Cognitive impairments of attention, memory and executive functions are a fundamental feature of the pathophysiology of schizophrenia. The neurophysiological and neurochemical changes in the auditory cortex are shown to underlie cognitive impairmentsin schizophrenia patients. Functional state of the neural substrate of auditory information processing could be objectively and non-invasively probed with auditory event-related potentials (ERPs) and event- related fields (ERFs). In the current work, we explored the neurochemical effect on the neural origins of auditory information processing in relation to schizophrenia. By means of ERPs/ERFs we aimed to determine how neural substrates of auditory information processing are modulated by antipsychotic medication in schizophrenia spectrum patients (Studies I, II) and by neuropharmacological challenges in healthy human subjects (Studies III, IV).
First, with auditory ERPs we investigated the effects of olanzapine (Study I) and risperidone (Study II) in a group of patients with schizophrenia spectrum disorders. After 2 and 4 weeks of treatment, olanzapine has no significant effects on mismatch negativity(MMN) and P300, which, as it has been suggested, respectively reflect preattentive and attention-dependent information processing. After 2 weeks of treatment, risperidone has no significant effect on P300, however risperidone reduces P200 amplitude. This latter effect of risperidone on neural resources responsible for P200 generation could be partly explained through the action of dopamine.
Subsequently, we used simultaneous EEG/MEG to investigate the effects of memantine (Study III) and methylphenidate (Study IV) in healthy subjects. We found that memantine modulates MMN response without changing other ERP components. This could be interpreted as being due to the possible influence of memantine through the NMDA receptors on auditory change- detection mechanism, with processing of auditory stimuli remaining otherwise unchanged. Further, we found that methylphenidate does not modulate the MMN response. This finding could indicate no association between catecholaminergic activities and electrophysiological measures of preattentive auditory discrimination processes reflected in the MMN. However, methylphenidate decreases the P200 amplitudes. This could be interpreted as a modulation of auditory information processing reflected in P200 by dopaminergic and noradrenergic systems.
Taken together, our set of studies indicates a complex pattern of neurochemical influences produced by the antipsychotic drugs in the neural substrate of auditory information processing in patients with schizophrenia spectrum disorders and by the pharmacological challenges in healthy subjects studied with ERPs and ERFs.Skitsofreniapotilailla on usein psykoottisten oireiden ohella kognitiivisia ongelmia esimerkiksi muistissa ja tarkkavaisuudessa, joihin vanhemmilla psykoosilääkkeillä ei ole vaikutusta. Viime vuosina on kehitetty uusia psykoosilääkkeitä, joiden on arveltu parantavan kognitiivisia oireita. Tässä työssä haluttiin selvittää uusien psykoosilääkkeiden vaikutuksia aivosähköisiin kognitiivisiin mittareihin elektroenkefalografia (EEG)-menetelmällä skitsofreniaspektrin potilailla. 4-viikon mittaisilla risperidoni- ja olantsapiinihoidoilla ei ollut vaikutusta mismatch negatiivisuus - eli MMN - ja P3-vasteisiin, jotka heijastavat tarkkaavaisuusprosessien eri vaiheita. Kuitenkin risperidoni pienensi P2-vastetta, mikä voi heijastaa muutosta potilaiden kognitiivisissa toiminnoissa. Yhdistetyllä MEG/EEG-menetelmällä tutkittiin terveillä koehenkilöillä metyylifenidaatin ja memantiinin vaikutuksia MMN-vasteeseen, jotta saataisiin selvyyttä tarkkaavaisuuden neurokemiallisesta säätelystä. Kerta-annos metyylifenitaaattia ei vaikuttanut MMN-vasteeseen, mutta se pienensi P2-vastetta. Kerta-annos memantiinia suurensi MMN-vastetta EEG:ssä, muttei magnetoenkefalografiassa. Kiihdyttävä glutamaattivälittäjäaine saattaa osallistua tarkkaavaisuuden säätelyyn etuaivokuorella. Risperidonilla, muttei olantsapiinillä oli vaikutuksia aivosähköisiin kognitiivisiin mittareihin lyhyen hoidon jälkeen, mikä voi välittyä dopamiinin kautta
