Wild-Wall, N., Juran, S., Oades, R. D., Weisbrod, M., Chen; E. Y. H., Röpcke, B., (2004)
Auditory change detection sources in the brain: An ERP-Study in early-onset, adolescent patients at the outbreak of schizophrenia and 15-years later.
Proceedings of the 16th World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions, 22-26 Aug 2004, Berlin, Germany (p.72).

Introduction: Severer illness, poorer prognosis and impaired brain structure are reported for patients with an onset of schizophrenia in adolescence. Is this reflected in early stimulus processing ?

Methods: This study compared
a) an electrophysiological measure of automatic, auditory attention-related function and its sources in the brain for 19 patients (17.5 years) at onset, and 17 patients 15 years after an early onset with age-matched healthy subjects. .
b) Mismatch Negativity (MMN), recorded from 32 sites during a simple visual vigilance task, was associated with a rare tone shorter than the standard. .
c) Brain electrical source analysis (BESA) confirmed bilateral frontal and temporal lobe dipoles (Jemel et al. 2002).

Results: Both patient groups showed a smaller MMN than the controls. There were several signs of illness progression in the older patient group:
a visual vigilance decrement was only evident in the older patients:
Second: the left superior temporal source was weaker: bilaterally the temporal sources were more ventral in first-episode patients:
Third: the left cingulate source changed orientation;
Fourth: the right inferior frontal source was active later: both frontal sources were located posterior to those in controls.

In the older patients the left temporal locus remained ventral (stasis), and the right temporal locus extended more anterolaterally (progression), while the right frontal source moved antero-laterally (normalised).
This illness-related progression of a cognitive impairment is consistent with a poorer prognosis for patients with an onset of psychosis in adolescence, with a neurodevelopmental hypothesis, and that there may often be initial structural impairments in young patients in contrast to the more variable, sporadic changes in those with a later onset.
NW-W was supported by the Alfried Krupp von Bohlen u. Halbach Stiftung