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Schizophr Res. 2020 Jan 7. pii: S0920-9964(19)30567-5. doi: 10.1016/j.schres.2019.11.060. [Epub ahead of print]

Reduced sleep spindle density in adolescent patients with early-onset schizophrenia compared to major depressive disorder and healthy controls.

Author information

1
Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland. Electronic address: miriam.gerstenberg@puk.zh.ch.
2
Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.
3
Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
4
Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland.
5
Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland.
6
Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland.

Abstract

OBJECTIVES:

During adolescence schizophrenia and major depressive disorder (MDD) increasingly emerge. Overlapping symptomatology during first presentation challenges the diagnostic process. Reduced sleep spindle density (SSD) was suggested as a biomarker in adults, discerning patients with schizophrenia from patients with depression or healthy controls (HC). We aimed to compare SSD in early-onset schizophrenia (EOS), with MDD, and HC, and to analyse associations of SSD with symptomatology and neurocognitive measures.

METHODS:

Automatic sleep spindle detection was performed on all-night high-density EEG (128 electrodes) data of 12 EOS, 19 MDD, and 57 HC (age range 9.8-19), allowing an age- and sex-matching of 1:2 (patients vs. HC). Severity of current symptoms and neurocognitive variables were assessed in all patients.

RESULTS:

SSD was defined between 13.75 and 14.50 Hz as within this frequency range SSD differed between EOS vs. HC in bin by bin analyses (12-15 Hz). In EOS, SSD was lower over 27 centro-temporal electrodes compared to HC and over 9 central electrodes compared to MDD. Reduced SSD in EOS compared to MDD and HC was accompanied by a high variability of SSD in all adolescents. SSD did not differ between MDD and HC. In the pooled sample of patients, lower SSD was associated with more severe Positive and Negative Symptoms Scale total score, more impaired memory consolidation and processing speed.

CONCLUSION:

A high variability of SSD in all adolescents may reflect the evolving character of SSD. The association of reduced SSD with the symptom dimension of impaired cognition cuts across diagnostical entities.

KEYWORDS:

Adolescence; Cognitive disturbances; Depression; High-density EEG; Psychosis; Sleep spindles

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