Impaired Frontal Midline Theta During Periods of High Reaction Time Variability in Schizophrenia

Background: Impairment in cognitive control is one of the most significant cognitive deficits in schizophrenia. Although it has generally been associated with altered engagement of lateral and medial prefrontal cortices, how attention fluctuations affect this engagement is still not known. In this context, we explored sustained (or proactive) and transient (or reactive) control engagement by investigating frontal theta-band oscillations during periods of low- and high-performance instability, assumed to represent intraindividual attentional fluctuations.

Methods: A total of 25 patients with schizophrenia (16 males) and 25 healthy matched control subjects (18 males) performed a long-sustained Go/NoGo task coupled with electroencephalographic recording. Proactive control was explored through frontal lateral theta during trial-by-trial conflict (Go N-1/Go N+1), whereas reactive control was explored through frontal midline theta and the N2 component during current-trial conflict (Go/NoGo). Variance in the time course of reaction time (RT) was computed to identify periods of low and high RT variability in each subject.

Results: Patients with schizophrenia exhibited no frontal lateral theta activity regardless of the RT variability periods, whereas in control subjects, this activity was preserved only during periods of low RT variability (less error prone). During these periods, patients exhibited preserved midline frontal theta activity and N2. However, during high RT variability periods (more error prone), the midline theta activity was impaired in patients but preserved in control subjects.

Conclusions: Our results reveal that the efficient engagement of reactive control in patients with schizophrenia and of proactive control in control subjects was state dependent. The findings highlight the importance of accounting for attentional fluctuations when investigating cognitive control impairment in schizophrenia.