Intraindividual Variability of Event-Related Potentials in Psychosis: A Registered Report

Neurophysiological tools have yielded valuable insights into the pathophysiology and treatment of psychosis. However, studies using event-related potentials (ERPs) have primarily focused on mean scores and neglected the within-person variability of ERP scores. The neglect of within-person variability of ERPs in the search for biomarkers might have resulted in crucial differences related to psychosis being missed. In this registered report, we aimed to determine whether distinct patterns of intraindividual variability in ERP biomarkers would be observed in people with a lifetime psychosis diagnosis.

Publicly available data posted to the National Institute of Mental Health Data Archive for 1R01MH110434-01 was obtained for 162 patients with a lifetime history of psychosis and 178 never-psychotic (NP) participants. Participants completed tasks that measured the auditory mismatch negativity (MMN), P300, error-related negativity, and reward positivity. Multilevel location-scale models were used to determine whether patients showed greater intraindividual variability of ERP scores than NP participants.

Contrary to predictions, the groups did not differ in within-person variability of MMN frequency, P300, or error-related negativity; patients showed less variability in MMN duration than NP participants. Exploratory analyses of a subset of patients with schizophrenia showed greater variability of MMN in this group than in the NP group. Greater severity of thought disorder and activation symptoms were associated with higher intraindividual MMN variability.

Distinct patterns of intraindividual variability in the measured ERPs were not observed for the broad group of people with lifetime psychotic disorders. Exploratory analyses suggest that intraindividual differences in ERPs are more relevant to schizophrenia and certain symptom dimensions than to psychotic disorders broadly, but research is needed to confirm these exploratory findings.