Correlation of frontal lobe electroencephalogram asymmetry and cognitive prognosis in schizophrenia

BACKGROUND Schizophrenia is a debilitating psychiatric disorder marked by cognitive impairments that affect functional outcomes. However, the neurobiological underpinnings of these deficits, particularly in relation to frontal lobe electroencephalography (EEG) asymmetry, remain insufficiently understood. This study aims to examine the association between frontal lobe EEG asymmetry and cognitive prognosis in individuals with schizophrenia. AIM To explore the association between frontal lobe EEG asymmetry and cognitive prognosis in patients with schizophrenia. METHODS This retrospective study analyzed data from 104 patients with schizophrenia who received treatment between 2020 and 2023. The patients were divided into good (n = 52) and poor (n = 52) cognitive prognosis groups based on post-treatment scores on the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. Frontal EEG asymmetry was assessed under eyes-open and eyes-closed conditions, and frontoparietal network (FPN) connectivity was evaluated using resting-state functional magnetic resonance imaging. Statistical correlations between EEG asymmetry, FPN connectivity, and cognitive outcomes were explored. RESULTS Notable differences in EEG asymmetry were observed under eyes-open conditions. Patients in the good cognitive prognosis group demonstrated mean eyes-open frontal alpha asymmetry values of -0.09 at F4-F3 and -0.155 at F6-F5, whereas those in the poor prognosis group showed values of -0.10 and -0.183, respectively. These differences were significantly correlated with cognitive outcomes (P = 0.0482 and P = 0.0111, respectively). Furthermore, left and right FPN connectivity were negatively correlated with poor cognitive prognosis (P = 0.015 and P = 0.008, respectively). However, no significant difference in laterality index was observed. CONCLUSION The findings suggest that eyes-open frontal EEG asymmetry and FPN connectivity are associated with cognitive prognosis in individuals with schizophrenia.