Abnormally Large Baseline P300 Amplitude Is Associated With Conversion to Psychosis in Clinical High Risk Individuals With a History of Autism: A Pilot Study

• Type of Material: Article
• Authors: Jennifer H Foss-Feig, Icahn School of Medicine at Mount Sinai; Sylvia B Guillory, Icahn School of Medicine at Mount Sinai; Brian J Roach, San Francisco VA Hlth Care Syst; Eva Velthorst, Icahn Sch Med Mt Sinai; Holly Hamilton, San Francisco VA Hlth Care Syst; Peter Bachman, University of Pittsburgh; Ayseni Belger, University of North Carolina; Ricardo Carrion, Zucker Hillside Hosp; Erica Duncan, Emory University; Jason Johannesen, Yale University; Gregory A Light, University of California San Diego; Margaret Niznikiewicz, Harvard University; Jean M Addington, University of Calgary; Kristin S Cadenhead, University of California San Diego; Tyrone D Cannon, Yale University; Barbara Cornblatt, Zucker Hillside Hosp; Thomas McGlashan, Yale University; Diana Perkins, University of North Carolina; Larry J Seidman, Harvard University; William S Stone, Harvard University; Ming Tsuang, University of California San Diego; Elaine Walker, Emory University; Scott Woods, Yale University; Carrie E Bearden, University of California Los Angeles; Daniel H Mathalon, San Francisco VA Hlth Care Syst
• Language: English
• Date: 2021-02-09
• Publisher: FRONTIERS MEDIA SA
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Foss-Feig, Guillory, Roach, Velthorst, Hamilton, Bachman, Belger, Carrion, Duncan, Johannesen, Light, Niznikiewicz, Addington, Cadenhead, Cannon, Cornblatt, McGlashan, Perkins, Seidman, Stone, Tsuang, Walker, Woods, Bearden and Mathalon.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3389/fpsyt.2021.591127
• Title of Journal or Parent Work: FRONTIERS IN PSYCHIATRY
• Volume: 12
• Start Page: 591127
• End Page: 591127
• Grant/Funding Information: This work was supported by the National Institute of Mental Health (Grant U01MH081984 to JA; Grants U01 MH081928; P50 MH080272; Commonwealth of Massachusetts SCDMH82101008006 to LS; Grants R01 MH60720, U01 MH082022, and K24 MH76191 to KC; Grant MH081902 and U01MH081902 to TC; Grant P50 MH066286 and support from the Staglin Family Music Festival for Mental Health to CB; Grant U01MH076989 to DM; Grant U01MH082004-01A1 to DP; Grant U01MH081988 to EW; Grant U01MH082022 to SW; and U01 MH081857-05 Grant to BC). ED receives or has received research support for work unrelated to this project from NIMH (1R01MH117315-01A1; 5R21MH117512-02), the Department of Veterans Affairs (1I01CX000974-01A1), Auspex Pharmaceuticals, Inc. and Teva Pharmaceuticals, Inc. ED was a full-time attending psychiatrist in the Mental Health Service Line at the Atlanta Veterans Affairs Health Care System, Decatur, GA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs. JF-F was supported by National Institute of Mental Health R21 MH115297, R01 MH119172, and by the Seaver Foundation. EV received support from the Netherland Organization for Scientific Research (NWO) VENI Grant No. 916-15-005 and the Seaver Foundation. EV was a Seaver Faculty Scholar and SG was a Seaver Fellow.
• Keywords: autism spectrum disorder; P300; EEG; psychosis; Life Sciences & Biomedicine; prodrome; Psychiatry; Science & Technology; conversion
• Research Categories: Psychology, Clinical; Health Sciences, Rehabilitation and Therapy

Abstract

Psychosis rates in autism spectrum disorder (ASD) are 5–35% higher than in the general population. The overlap in sensory and attentional processing abnormalities highlights the possibility of related neurobiological substrates. Previous research has shown that several electroencephalography (EEG)-derived event-related potential (ERP) components that are abnormal in schizophrenia, including P300, are also abnormal in individuals at Clinical High Risk (CHR) for psychosis and predict conversion to psychosis. Yet, it is unclear whether P300 is similarly sensitive to psychosis risk in help-seeking CHR individuals with ASD history. In this exploratory study, we leveraged data from the North American Prodrome Longitudinal Study (NAPLS2) to probe for the first time EEG markers of longitudinal psychosis profiles in ASD. Specifically, we investigated the P300 ERP component and its sensitivity to psychosis conversion across CHR groups with (ASD+) and without (ASD–) comorbid ASD. Baseline EEG data were analyzed from 304 CHR patients (14 ASD+; 290 ASD–) from the NAPLS2 cohort who were followed longitudinally over two years. We examined P300 amplitude to infrequent Target (10%; P3b) and Novel distractor (10%; P3a) stimuli from visual and auditory oddball tasks. Whereas P300 amplitude attenuation is typically characteristic of CHR and predictive of conversion to psychosis in non-ASD sample, in our sample, history of ASD moderated this relationship such that, in CHR/ASD+ individuals, enhanced – rather than attenuated - visual P300 (regardless of stimulus type) was associated with psychosis conversion. This pattern was also seen for auditory P3b amplitude to Target stimuli. Though drawn from a small sample of CHR individuals with ASD, these preliminary results point to a paradoxical effect, wherein those with both CHR and ASD history who go on to develop psychosis have a unique pattern of enhanced neural response during attention orienting to both visual and target stimuli. Such a pattern stands out from the usual finding of P300 amplitude reductions predicting psychosis in non-ASD CHR populations and warrants follow up in larger scale, targeted, longitudinal studies of those with ASD at clinical high risk for psychosis.