The Impact of Attention on Speech Entrainment in Clinical High-Risk for Psychosis Individuals

Language comprehension is disrupted in schizophrenia and early-stage psychosis, but the contributions of bottom-up and top-down processing remain unclear. In the current electroencephalography (EEG) study, we investigated speech entrainment in a sample of n=21 individuals at clinical high-risk for psychosis (CHR-P) and n=25 healthy controls (HCs). Continuous speech was presented through an audiobook in three listening conditions: (1) “Active”, in which participants attended to speech; (2) “Passive”, in which participants passively listened to the audiobook while performing a concurrent visual Flanker task; and (3) “Passive-reversed”, in which participants listened to an unintelligible time-reversed and noise-vocoded version of the audiobook while performing the Flanker task. Mutual Information (MI) analyses were used to assess shared information between the speech amplitude envelope and neural oscillations in the delta (0.25-3 Hz), theta (4.5-6.5 Hz), and alpha (7-10 Hz) frequency ranges. Sensor-level and source-level results indicate stronger delta entrainment in the Active vs. Passive conditions across groups. However, compared to controls, CHR-Ps showed reduced theta entrainment in auditory cortices, independent of condition, and decreased alpha entrainment in the Passive vs. Active condition. The findings point to theta entrainment deficits in CHR-Ps during continuous speech processing, indexing a bottom-up impairment. In contrast, delta and alpha entrainment in CHR-Ps were modulated by attention. Together, these findings highlight that both bottom-up and top-down impairments contribute to speech entrainment deficits in CHR-Ps.