASSR measures among HCs, patients with non-TRS, and patients with TRS. TRS criteria were defined by a score of 4 or higher on two items of the Positive and Negative Syndrome Scale (PANSS) positive symptoms despite standard antipsychotic treatment. Participants were examined for ASSR with 40-Hz click-train stimulus, and then time-frequency analysis was performed to calculate evoked power and phase-locking factor (PLF) of 40-Hz ASSR.
A total of 79 participants were included: 27 patients with TRS (PANSS = 92.6 ± 15.8); 27 patients with non-TRS (PANSS = 63.3 ± 14.7); and 25 HCs. Evoked power in 40-Hz ASSR was lower in the TRS group than in the HC group (F = 8.37, p = 0.015; TRS vs. HCs: p = 0.012, d = 1.1) while no differences in PLF were found between the groups.
These results suggest that glutamatergic and GABAergic neurophysiological dysfunctions are involved in the pathophysiology of TRS. Our findings warrant more comprehensive and longitudinal studies for deep phenotyping of TRS.

Copyright © 2023. Published by Elsevier B.V.

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ABOUT THE EXPERTS

Kamiyu Ogyu,Karin Matsushita,Shiori Honda,Masataka Wada,Shunsuke Tamura,Kazumasa Takenouchi,Yui Tobari,Keisuke Kusudo,Hideo Kato,Teruki Koizumi,Naohiro Arai,Akihiro Koreki,Mie Matsui,Hiroyuki Uchida,Shinya Fujii,Mitsumoto Onaya,Yoji Hirano,Masaru Mimura,Shinichiro Nakajima,Yoshihiro Noda

Kamiyu Ogyu

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan; Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba 266-0007, Japan.

Karin Matsushita

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan.

Shiori Honda

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan.

Masataka Wada

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan.

Shunsuke Tamura

Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.

Kazumasa Takenouchi

Department of Clinical Laboratory Medicine, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba 266-0007, Japan.

Yui Tobari

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan; Faculty of Environment and Information Studies, Keio University, Kanagawa, Kanagawa 252-0882, Japan.

Keisuke Kusudo

Department of Psychiatry, National Hospital Organization Chiba Medical Center, Chiba 260-8606, Japan.

Hideo Kato

Department of Epileptology, National Center of Neurology and Psychiatry Hospital, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan.

Teruki Koizumi

Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba 266-0007, Japan.

Naohiro Arai

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan.

Akihiro Koreki

Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba 266-0007, Japan.

Mie Matsui

Department of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa 920-1164, Japan.

Hiroyuki Uchida

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan.

Shinya Fujii

Faculty of Environment and Information Studies, Keio University, Kanagawa, Kanagawa 252-0882, Japan.

Mitsumoto Onaya

Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba 266-0007, Japan.

Yoji Hirano

Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; Department of Psychiatry, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.

Masaru Mimura

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan.

Shinichiro Nakajima

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan; Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada. Electronic address: shinichiro.l.nakajima@gmail.com.

Yoshihiro Noda

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan. Electronic address: yoshi-tms@keio.jp.