College of Psychiatric and Neurologic Pharmacists

In this issue of Biological Psychiatry, Atkinson et al. () describe alterations in early preattentive brain electrical activity in individuals meeting criteria for ultrahigh risk (UHR) for the development of psychosis. Identifying biological markers in high-risk populations is a critical step toward informing about the pathophysiology of the disorder, predicting onset of psychosis, and potentially devising early interventions to change the course of the illness. The auditory mismatch negativity (MMN) described by Atkinson et al. is an electrical brain response that is elicited by any discriminable change in the regularity of the acoustical auditory environment. It is hypothesized to represent the initial processing step in a biologically important series of cognitive and brain events involved in alerting and redirecting the organism's attention toward novel, potentially significant, auditory stimuli in the environment. The MMN may be followed by a positive component, the P3a, which is associated with the involuntary switching of attention to salient information in the environment. Although MMN is generally considered automatic and thereby independent of primary task, some have studies have demonstrated that the complexity of a primary task can modulate the amplitude of the MMN ().

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