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A 'brain wave' test for schizophrenia risk?

There is a significant need for objective tests that could improve clinical prediction of future psychosis.

One strategy has been to determine whether physiologic measures that are abnormal in people diagnosed with schizophrenia might also be useful in estimating the risk for developing this illness. This is the strategy taken by German and Swiss researchers in the current issue of Biological Psychiatry.

They used electroencephalography (EEG), which measures the brain's electrical activity or "brain waves", to study the brain's response to commonly and rarely presented tones that differed in length.

When these rare "deviant" tones are presented to healthy people, the brain automatically generates a particular electrical wave called mismatch negativity, or MMN. People diagnosed with schizophrenia have reduced MMN.

In this new study, the researchers followed a group of people clinically at high risk for developing psychosis. They found that the individuals who went on to develop schizophrenia had smaller MMN than the subgroup who did not. This finding suggests that MMN might be useful in predicting the later development of schizophrenia.

"With this type of study, the devil is always in the details. How sensitive is MMN as a risk predictor? How reliable is it? How many people are mistakenly classified? How long of a follow-up period is necessary to make this test useful? Are there subgroups of individuals for whom this test is or is not reliable?" mused Dr. John Krystal, Editor of Biological Psychiatry. "If we hope to use this type of measure to guide research and even clinical interventions, then it has to be an extremely robust measure with respect to the issues that I just mentioned, among others. Yet, this is exactly the type of initial step that we need to move toward clinically meaningful biological tests."

First author Dr. Mitja Bodatsch agreed, adding that "integration of both biological and clinical measures into multidimensional models might be the crucial next step forward to improve risk staging in psychiatry."

Notes to Editors:

The article is "Prediction of Psychosis by Mismatch Negativity" by Mitja Bodatsch, Stephan Ruhrmann, Michael Wagner, Ralf Müller, Frauke Schultze-Lutter, Ingo Frommann, Jürgen Brinkmeyer, Wolfgang Gaebel, Wolfgang Maier, Joachim Klosterkötter, and Anke Brockhaus-Dumke. Bodatsch, Ruhrmann, Müller, Schultze-Lutter, Klosterkötter, and Brockhaus-Dumke are affiliated with the University of Cologne, Germany. Wagner, Frommann, and Maier are from Rheinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany. Brinkmeyer and Gaebel are with Heinrich Heine University of Düsseldorf, Dusseldorf, Germany. Brockhaus-Dumke is also with Rheinhessen-Fachklinik Alzey, Alzey, Germany. Schultze-Lutter is also from University Hospital of Child and Adolescent Psychiatry, Bern, Switzerland. The article appears in Biological Psychiatry, Volume 69, Number 10 (May 15, 2011), published by Elsevier.

The authors' disclosures of financial and conflicts of interests are available in the article.

John H. Krystal, M.D. is Chairman of the Department of Psychiatry at the Yale University School of Medicine and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available at


Full text of the article mentioned above is available upon request. Contact Chris J. Pfister at to obtain a copy or to schedule an interview.

About Biological Psychiatry

This international rapid-publication journal is the official journal of the Society of Biological Psychiatry. It covers a broad range of topics in psychiatric neuroscience and therapeutics. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and treatment of major neuropsychiatric disorders. Full-length reports of novel results, commentaries, case studies of unusual significance, and correspondence judged to be of high impact to the field are published, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Concise reviews and editorials that focus on topics of current research and interest are also published rapidly.

Biological Psychiatry ( is ranked 4th out of 117 Psychiatry titles and 13th out of 230 Neurosciences titles in the 2009 ISI Journal Citations Reports® published by Thomson Reuters. The 2009 Impact Factor score for Biological Psychiatry has increased to 8.926.

About Elsevier

Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include SciVerse ScienceDirect, SciVerse Scopus, Reaxys, MD Consult and Nursing Consult, which enhance the productivity of science and health professionals, and the SciVal suite and MEDai's Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Chris J. Pfister | EurekAlert!
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