Mismatch negativity as a marker for evaluating overall neurocognitive impairment following postconcussion syndrome

doi:10.5498/wjp.121207

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 121207
Published online Aug 19, 2026. doi: 10.5498/wjp.121207

Mismatch negativity as a marker for evaluating overall neurocognitive impairment following postconcussion syndrome

Jun-Jie Wang, Wen-Ye Wu, Kai-Jie Fang, Juan Yan, Fu-Gang Luo, Hao-Zhe Li

Jun-Jie Wang, Judicial Appraisal Institute, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China

Wen-Ye Wu, Kai-Jie Fang, Juan Yan, Quality Control Office, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China

Fu-Gang Luo, Intensive Care Unit, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China

Hao-Zhe Li, Shanghai Key Lab of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China

Co-corresponding authors: Fu-Gang Luo and Hao-Zhe Li.

Author contributions: Wang JJ and Li HZ performed conceptualization, methodology, review and editing of manuscript, and funding acquisition; Wang JJ, Wu WY, Fang KJ, and Luo FG did data curation; Wang JJ, Wu WY, Fang KJ, and Yan J did investigation; Wang JJ wrote the original draft; Luo FG and Li HZ contributed equally as co-corresponding authors. All authors approved the final version to publish.

AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.

Supported by Open Project of the Academy of Forensic Science, No. KF202115; National Key R&D Program of China, No. 2022YFC3302001; National Natural Science Foundation of China, No. 81801881; and Science and Technology Committee Shanghai Municipality, No. 20DZ1200300, No. 21DZ2270800, and No. 19DZ2292700.

Institutional review board statement: The studies involving humans were approved by the Ethics Committee of Hangzhou Seventh People’s Hospital, No. 2021-047.

Informed consent statement: The participants provided their written informed consent to participate in this study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Hao-Zhe Li, Shanghai Key Lab of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, No. 1347 Guangfuxi Road, Putuo District, Shanghai 200063, China. lihaozhe_kira@foxmail.com

Received: March 19, 2026
Revised: May 19, 2026
Accepted: June 26, 2026
Published online: August 19, 2026
Processing time: 121 Days and 4.4 Hours

Abstract

BACKGROUND

Mismatch negativity (MMN) is used to assess psychiatric and neurological disorders. Currently, methods for evaluating neurocognitive dysfunction following traumatic brain injury, particularly postconcussion syndrome (PCS), are limited.

AIM

To investigate the correlation between MMN and social function, personality changes, and daily living abilities in patients with PCS.

METHODS

Overall, 63 patients with PCS and 56 age- and sex-matched healthy controls were included. Intelligence quotient (IQ) was measured using the Chinese Revised Wechsler Adult Intelligence Scale. Social and daily living functions were assessed using the Social Disability Screening Schedule, functional activities questionnaire, and Activity of Daily Living Scale. Personality changes were evaluated using the post-traumatic brain injury personality change scale. MMN data were collected using the classical auditory oddball paradigm.

RESULTS

There were no significant differences in age and sex between the groups. Social dysfunction was significantly higher in the PCS than in the control group (P < 0.001). Daily living ability impairment scores were higher, and IQ levels were lower in patients in the PCS compared with control group; patients in the PCS group did not reach mild intellectual impairment. In the PCS group, negative amplitudes at Fz (r = 0.255, P_FDR = 0.048), F1 (r = 0.465, P_FDR = 0.003), and F2 (r = 0.281, P_FDR = 0.028) were significantly correlated with the degree of social dysfunction and personality change after controlling for age, IQ, and education level using partial correlation analysis.

CONCLUSION

MMN amplitude was significantly reduced in PCS; lower amplitudes were associated with more severe social function impairments and personality changes. MMN amplitude reduction may reflect neurocognitive dysfunction in PCS and could serve as a potential electrophysiological marker.

Keywords: Postconcussion syndrome; Mismatch negativity; Event-related potentials; Cognitive impairment; Traumatic brain injury

Core Tip: Postconcussion syndrome (PCS) can result in long-term cognitive impairment, impacting daily function and social interactions. Despite its prevalence, effective evaluation methods for PCS-related neurocognitive dysfunction remain limited. Patients with PCS experience social dysfunction and personality changes. Mismatch negativity amplitude in the prefrontal region correlates with social dysfunction and personality changes, with smaller amplitudes indicating more severe social dysfunction and personality changes. Mismatch negativity may therefore serve as a potential indicator for assessing the symptoms of PCS.