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Prepulse inhibition of the acoustically evoked startle reflex in patients with an acute schizophrenic psychosis—A longitudinal study

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Abstract

Deficits in sensorimotor gating as assessed by prepulse inhibition (PPI) of the startle reflex have been reported in schizophrenia. However, the state or trait nature of these deficits and the relationships with clinical features and psychopathological symptoms are not clear. To explore these issues, we performed a longitudinal study with schizophrenia inpatients.

We examined 36 medicated schizophrenia inpatients twice in the course of an acute psychotic episode: recently after admission and after psychopathological improvement 2–3 weeks later. In addition, we examined 18 healthy control subjects twice (two weeks apart).

Relative to control subjects, patients with schizophrenia had lower PPI only in the acute, but not in the improved clinical state. Larger PPI deficits were associated with more severe formal thought disorder and bizarre behavior.

In the present longitudinal study, PPI deficits in schizophrenic patients appeared to be state dependent. Taking into account recent evidence from the literature we propose that reduced PPI may be a mediating vulnerability marker of schizophrenia: Impairments in sensorimotor mechanisms which subserve PPI of the startle reflex may both predispose individuals to develop psychosis, and, in addition, may covary with the presence of acute positive symptoms.

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References

  1. Andreasen NC (1984a) The scale for the assessment of negative symptoms (SANS). Iowa City, IA: The university of Iowa

  2. Andreasen NC (1984b) The scale for the assessment of positive symptoms (SANS). Iowa City, IA: The university of Iowa

  3. Bleuler E (1911) Dementia praecox or the group of schizophrenias. Translated by J Zinkin, New York: International University Press, Inc. 1950

  4. Blumenthal TD, Creps CL (1994) Normal startle responding in psychosis-prone college students. Personality and Individual Differences 17:345–355

    Google Scholar 

  5. Braff DL, Stone C, Callaway E, Geyer MA, Glick ID, Bali L (1978) Prestimulus effects of human startle reflex in normals and schizophrenics. Psychophysiol 15:339–343

    CAS  PubMed  Google Scholar 

  6. Braff DL, Grillon C, Geyer MA (1992) Gating and habituation of the startle reflex in schizophrenic patients. Arch Gen Psychiatry 49:206–215

    CAS  PubMed  Google Scholar 

  7. Braff DL (1993) Information processing and attention dysfunctions in schizophrenia. Schizophr Bull 19:233–259

    CAS  PubMed  Google Scholar 

  8. Braff DL, Swerdlow NR, Geyer MA (1999) Symptom correlates of prepulse inhibition deficits in male schizophrenic patients. Am J Psychiatry 156:596–602

    CAS  PubMed  Google Scholar 

  9. Braff DL, Geyer MA, Swerdlow NR (2001a) Human studies of prepulse inhibition of startle: normal subjects, patient groups, and pharmacological studies. Psychopharmacol (Berl) 156:234–258

    Article  CAS  Google Scholar 

  10. Braff DL, Geyer MA (1990) Sensorimotor gating and schizophrenia: Human and animal model studies. Arch Gen Psychiatry 47:181–188

    CAS  PubMed  Google Scholar 

  11. Cadenhead KS, Geyer MA, Braff DL (1993) Impaired startle prepulse inhibition and habituation in patients with schizotypal personality disorder. Am J Psychiatry 150:1862–1867

    CAS  PubMed  Google Scholar 

  12. Cadenhead KS, Kumar C, Braff D (1996) Clinical and experimental characteristics of “hypothetically psychosis prone” college students. J Psychiatr Res 30:331–340

    Article  CAS  PubMed  Google Scholar 

  13. Cadenhead KS, Carasso BS, Swerdlow NR, Geyer MA, Braff DL (1999) Prepulse inhibition and habituation of the startle response are stable neurobiological measures in a normal male population. Biol Psychiatry 45:360–364

    Article  CAS  PubMed  Google Scholar 

  14. Cadenhead KS, Swerdlow NR, Shafer KM, Diaz M, Braff DL (2000) Modulation of the startle response and startle laterality in relatives of schizophrenic patients and in subjects with schizotypal personality disorder: evidence of inhibitory deficits. Am J Psychiatry 157:1660–1668

    CAS  PubMed  Google Scholar 

  15. Dawson ME, Hazlett EA, Filion DL, Nuechterlein KH, Schell AM (1993) Attention and schizophrenia: Impaired modulation of the startle reflex. J Abnormal Psychol 102:633–641

    Article  CAS  Google Scholar 

  16. Duncan EJ, Szilagi S, Efferen T, Schwartz MP, Parwani A, Chakrovorty S, Madonick SH, Kunzova A, Harmon JW, Angrist B, Gonzenbach S, Rotrosen JP (2003) Effect of treatment status on prepulse inhibition of acoustic startle in schizophrenia. Psychopharmacol 167:63–71

    CAS  Google Scholar 

  17. Duncan EJ, Szilagi S, Schwartz MP, Kunzova A ,Negi S, Efferen T, Peselow E, Chakrovorty S, Stephanides M, Harmon JW, Bugarski-Kirola D, Gonzenbach S, Rotrosen JP (2003) Prepulse inhibition of acoustic startle in subjects with schizophrenia treated with olanzapine or haloperidol. Psych Res 120:1–12

    Google Scholar 

  18. Geyer MA, Swerdlow NR, Mansbach RS, Braff DL (1990) Startle response models of sensorimotor gating and habituation deficits in schizophrenia. Brain Res Bull 25:485–498

    Article  CAS  PubMed  Google Scholar 

  19. Gottschalk LA, Haer JL, Bates DE (1972) Effect of sensory overload on psychological state. Arch Gen Psychiatry 27:451–457

    CAS  PubMed  Google Scholar 

  20. Hamm A, Weike A, Schupp T (2001) The effect of neuroleptic medication on prepulse inhibition in schizophrenic patients: current status and future issues. Psychopharmacol 156:259–265

    Article  CAS  Google Scholar 

  21. Hazlett EA, Buchsbaum MS, Haznedar MM, Singer MB, Germans MK, Schnur DB, Jimenez EA, Buchsbaum BR, Troyer BT (1998) Prefrontal cortex glucose metabolism and startle eyeblink modification abnormalities in unmedicated schizophrenia patients. Psychophysiology 35:186–198

    Article  CAS  PubMed  Google Scholar 

  22. Karper LP, Freeman GK, Grillon C, Morgan CA, III, Charney DS, Krystal JH (1996) Preliminary evidence of an association between sensorimotor gating and distractibility in psychosis. J Neuropsychiatry Clin Neurosci 8:60–66

    CAS  PubMed  Google Scholar 

  23. Kraepelin E (1913) Dementia praecox and Paraphrenia. Translated by RM, Barclay, Edinburgh: E & S Livingston, 1919

  24. Kumari V, Soni W, Sharma T (1999) Normalization of information processing deficits in schizophrenia with clozapine. Am J Psychiatry 156:1046–1051

    CAS  PubMed  Google Scholar 

  25. Kumari V, Soni W, Mathew VM, Sharma T (2000) Prepulse inhibition of the startle response in men with schizophrenia: effects of age of onset of illness, symptoms, and medication. Arch Gen Psychiatry 57:609–614

    CAS  PubMed  Google Scholar 

  26. Kumari V, Zachariah E, Galea A,Mehrotra R, Taylor D, Sharma T (2001) Effects of procyclidine on prepulse inhibition of the acoustic startle response in healthy human volunteers. Psychopharmacol 154:221–229

    Article  CAS  Google Scholar 

  27. Kumari V, Soni W, Sharma T (2002) Prepulse inhibition of the startle response in risperidone-treated patients: comparison with typical antipsychotics. Schizophr Res 55:139–146

    Article  PubMed  Google Scholar 

  28. Ludewig K, Geyer MA, Etzensberger M, Vollenweider FX (2002) Stability of acoustic startle reflex, prepulse inhibition and habituation in schizophrenia. Schizophr Res 55:129–137

    Article  PubMed  Google Scholar 

  29. Ludewig K, Geyer MA, Vollenweider FX (2003) Deficits in prepulse inhibition and habituation in never medicated, firstepisode schizophrenia. Biol Psychiatry 54:121–128

    Article  PubMed  Google Scholar 

  30. Mackeprang T, Kristiansen KT, Glenthoj BY (2002) Effects of antipsychotics on prepulse inhibition of the startle response in drug-naive schizophrenic patients. Biol Psychiatry 52:863–873

    Article  CAS  PubMed  Google Scholar 

  31. McGhie A, Chapman J (1961) Disorders of attention and perception in early schizophrenia. Br J Med Psychol 43:103–116

    Google Scholar 

  32. Meincke U, Mörth D, Voß T, Gouzoulis-Mayfrank E (2002) Electromyographical differentiation between the acoustic blink and startle reflex—implications for studies investigating startle behavior. Eur Arch Psychiatry Clin Neurosci 252:141–145

    Article  PubMed  Google Scholar 

  33. Nüchterlein KH, Dawson ME (1984a) Information processing and attentional functioning in the developmental course of schizophrenic disorders. Schizophr Bull 10:160–203

    Google Scholar 

  34. Nüchterlein KH, Dawson ME (1984b) A heuristic vulnerability/ stress model of schizophrenic episodes. Schizophr Bull 10:300–312

    Google Scholar 

  35. Oranje B, Van Coel CJ, Gispen-De Wied CC, Verbaten MN, Kahn RS (2002) Effects of typical and atypical antipsychotics on the prepulse inhibition of the startle reflex in patients with schizophrenia. J Clin Psychopharmacol 22:359–365

    Article  CAS  PubMed  Google Scholar 

  36. Overall JE, Gorham DR (1976) Brief psychiatric Rating Scale. In: Guy W (ed) ECDEU. Assessment Manual of Psychopharmacology, Rockville, pp 157–169

  37. Parwani A, Duncan EJ, Bartlett E, Madonick SH, Efferen TR, Rajan R, Sanfilippo M, Chappell PB, Chakravorty S, Gonzenbach S, Ko GN, Rotrosen JP (2000) Impaired prepulse inhibition of acoustic startle in schizophrenia. Biol Psychiatry 47:662–669

    Article  CAS  PubMed  Google Scholar 

  38. Perry W, Braff DL (1994) Information-processing deficits and thought disorder in schizophrenia. Am J Psychiatry 151:363–367

    CAS  PubMed  Google Scholar 

  39. Perry W, Geyer MA, Braff DL (1999) Sensorimotor gating and thought disturbance measured in close temporal proximity in schizophrenic patients. Arch Gen Psychiatry 56:277–281

    Article  CAS  PubMed  Google Scholar 

  40. Perry W, Feifel D, Minassian A, Bhattacharje I, Braff DL (2002) Information processing deficits in acutely psychotic schizophrenia patients medicated and unmedicated at the time of admission. Am J Psychiatry 159:1375–1381

    Article  PubMed  Google Scholar 

  41. Rodriguez-Fornells A, Riba J, Gironell A, Kulisevsky J, Barbanoj MJ (1999) Effects of alprazolam on the acoustic startle response in humans. Psychopharmacology (Berl) 143:280–285

    Google Scholar 

  42. Saccuzzo DP, Braff DL (1986) Information-processing abnormalities: trait- and state-dependent components. Schizophr Bull 12:447–445

    CAS  PubMed  Google Scholar 

  43. Schachinger H, Muller BU, Strobel W, Langewitz W, Ritz R (1999) Midazolam effects on prepulse inhibition of the acoustic blink reflex. Br J Clin Pharmacol 47:421–426

    Article  CAS  PubMed  Google Scholar 

  44. Schell AM, Dawson ME, Hazlett EA, Filion DL (1995) Attentional modulation of startle reflex in psychosis-prone college students. Psychophysiol 32:266–273

    CAS  Google Scholar 

  45. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428

    Article  Google Scholar 

  46. Simons RF, Giardina BD (1992) Reflex modification in psychosis-prone young adults. Psychophysiol 29:8–16

    CAS  Google Scholar 

  47. Swerdlow NR, Filion D, Geyer MA, Braff DL (1995) “Normal”personality correlates of sensorimotor, cognitive, and visuospatial gating. Biol Psychiatry 37:286–299

    Article  CAS  PubMed  Google Scholar 

  48. Weike AJ, Bauer U, Hamm AO (2000) Effective neuroleptic medication removes prepulse inhibition deficits in schizophrenia patients. Biol Psychiatry 47:61–70

    Article  CAS  PubMed  Google Scholar 

  49. Weike AI, Hamm AO, Vaitl D (2001) Sensorimotor gating and attitudes related to schizotypal proneness. Psychol Rep 88:1035–1045

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dept. of Psychiatry & Psychotherapy, Technical University of Aachen, Pauwelsstraße 30, 52057, Aachen, Germany

    U. Meincke MD, D. Mörth, T. Voß, B. Thelen & E. Gouzoulis–Mayfrank

  2. Dept. of Psychiatry, University of California, San Diego, La Jolla (CA), USA

    M. A. Geyer

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  1. U. Meincke MD
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  2. D. Mörth
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  3. T. Voß
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  5. M. A. Geyer
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  6. E. Gouzoulis–Mayfrank
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Correspondence to U. Meincke MD.

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Meincke, U., Mörth, D., Voß, T. et al. Prepulse inhibition of the acoustically evoked startle reflex in patients with an acute schizophrenic psychosis—A longitudinal study. Eur Arch Psychiatry Clin Neurosci 254, 415–421 (2004). https://doi.org/10.1007/s00406-004-0523-0

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  • DOI: https://doi.org/10.1007/s00406-004-0523-0

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