Theta phase synchrony is sensitive to corollary discharge abnormalities in early illness schizophrenia but not in the clinical high-risk syndrome

Background: Across the animal kingdom, responses in auditory cortex are dampened during vocalizing compared to passive listening, reflecting the action of the corollary discharge mechanism. In humans, it is seen as suppression of the EEG-based N1 event-related potential, with less N1-suppression seen in people with schizophrenia and those at clinical high risk (CHR) for psychosis. Because N1 is an admixture of theta (4-7Hz) power and phase synchrony, we asked which is responsible for N1 effects and if they outperform the sensitivity of N1 to corollary discharge and schizophrenia. Methods: Theta phase and power values were extracted from EEG data acquired from CHR youth (n=71), early illness schizophrenia patients (ESZ; n=84), and healthy controls (HC; n=103) as they said /ah/ (Talk) and then listened to the sounds played back (Listen). A principal components analysis extracted theta inter-trial coherence (ITC; phase consistency) and event related spectral power, peaking in the N1 latency range. Results: Theta ITC-suppression (Cohen d=1.46) was greater than N1-suppression in HC (Cohen d=.63). Both were both reduced in ESZ, but only N1-suppression was reduced in CHR. When deprived of the variance shared with theta-ITC suppression, N1-suppression was no longer sensitive to HC vs. ESZ or HC vs. CHR group differences. Deficits in theta ITC-suppression were correlated with delusions (p=.007) in ESZ. Suppression of theta power was not affected by Group. Conclusions: Theta ITC-suppression may provide a simpler assay of the corollary discharge mechanism than N1-suppression. Deficits in circuits that generate low frequency oscillations may be an important component of schizophrenia.