Antisaccade error rates in first-episode psychosis, ultra-high risk for psychosis and unaffected relatives of schizophrenia: A systematic review and meta-analysis

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Authors
Ekin, Merve
Akdal, Gülden
Bora, Emre
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Date
2024-02-16
Publisher
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Schizophrenia Research
Issue
Volume
266
Pages
Pages
41-49
ISSN
0920-9964
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2025-03-26
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Background Antisaccade, which is described as looking at the opposite location of the target, is an eye movements paradigm used for assessing cognitive functions in schizophrenia. Initiation and sustainment of saccades in antisaccade are managed by frontal and parietal cortical areas. Antisaccade abnormalities are well-established findings in schizophrenia. However, studies in the early phases of psychotic disorders and clinical/familial risk for psychosis reported inconsistent findings. The current systematic review aimed to review the results of studies investigating antisaccade error rates in first-episode psychosis (FEP), individuals with ultra-high-risk for psychosis (UHRsingle bondP), and familial-high-risk for psychosis (FHRsingle bondP) compared to healthy controls. Method A meta-analysis of 17 studies was conducted to quantitatively review antisaccade errors in FEP, UHR-P and FHRsingle bondP. The error rate (Hedges'g) was compared between the total of 860 FEP, UHRsingle bondP, FHRsingle bondP, and 817 healthy controls. Hedges' g for effect size, I2 for estimating the percentage of variability, and publication bias were evaluated through the R software. Results The outcomes of this meta-analysis suggested that FEP is associated with a robust deficit in the antisaccade error rate (g = 1.16, CI = 0.95–1.38). Additionally, both the clinical and familial high-risk groups showed small but significant increases in AS errors (g = 0.26, CI = 0.02–0.52 and g = 0.34, CI = 0.13–0.55, respectively). Conclusion The large effect size estimated for FEP was compatible with previously reported results in chronic schizophrenia patients. Additionally, relatives had abnormalities with small to medium effect sizes and significant differences. The current findings suggest that antisaccade errors might be a potential endophenotype for psychotic disorders.
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