Non-rapid eye movement sleep and wake neurophysiology in schizophrenia


Motivated by the potential of objective
neurophysiological markers to index thalamocortical function in patients
with severe psychiatric illnesses, we comprehensively characterized key
non-rapid eye movement (NREM) sleep parameters across multiple domains,
their interdependencies, and their relationship to waking event-related
potentials and symptom severity. In 72 schizophrenia (SCZ) patients and
58 controls, we confirmed a marked reduction in sleep spindle density
in SCZ and extended these findings to show that fast and slow spindle
properties were largely uncorrelated. We also describe a novel measure
of slow oscillation and spindle interaction that was attenuated in SCZ.
The main sleep findings were replicated in a demographically distinct
sample, and a joint model, based on multiple NREM components,
statistically predicted disease status in the replication cohort.
Although also altered in patients, auditory event-related potentials
elicited during wake were unrelated to NREM metrics. Consistent with a
growing literature implicating thalamocortical dysfunction in SCZ, our
characterization identifies independent NREM and wake EEG biomarkers
that may index distinct aspects of SCZ pathophysiology and point to
multiple neural mechanisms underlying disease heterogeneity. This study
lays the groundwork for evaluating these neurophysiological markers,
individually or in combination, to guide efforts at treatment and
prevention as well as identifying individuals most likely to benefit
from specific interventions.

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