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:
First: 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.

Conclusions:
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.
Support: NW-W was supported by the Alfried Krupp von Bohlen u. Halbach Stiftung