Reduced prepulse inhibition in adolescents at risk for psychosis: a 2-year follow-up study.
BACKGROUND
Reduced prepulse inhibition (PPI) of the auditory startle reflex is a hallmark feature of attention-processing deficits in patients with schizophrenia and other psychotic disorders. Recent evidence suggests that these deficits may also be present before the onset of psychosis in individuals at ultra-high risk (UHR) and become progressively worse as psychosis develops. We conducted a longitudinal follow-up study to observe the development of PPI over time in UHR adolescents and healthy controls.


METHODS
Two-year follow-up data of PPI measures were compared between UHR adolescents and a matched control group of typically developing individuals.


RESULTS
We included 42 UHR adolescents and 32 matched controls in our study. Compared with controls, UHR individuals showed reduced PPI at both assessments. Clinical improvement in UHR individuals was associated with an increase in PPI parameters.


CONCLUSIONS
A developmental increase in startle magnitude partially confined the interpretation of the association between clinical status and PPI. Furthermore, post hoc analyses for UHR individuals who became psychotic between assessments had limited power owing to a low transition rate (14%).


CONCLUSIONS
Deficits in PPI are present before the onset of psychosis and represent a stable vulnerability marker over time in UHR individuals. The magnitude of this marker may partially depend on the severity of clinical symptoms.
Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands. tim.ziermans@ki.se
Tim
T
Ziermans
Patricia
P
Schothorst
Maurice
M
Magnée
Herman
H
van Engeland
Chantal
C
Kemner
D000161:Acoustic Stimulation; D000293:Adolescent; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D013216:Reflex, Startle / Q000502:physiology*; D012306:Risk; D055139:Sensory Gating / Q000502:physiology*; D055815:Young Adult
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