The correlation between auditory mismatch negativity and symptoms in patients with schizophrenia: a systematic review and meta-analysis

Auditory mismatch negativity (MMN) is a neurophysiological response measured with electro- or magnetoencephalography (M/EEG). The response constitutes an event-related potential (ERP) component elicited by a deviant sound (e.g., frequency or duration deviant) in a sequence of standard sounds. MMN is commonly computed as a difference waveform obtained by subtracting standard from deviant ERPs and appears as a negative deflection approximately 100–250 ms after deviant sound onset. MMN amplitude has repeatedly been found to be reduced in patients with schizophrenia and represents a promising biomarker in neuropsychiatry. However, the correlation between auditory MMN and clinical symptoms remains overall inconsistent across studies. This study aims to further clarify the putative relationship between auditory MMN and clinical parameters in patients with schizophrenia and psychotic disorders through a systematic review and meta-analysis of correlation coefficients.

We systematically searched for studies reporting correlations between auditory MMN and clinical parameters, including positive and negative symptoms, functioning, and cognitive performance, in patients with schizophrenia in Embase, Scopus, and PubMed. Articles were screened based on titles and abstracts, followed by full-text screening to determine inclusion eligibility. Data extraction is currently ongoing and is being performed by two independent reviewers using a standardised template in a Covidence project designed for the purpose. Measures of correlation, including Spearman’s ρ, Pearson’s r, and regression coefficients, are being extracted from studies with quantitative data. Using a random-effects model with a restricted maximum likelihood (REML) approach, we are specifically calculating summary effect sizes via Fisher’s z-transformation for each clinical domain.

Currently, 3691 records have been identified in Embase (n = 1310), Scopus (n = 1299), and PubMed (n = 1082). Following removal of duplicates (n = 2265) and full-text screening, we have included 166 studies, of which 104 report quantitative data for the meta-analysis. Preliminary results reveal a small but statistically significant positive correlation between duration deviant MMN and both positive and negative symptoms, indicating that reduced MMN is associated with greater symptom severity. In contrast, frequency deviant MMN shows no significant correlation with either positive or negative symptoms. However, both duration and frequency deviant MMN show a negative correlation with cognitive performance, such that reduced MMN is associated with poorer cognitive performance across studies.

The poster will include updated data on the correlation between auditory MMN and clinical parameters, including positive and negative symptoms, general symptoms, overall symptom burden, functioning, and cognitive performance. Moreover, it will present results on the correlation between auditory MMN and specific cognitive subdomains, including, but not limited to, working memory, speed of processing, reasoning and problem solving, and social cognition. The final results will also include a systematic risk-of-bias assessment and investigation of small-study effects (i.e., publication bias and selective reporting) using funnel plots and Egger’s regression test.

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