Clément Dondé 1,2,3

  1. INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France
  2. University Lyon 1, Villeurbanne, F-69000, France
  3. Centre Hospitalier Le Vinatier, Bron, France

Schizophrenia is a longstanding mental health problem with a varied clinical picture; in other words, no two individuals’ experiences will look the same. To date, no measures are available that help us to identify or separate different ‘types’ of schizophrenia with different underlying biology. Over recent years, there has been more recognition that schizophrenia is widely associated with problems in early auditory processing, which can be demonstrated using clinically applicable tasks such as tone-matching task.

Our study combined tone-matching task performances across 310 schizophrenia individuals and 219 healthy controls, along with clinical, cognitive and braing imaging using resting-state functional-connectivity (RSFC) magnetic resonance imaging (MRI) measures. 

We provide the first demonstration that the early auditory processing deficits are distributed across twodistinct groups in patients with schizophrenia (p<0.0001 vs. Unimodal distribution), with one group showing entirely unimpaired tone-matching task performance (schizophrenia-early auditory processing+), and a second showing an extremely large tone-matching task impairment (schizophrenia-early auditory processing-), relative to both controls (d=2.1) and schizophrenia-early auditory processing+ patients (d=3.4). The schizophrenia-early auditory processing- group were common among samples drawn from inpatient sites, showed higher levels of cognitive symptoms, worse social cognition and a deficit in neurocognition, and reduced functional capacity. 

Brain imaging (RSFC MRI) analyses showed significant reduction in schizophrenia-early auditory processing- relative to controls between subcortical and cortical auditory regions. These results indicate that early auditory processing measure can differentiate between schizophrenia subgroups. As the tone-matching task can be readily implemented within routine clinical settings, its use may be critical to account for the varied clinical outcomes currently seen across schizophrenia patients, as well as for pre-clinical detection and appropriate treatment selection.