Aim: Neurophysiological markers of schizophrenia may help identify individuals who are at an increased risk of developing psychosis. As an operational measure of sensorimotor gating, pre-pulse inhibition (PPI) deficit has been investigated in clinical highrisk (CHR) individuals. In this study, we performed a systematic review and metaanalysis of studies that investigated PPI in CHR individuals.Methods: Relevant studies published as of July 2019 were retrieved from the PubMed, Cochrane, Embase, PscyINFO, EBSCO and Chinese databases. PPI was evaluated by calculating the standard mean differences (SMDs) between CHR individuals and healthy controls (HC) in meta-analysis. Quality of studies was assessed using the Newcastle-Ottawa Scale. I 2 index was used to assess heterogeneity and Egger's test was used to assess publication bias.Results: Eight studies were found to be eligible. The meta-analysis included five studies with a combined study population of 184 CHR subjects and 161 HC. CHR individuals showed lower PPI levels compared to HC in 120 ms inter-stimulus interval or stimulus onset asynchrony paradigm (P = .491, SMD = −0.62). No significant heterogeneity was observed in 120 ms PPI paradigm (χ 2 = 3.41, P = .491, I 2 = 0.0%).
Conclusion:CHR individuals had lower PPI level compared to HC in 120 ms paradigm, which were relatively stable and significant. The results indicate the presence of information processing and inhibitory problems prior to the development of fullblown psychosis. PPI may be clinically used as an objective indicator to supplement the understanding of CHR individuals.
K E Y W O R D Sclinical high-risk for psychosis, healthy controls, meta-analysis, pre-pulse inhibition, systematic review
| INTRODUCTIONEarly detection and intervention for schizophrenia is an increasing area of interest in schizophrenia research. The concept of clinical highrisk (CHR) state, which was aimed to describe people with potential prodromal symptoms, has evolved to include the prepsychotic phase (Fusar-Poli et al., 2013). There are two broad sets of criteria to diagnose the CHR state: ultra-high risk (UHR) and basic symptom (BS) criteria (Olsen & Rosenbaum, 2006). The BS criteria can identify an earlier prodromal state whereas the UHR criteria tend to reflect a somewhat later