Contributions of early cortical processing and reading ability to functional status in individuals at clinical high risk for psychosis.
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.
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.
Ricardo E
RE
Carrión
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.
Barbara A
BA
Cornblatt
Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA.
Danielle
D
McLaughlin
Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA.
Jeremy
J
Chang
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.
Andrea M
AM
Auther
Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA.
Ruth H
RH
Olsen
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.
Daniel C
DC
Javitt
D000161:Acoustic Stimulation; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002540:Cerebral Cortex / Q000503:physiopathology*; D016009:Chi-Square Distribution; D002648:Child; D003265:Contingent Negative Variation / Q000502:physiology*; D003430:Cross-Sectional Studies; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D062706:Prodromal Symptoms; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000473:pathology* / Q000503:physiopathology*; D011932:Reading; D021641:Recognition, Psychology / Q000502:physiology*; D055815:Young Adult
Clinical high risk; Early intervention; Mismatch negativity; Reading; Social functioning