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The functional neuroanatomy of schizophrenic subsyndromes

Published online by Cambridge University Press:  31 July 2003

G. D. HONEY
Affiliation:
University of Cambridge, Department of Psychiatry, Brain Mapping Unit, Addenbrooke's Hospital, Cambridge; Section of Cognitive Psychopharmacology, Department of Computing and Biostatistics, Department of Clinical Neurosciences, Institute of Psychiatry, King's College, University of London
T. SHARMA
Affiliation:
University of Cambridge, Department of Psychiatry, Brain Mapping Unit, Addenbrooke's Hospital, Cambridge; Section of Cognitive Psychopharmacology, Department of Computing and Biostatistics, Department of Clinical Neurosciences, Institute of Psychiatry, King's College, University of London
J. SUCKLING
Affiliation:
University of Cambridge, Department of Psychiatry, Brain Mapping Unit, Addenbrooke's Hospital, Cambridge; Section of Cognitive Psychopharmacology, Department of Computing and Biostatistics, Department of Clinical Neurosciences, Institute of Psychiatry, King's College, University of London
V. GIAMPIETRO
Affiliation:
University of Cambridge, Department of Psychiatry, Brain Mapping Unit, Addenbrooke's Hospital, Cambridge; Section of Cognitive Psychopharmacology, Department of Computing and Biostatistics, Department of Clinical Neurosciences, Institute of Psychiatry, King's College, University of London
W. SONI
Affiliation:
University of Cambridge, Department of Psychiatry, Brain Mapping Unit, Addenbrooke's Hospital, Cambridge; Section of Cognitive Psychopharmacology, Department of Computing and Biostatistics, Department of Clinical Neurosciences, Institute of Psychiatry, King's College, University of London
S. C. R. WILLIAMS
Affiliation:
University of Cambridge, Department of Psychiatry, Brain Mapping Unit, Addenbrooke's Hospital, Cambridge; Section of Cognitive Psychopharmacology, Department of Computing and Biostatistics, Department of Clinical Neurosciences, Institute of Psychiatry, King's College, University of London
E. T. BULLMORE
Affiliation:
University of Cambridge, Department of Psychiatry, Brain Mapping Unit, Addenbrooke's Hospital, Cambridge; Section of Cognitive Psychopharmacology, Department of Computing and Biostatistics, Department of Clinical Neurosciences, Institute of Psychiatry, King's College, University of London

Abstract

Background. There is considerable variability between patients in their expression of the diverse range of symptoms encompassed by the syndrome of schizophrenia, which may modulate functional activation to cognitive processing.

Method. Here we investigate associations between schizophrenic subsyndrome scores, identified by factor analysis, and experimentally controlled brain activation. Five factors were defined by rotated principal components analysis of PANSS rating scale measurements in 100 patients with schizophrenia. A subsample of 30 patients and a group of 27 comparison subjects were studied using functional magnetic resonance imaging (fMRI) during the performance of two periodically designed cognitive activation experiments: verbal working memory and psychomotor sequencing.

Results. Factor analysis replicated the five dimensions consistently reported. Within the patient group, power of activation by working memory was negatively associated with global symptom severity in left lingual and temporo-parietal cortices; negatively associated with positive subsyndrome scores in left inferior frontal and superior temporal cortices and basal ganglia; and positively associated with negative subsyndrome scores in lateral and medial premotor cortex. No relationship was observed between subsyndrome scores and functional activation during the motor task. Between-group comparisons demonstrated reduced power of response to the working memory task by patients in bilateral dorsolateral prefrontal and left pre- and post-central cortices.

Conclusions. In this study we observed task-specific modulation of functional response associated with symptom expression in schizophrenia. Our findings are compatible with previous empirical findings and theoretical conceptualization of human brain function, in terms of capacity constraints on activation in the face of competing demands from pathological and task-related cognitive activity.

Type
Research Article
Copyright
© 2003 Cambridge University Press

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