Neural correlates of impaired cognitive flexibility in schizophrenia: An ERP study using the cued task-switching paradigm

Background: Patients with schizophrenia (SCZ) have impaired cognitive flexibility; however, the neuroelectrophysiological mechanism underlying this impairment remains unclear. The cued task-switching paradigm (CTSP) is used to measure cognitive flexibility. The aim of this study is to investigate the neuroelectrophysiological mechanism of impaired cognitive flexibility in patients with schizophrenia using event-related potential (ERP) technology with CTSP. Methods: Our sample included 39 patients with schizophrenia and 46 healthy controls (HCs). All participants underwent ERP recording while performing the CTSP. Error rates (ERs), reaction times (RTs), and the switching costs of ERs and RTs were used for the analysis of behavioral data. Time-domain analysis was used for the analysis of ERP data. Results: Patients with schizophrenia had higher ERs and longer RTs. ERP data analysis revealed that compared with HCs, patients with schizophrenia exhibited greater P3 amplitudes and longer latencies, as well as smaller difference wave amplitudes, during CTSP. Conclusion: Patients with schizophrenia showed impaired cognitive flexibility and neural correlates of these impairments, as reflected by an abnormal ERP P3. These findings provide valuable insights into the understanding of the neural mechanisms underlying impaired cognitive flexibility and may guide targeted interventions in patients with schizophrenia.