Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-18T08:41:24.737Z Has data issue: false hasContentIssue false
  • English
  • Français

Prefrontal cortex activity in people with schizophrenia and control subjects

Evidence from positron emission tomography for remission of ‘hypofrontality’ with recovery from acute schizophrenia

Published online by Cambridge University Press:  03 January 2018

Sean A. Spence ,
Steven R. Hirsch ,
David J. Brooks  and
Paul M. Grasby
Sean A. Spence*
Affiliation:
Imperial College School of Medicine, MRC Cyclotron Unit
Steven R. Hirsch
Affiliation:
Imperial College School of Medicine, Academic Department of Psychiatry, Charing Cross Hospital
David J. Brooks
Affiliation:
Imperial College School of Medicine, MRC Cyclotron Unit
Paul M. Grasby
Affiliation:
Imperial College School of Medicine, MRC Cyclotron Unit
*
Dr Sean Spence, Imperial College School of Medicine, MRC Cyclotron Unit, Hammersmith Hospital, Du Cane Road, London W12 ONN; e-mail: sean@wren.rpms.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Hypo-activation of the left dorsolateral prefrontal cortex is inconsistently found in neuroimaging studies of schizophrenia. As the left dorsolateral prefrontal cortex is involved in the generation of action, disordered function in this region may be implicated in schizophrenic symptomatology.

Method

We used H215O positron emission tomography to study dorsolateral prefrontal cortical function in men with schizophrenia (n=13) and male control subjects (n=6) performing joystick movements on two occasions, 4–6 weeks apart. The patients were initially in relapse. To clarify dorsolateral prefrontal cortical function we also scanned another group of control subjects (n=5) performing mouth movements.

Results

The control subjects performing hand or mouth movements activated the left dorsolateral prefrontal cortex to a maximum when the movements were self-selected. The men with relapsed schizophrenia exhibited left dorsolateral prefrontal cortical hypo-activation, which remitted with symptomatic improvement.

Conclusions

Hypofrontality in these patients is a dynamic phenomenon across time, possibly related to current symptomatology. The most appropriate question about the presence of hypofrontality in schizophrenia may be when, rather than whether, it will occur.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 4 , April 1998 , pp. 316 - 323
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

∗.

S.A.S. was one of the recipients of the Royal College of Psychiatrists Research Prize and Bronze Medal 1997 for an extended version of this paper.

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1983), The Scale for the Assessment of Negative Symptoms (SANS). Iowa, IA: University of Iowa.Google Scholar
Andreasen, N. C. (1984) The Scale for the Assessment of Positive Symptoms (SAPS). Iowa, IA: University of Iowa.Google Scholar
Bailey, D. L. Jones, T. Frfston, K. F. et al (1991) Physical validation of statistical parametric mapping. Journal of Cerebral Blood Flow and Metabolism, 11, S150.Google Scholar
Barnes, T. R. E. (1989) A rating scale for drug-induced akathisia. British Journal of Psychiatry, 154, 672–676.Google Scholar
Barnes, T. R. E. & Trauer, T. (1982) Reliability and validity of a tardive dyskinesia videotape rating technique. British Journal of Psychiatry, 140, 508–515.CrossRefGoogle ScholarPubMed
Dias, R. Robbins, T. W. & Roberts, A. C. (1996) Dissociation in prefrontal cortex of affective and attentional shifts. Nature, 380, 69–72.CrossRefGoogle ScholarPubMed
Dolan, R. J. Bench, C. J. Liddle, P. F. et al (1993) Dorsolateral prefrontal cortex dysfunction in the major psychoses: symptom or disease specificity? Journal of Neurology, Neurosurgery and Psychiatry, 56, 1290–1294.CrossRefGoogle ScholarPubMed
Friston, K. F. Holmes, A. P. Worsley, K. J. et al (1995) Statistical parametric maps in functional imaging: a general linear approach. Human Brain Mapping, 2, 189–210.Google Scholar
Frith, C. D. (1987) The positive and negative symptoms of schizophrenia reflect impairment in the perception and initiation of action. Psychological Medicine, 17, 631–648.CrossRefGoogle ScholarPubMed
Frith, C. D. Friston, K. F. Uddle, P. F. et al (1991) Willed action and the prefrontal cortex in man: a study with PET. Proceedings of the Royal Society of London Series B: Biological Sciences, 244, 241–246.Google Scholar
Goldman-Rakic, P. S. Bates, J. F. & Chafee, M. V. (1992) The prefrontal cortex and internally generated motor acts. Current Opinions in Neurobiology, 2, 830–835.Google Scholar
Goldman-Rakic, P. S. & Selemon, L. D. (1997) Functional and anatomical aspects of prefrontal pathology in schizophrenia. Schizophrenia Bulletin, 23, 437–458.Google Scholar
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology (revised edn). pp. 534–537. Washington. DC: Department of Health, Education and Welfare.Google Scholar
Krasucki, C. & McFarlana, F. (1986) Electrocardiograms, high-dose antipsychotic treatment and College guidelines. Psychiatric Bulletin, 20, 326–330.CrossRefGoogle Scholar
Musalek, M. Podrelu, I. Walter, H. et al (1989) Regional brain function in hallucinations: a study of regional cerebral blood flow with 99m-Tc-HMPAO-SPET in patients with auditory hallucinations, tactile hallucinations, and normal controls. Comprehensive Psychiatry, 30, 99–108.CrossRefGoogle ScholarPubMed
Sabri, O. Erkwoh, R. Schreckenberger, M. et al (1997) Correlation of positive symptoms exclusively to hyperperfusion or hypoperfusion of cerebral cortex in never-treated schizophrenics. Lancet, 349, 1735–1739.Google Scholar
Simpson, G. W. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side-effects. Acta Psychiatrica Scandinavica, 45 (suppl. 212), 11–19.CrossRefGoogle Scholar
Spence, S. A. Brooks, D. J. Hirsch, S. R. et al (1997) A PET study of voluntary movement in schizophrenic patients experiencing passivity phenomena (delusions of alien control). Brain, 120, 1997–2011.Google Scholar
Talairach, J. & Tournoux, P. (1988) A Co-Planar Stereotactic Atlas of a Human Brain. Stuttgart: Thieme Verlag.Google Scholar
Weinberger, D. R. & Berman, K. F. (1998) Prefrontal function in schizophrenia: confounds and controversies. Philosophical Transactions of the Royal Society of London Series B: Biological Sciences, 351, 1495–1503.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.