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Auditory brainstem response (ABR) profiling tests as diagnostic support for schizophrenia and adult attention-deficit hyperactivity disorder (ADHD)

Published online by Cambridge University Press:  14 August 2017

Eva Juselius Baghdassarian Open the ORCID record for Eva Juselius Baghdassarian [Opens in a new window] ,
Maria Nilsson Markhed ,
Eva Lindström ,
Björn M Nilsson  and
Tommy Lewander
Eva Juselius Baghdassarian*
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
Maria Nilsson Markhed
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
Eva Lindström
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
Björn M Nilsson
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
Tommy Lewander
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
*
Eva Juselius Baghdassarian, Department of Neuroscience, Psychiatry, Uppsala University Hospital, Akademiska sjukhuset, 751 85 Uppsala, Sweden. Tel: +46 739891814; E-mail: eva.baghdassarian@neuro.uu.se
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Abstract

Objective

To evaluate the performances of two auditory brainstem response (ABR) profiling tests as potential biomarkers and diagnostic support for schizophrenia and adult attention-deficit hyperactivity disorder (ADHD), respectively, in an investigator-initiated blinded study design.

Method

Male and female patients with schizophrenia (n=26) and adult ADHD (n=24) meeting Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) diagnostic criteria and healthy controls (n=58) comprised the analysis set (n=108) of the total number of study participants (n=119). Coded sets of randomized ABR recordings were analysed by an independent party blinded to clinical diagnoses before a joint code-breaking session.

Results

The ABR profiling test for schizophrenia identified schizophrenia patients versus controls with a sensitivity of 84.6% and a specificity of 93.1%. The ADHD test identified patients with adult ADHD versus controls with a sensitivity of 87.5% and a specificity of 91.4%.

Conclusion

The ABR profiling tests discriminated schizophrenia and ADHD versus healthy controls with high sensitivity and specificity. The methods deserve to be further explored in larger clinical studies including a broad range of psychiatric disorders to determine their utility as potential diagnostic biomarkers.

Keywords

ADHDERPschizophreniapsychiatric disorders
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 30 , Issue 3 , June 2018 , pp. 137 - 147
Copyright
© Scandinavian College of Neuropsychopharmacology 2017 

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References

1. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 4th edn, Text Revision, DSM-IV-TR. Washington, DC: American Psychiatric Association, 1994.Google Scholar
2. Feldcamp, LA, Wong, AHC. Biomarkers in schizophrenia. In: Turck CW editor Biomarkers for Psychiatric Disorders. New York: Springer – Science and Business Media, LLC, 2008; pp. 23–54.Google Scholar
3. Insel, T, Cuthbert, B, Garvey, M et al. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 2010;167:748–751.Google Scholar
4. Kapur, S, Phillips, AG, Insel, TR. Why has it taken so long for biological psychiatry to develop clinical tests and what to do about it? Mol Psychiatry 2012;17:1174–1179.Google Scholar
5. Jeon, YW, Polich, J. Meta-analysis of P300 and schizophrenia: patients, paradigms, and practical implications. Psychophysiology 2003;40:684–701.Google Scholar
6. Luck, SJ, Mathalon, DH, O´Donnell, BF et al. A roadmap for the development and validation of event-related potential biomarkers in schizophrenia research. Biol Psychiatry 2011;70:28–34.Google Scholar
7. Näätänen, R, Shiga, T, Asano, S, Yabe, H. Mismatch negativity (MMN) deficiency: a break-through biomarker in predicting psychosis onset. Int J Psychophysiol 2015;95:338–344.Google Scholar
8. Snyder, SM, Rugino, TA, Hornig, M, Stein, MA. Integration of an EEG biomarker with a clinician’s ADHD evaluation. Brain Behav 2015;5:e00330.Google Scholar
9. Lis, S, Baer, N, Stein-En-Nosse, C, Gallhofer, B, Sammer, G, Kirsch, P. Objective measurement of motor activity during cognitive performance in adults with attention-deficit/hyperactivity disorder. Acta Psychiatr Scand 2010;122:285–294.Google Scholar
10. Bijlenga, D, Jasperse, M, Gelhaar, JJ, Kooiji, S. Objective QbTest and subjective evaluation of stimulant treatment in adult attention deficit-hyperactivity disorder. Eur Psychiatry 2015;30:179–185.Google Scholar
11. Kropotov, JD. Functional neuromarkers for psychiatry. Applications for diagnosis and treatment. London: Elsevier and Academic Press, 2016.Google Scholar
12. Jewett, DL, Williston, JS. Auditory-evoked far fields averaged from the scalp of humans. Brain 1971;94:681–696.Google Scholar
13. Burkard, R, Don, M, Eggermont, JJ. Auditory evoked potentials. Basic principles and clinical application. Philadelphia: Lippincott Williams & Wilkins, 2006.Google Scholar
14. Hall, JW III. New handbook of auditory evoked responses. Boston: Pearson Education Inc., 2007.Google Scholar
15. Legatt, AD. Electrophysiologic auditory tests. Handb Clin Neurol 2015;129:289–311.Google Scholar
16. Hosford-Dunn, H. Auditory brainstem response audiometry. Applications in central disorders. Otolaryngol Clin North Am 1985;18:257–284.Google Scholar
17. Musiek, FE, Baran, JA. The auditory system: anatomy, physiology, and clinical correlates. Boston: Pearson Education Inc, 2007.Google Scholar
18. Beattie, RC. Interaction of click polarity, stimulus level, and repetition rate on the auditory brainstem response. Scand Audiol 1988;17:99–109.Google Scholar
19. Hayashida, Y, Mitani, H, Hosomi, H, Amemiya, M, Mifune, K, Tomita, S. Auditory brain stem responses in relation to the clinical symptoms of schizophrenia. Biol Psychiatry 1986;21:177–188.Google Scholar
20. Lindström, L, Klockhoff, I, Svedberg, A, Bergstrom, K. Abnormal auditory brain-stem responses in hallucinating schizophrenic patients. Br J Psychiatry 1987;151:9–14.Google Scholar
21. Lindström, L, Wieselgren, IM, Klockhoff, I, Svedberg, A. Relationship between abnormal brainstem auditory-evoked potentials and subnormal CSF levels of HVA and 5-HIAA in first-episode schizophrenic patients. Biol Psychiatry 1990;28:435–442.Google Scholar
22. Igata, M, Ohta, M, Hayashida, Y, Abe, K. Missing peaks in auditory brainstem responses and negative symptoms in schizophrenia. Jpn J Psychiatry Neurol 1994;48:571–578.Google Scholar
23. Harell, M, Englender, M, Demer, M, Kimhi, R, Zohar, M. Auditory brain stem responses in schizophrenic patients. Laryngoscope 1986;96:908–910.Google Scholar
24. Kimhi, R, Englender, M, Zohar, M, Harell, H. Brainstem auditory evoked responses in hospitalized unmedicated schizophrenic patients. Isr J Psychiatry Relat Sci 1987;24:289–294.Google Scholar
25. Källstrand, J, Montnemery, P, Nielzén, S, Olsson, O. Auditory masking experiments in schizophrenia. Psychiatry Res 2002;113:115–125.Google Scholar
26. Källstrand, J, Olsson, O, Nehlstedt, SF, Sköld, ML, Nielzén, S. Abnormal auditory forward masking pattern in the brainstem response of individuals with Asperger syndrome. Neuropsychiatr Dis Treat 2010;6:289–296.Google Scholar
27. Veuillet, E, Georgieff, N, Philibert, B, Dalery, J, Marie-Cardine, M, Collet, L. Abnormal peripheral auditory asymmetry in schizophrenia. J Neurol Neurosurg Psychiatry 2001;70:88–94.Google Scholar
28. Källstrand, J, Nehlstedt, SF, Sköld, ML, Nielzén, S. Lateral asymmetry and reduced forward masking effect in early brainstem auditory evoked responses in schizophrenia. Psychiatry Res 2012;196:188–193.Google Scholar
29. Pfefferbaum, A, Horvath, TB, Roth, WT, Tinklenberg, JR, Kopell, BS. Auditory brain stem and cortical evoked potentials in schizophrenia. Biol Psychiatry 1980;15:209–223.Google Scholar
30. Brecher, M, Begleiter, H. Brain stem auditory evoked potentials in unmedicated schizophrenic patients. Biol Psychiatry 1985;20:199–202.Google Scholar
31. Igata, M., Ohta, M, Hayashida, Y, Abe, K. Normalization of auditory brainstem responses resulting from improved clinical symptoms in schizophrenia. Schizophr Res 1995;16:81–82.Google Scholar
32. Lahat, E, Avital, E, Barr, J, Berkovitch, M, Arlazoroff, A, Aladjem, M. BAEP studies in children with attention deficit disorder. Dev Med Child Neurol 1995;37:119–123.Google Scholar
33. Puente, A, Ysunza, A, Pamplona, M, Silva-Rojas, A, Lara, C. Short latency and long latency auditory evoked responses in children with attention deficit disorder. Int J Pediatr Otorhinolaryngol 2002;62:45–51.Google Scholar
34. Källstrand, J, Lewander, T, Baghdassarian, E, Nielzén, S. A new method for analyzing auditory brain-stem response waveforms using a moving-minimum subtraction procedure of digitized analogue recordings. Neuropsychiatr Dis Treat 2014;10:1011–1016.Google Scholar
35. Claesdotter-Hybbinette, E, Safdarzadeh-Haghighi, M, Råstam, M, Lindvall, M. Abnormal brainstem auditory response in young females with ADHD. Psychiatry Res 2015;229:750–754.Google Scholar
36. Schochat, E, Scheuer, CI, Andrade, ER. ABR and auditory P300 findings in children with ADHD. Arq Neuropsiquiatr 2002;60:742–747.Google Scholar
37. Vaney, N, Anjana, Y, Khaliq, F. No auditory conduction abnormality in children with attention deficit hyperactivity disorder. Funct Neurol 2011;26:159–163.Google Scholar
38. Barry, RJ, Johnstone, SJ, Clarke, AR. A review of electrophysiology in attention-deficit/hyperactivity disorder: II. Event-related potentials. Clin Neurophysiol 2003;114:184–198.Google Scholar
39. Johnstone, SJ, Barry, RJ, Clarke, AR. Ten years on: a follow-up review of ERP research in attention-deficit/hyperactivity disorder. Clin Neurophysiol 2013;124:644–657.Google Scholar
40. Källstrand, J, Nielzén, S. Identification of brainstem biomarkers supporting clinical diagnoses of ADHD and schizophrenia using non-invasive ABR technique. EC Neurol 2016;3:294–304.Google Scholar
41. Sköld, M, Källstrand, J, Nehlstedt, S et al. Thalamocortical abnormalities in auditory brainstem response patterns distinguish DSM-IV bipolar disorder type I from schizophrenia. J Affect Disord 2014;169:105–111.Google Scholar
42. Pedersen, G, Hagtvet, KA, Karterud, S. Generalizability studies of the Global Assessment of Functions-split version. Compr Psychiatry 2007;48:88–94.Google Scholar
43. Pedersen, G, Karterud, S. The symptom and function dimensions of the Global Assessment of Functioning (GAF) scale. Compr psychiatry 2012;53:292–298.Google Scholar
44. Guy, W. ECDEU assessment manual for psychopharmacology. Rockville, MD: US Department of Health, Education and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, 1976.Google Scholar
45. Saunders, JB, Aasland, OG, Babor, TF, De La Fuente, JR, Grant, M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction 1993;88:791–804.Google Scholar
46. Babor, T, Higgins-Biddle, JC, Saunders, JB, Monteiro, MG. Audit. The alcohol disorders identification test. Guidelines for use in primary care, 2nd edn. Geneva: WHO, 2001.Google Scholar
47. Herlofson, J. Handbook. SCID-I och SCID-II för DSM-IV. Kristianstad: Pilgrim Press, 1999.Google Scholar
48. First, MBB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured clinical interview for DSM-IV axis i disorders, clinician version (SCID-CV). Washington, DC: American Psychiatric Press Inc., 1996.Google Scholar
49. Klein, DN, Crosby Quimette, P, Kelly, HS, Ferro, T, Riso, LP. Test-retest reliability of team consensus best-estimate diagnoses of axis I and II disorders in a family study. Am J Psychiatry 1994;151:1043–1047.Google Scholar
50. Kessler, RC, Adler, L, Ames, M et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005;35:245–256.Google Scholar
51. Adler, LA, Spencer, T, Faraone, SV et al. Validity of pilot Adult ADHD Self-Report Scale (ASRS) to rate adult ADHD symptoms. Ann Clin Psychiatry 2006;18:145–148.Google Scholar
52. Miller, TJ, Mcglashan, TH, Woods, SW et al. Symptom assessment in schizophrenic prodromal states. Psychiatric Q 1999;70:273–287.Google Scholar
53. Miller, TJ, Mcglashan, TH, Rosen, JL et al. Prospective diagnosis of the initial prodrome for schizophrenia based on the structured interview for prodromal syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry 2002;159:863–865.Google Scholar
54. Fawcett, T. An introduction to ROC analysis. Pattern Recognit Lett 2006;27:861–874.Google Scholar
55. Motulsky, H. Intuitive biostatistics. A nonmathematical guide to statistical thinking, 3rd edn. New York, Oxford: Oxford university Press, 2014.Google Scholar
56. Whiting, PF, Davenport, C, Jameson, C et al. How well do health professionals interpret diagnostic information? A systematic review. BMJ Open 2015;5:e008155.Google Scholar
57. Woods, SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 2003;64:663–667.Google Scholar
58. Woods, SW. Chlorpromazine equivalent doses for atypical antipsychotics: an update 2003-2010. Accessed May 15, 2017. Available at http://scottwilliamwoods.com/eequivalencesupdate.php.Google Scholar
59. Spitzer, RL. Psychiatric diagnosis: are clinicians still necessary? Compr Psychiatry 1983;24:399–411.Google Scholar
60. Luck, SJ, Kappenman, ES eds. The Oxford handbook of event-related potential components. Oxford: Oxford University Press, 2012.Google Scholar
61. Light, GA, Näätänen, R. Mismatch negativity is a breakthrough biomarker for understanding and treating psychotic disorders. Proc Natl Acad Sci USA 2013;110:15175–15176.Google Scholar
62. Beedie, SA, Benson, PJ, Giegling, I, Rujescu, D, St Clair, DM. Smooth pursuit and visual scan paths: independence of two candidate oculomotor risk markers for schizophrenia. World J Biol Psychiatry 2012;13:200–210.Google Scholar
63. Sackett, DL, Haynes, RB. The architecture of diagnosis research. BMJ 2002;324:539–541.Google Scholar
64. Micheel, CM, Ball, JR eds. Evaluation of biomarkers and surrogate endpoints in chronic disease. Washington, DC: Institute of Medicine, The National Academic Press, 2010.Google Scholar
65. Perlis, RH. Translating biomarkers to clinical practice. Mol Psychiatry 2011;16:1076–1087.Google Scholar
66. Nielzén, S, Holmberg, J, Sköld, M, Nehlstedt, S. Brain stem audiometry may supply markers for diagnostic and therapeutic control in psychiatry. Neurosci Lett 2016;632:163–168.Google Scholar