Human and animal studies of schizophrenia-related gating deficits

Prepulse Inhibition (PPI) of the startle response and the P50 auditory-evoked potential suppression are used to assess impairments in the regulation of the neural substrates and to determine the clinical significance of inhibitory deficits in schizophrenia. The study of gating deficits in schizophrenia and in related animal model studies have already advanced our understanding of the neural substrates of information processing abnormalities in patients with schizophrenia. Individuals with schizotypal personality disorder as well as clinically unaffected family members of patients with schizophrenia show PPI and P50 suppression deficits. These "schizophrenic spectrum" populations are not grossly psychotic, nor are they receiving antipsychotic medications. Therefore, the gating deficits are presumed to reflect core (eg, intermediate phenotypic) schizophrenia-linked information processing abnormalities. Several studies have reported that gating deficits are associated with clinical ratings of psychiatric symptoms, thought disorder, and neuropsychologic deficits in patients with schizophrenia. In addition, recent human pharmacologic studies have indicated that gating deficits can be reversed by rationally-selected compounds. Animal model studies have generally shown convergence with the human studies and may lead to improved identification of efficacious new antipsychotic medications for patients with schizophrenia.

Sex differences in sensorimotor gating of the human startle reflex: all smoke?

RATIONALE

A recent report described sex differences in the effects of nicotine use and withdrawal on prepulse inhibition of acoustic startle (PPI), but no sex differences in PPI in non-smokers.

OBJECTIVE

To determine whether previously reported male>female acoustic PPI reflect sex differences in smoking effects on PPI, rather than simple sex differences in the regulation of PPI. A retrospective analyses of >600 carefully screened normals tested over the past 12 years was completed.

RESULTS

Male>female acoustic PPI was detected in analyses that included: 1) all subjects; or 2) self-declared non-smokers.

CONCLUSIONS

Sex differences in PPI cannot be accounted for by smoking history, because they are present across a large sample of non-smoking normal controls.

The nonlinear, complex sequential organization of behavior in schizophrenic patients: neurocognitive strategies and clinical correlations

BACKGROUND

Thought disorder is a hallmark of schizophrenia and can be inferred from disorganized behavior. Measures of the sequential organization of behavior are important because they reflect the cognitive processes of the selection and sequencing of behavioral elements, which generate observable and analyzable behavioral patterns. In this context, sequences of choices generated by schizophrenic patients in a two-choice guessing task fluctuate significantly, which reflects an "oscillating dysregulation" between highly predictable and highly unpredictable subsequences within a single test session. In this study, we aimed to clarify the significance of dysregulation by seeing whether demographic, clinical, neuropsychological, and psychological measures predict the degree of dysregulation observed on this two-choice task.

METHODS

Thirty schizophrenic patients repeatedly performed a LEFT or RIGHT key press that was followed by a stimulus, which occurred randomly on the left or right side of the computer screen. Thus, the stimulus location had nothing to do with the key press behavior. The range of key press sequence predictabilities as measured by the dynamical entropy was used to quantify the dysregulation of response sequences and reflects the range of fixity and randomness of the responses. A factor analysis was performed and step-wise multiple regression analyses were used to relate the factor scores to demographic, clinical, symptomatic, Wisconsin Card Sorting Test (WCST), and Rorschach variables.

RESULTS

The LEFT/RIGHT key press sequences were determined by three factors: 1) the degree of win-stay/lose-shift strategy; 2) the degree of contextual influence on the current choice; and 3) the degree of dysregulation on the choice task. Demographic and clinical variables did not predict any of the three response patterns on the choice task. In contrast, the WCST and Rorschach test predicted performance on various factors of choice task response patterns.

CONCLUSIONS

Schizophrenic patients employ several rules, i.e., "win-stay/lose-shift" and "decide according to the previous choice," that fluctuate significantly when generating sequences on this task, confirming that a basic behavioral dysregulation occurs in a single schizophrenic subject across a single test session. The organization or the "temporal architecture" of the behavioral sequences is not related to symptoms per se, but is related to deficits in executive functioning, problem solving, and perceptual organizational abilities.

Cross-species studies of sensorimotor gating of the startle reflex

Sensorimotor gating of the startle reflex can be assessed across species, using similar stimuli to elicit comparable response characteristics. As measured by prepulse inhibition (PPI), gating is reduced in patients with some neuropsychiatric disorders, and in rats after manipulations of limbic cortex, striatum, pallidum, or pontine tegmentum. This limbic "CSPP" circuitry can be studied in rats to reveal the neurochemical and neuroanatomical substrates regulating PPI at a high level of resolution. This detailed circuit information is used as a "blueprint" to identify substrates that may lead to PPI deficits in psychiatric-disordered humans. Some human disorders with identifiable, localized lesions in CSPP circuitry, for example, Huntington's disease, provide direct validation for this cross-species model. Studies have begun to assess the pharmacological homology of PPI across species, as an initial step towards translating detailed neural circuit information from rats to humans. These initial studies suggest the possibility that the effects of dopaminergic (DAergic) drugs on PPI (reducing PPI) may be homologous across species; nicotinic drugs may also produce similar effects on PPI across species (increasing PPI). By contrast, the effects of glutamatergic and serotonergic drugs may exhibit disparate effects on PPI across species. The use of DAergic agonists in human studies is complicated by their significant side effects, but new studies demonstrate that several "human friendly" direct DA agonists disrupt PPI in rats and are thus good candidates for further studies of the cross-species homology of the DAergic regulation of PPI. In this manner, PPI can be used to probe the sensitivity of DAergic systems, and perhaps other CSPP elements, across normal and neuropsychiatric-disordered populations.

Cognitive functions in schizotypal personality disorder

OBJECTIVE

Schizophrenia spectrum subjects have cognitive deficits in a variety of domains. Schizotypal personality disordered (SPD) subjects do not have many of the confounds seen in schizophrenic patients, but may have the same pattern of cognitive deficits in attention and executive functioning.

HYPOTHESIS

We hypothesized that SPD subjects would have impairments on measures of attention, abstract reasoning, cognitive inhibition, working memory and verbal recognition memory when compared to normal subjects, and that these deficits would be intermediate to those observed in schizophrenic patients.

METHOD

SPD subjects (N=20) were compared to age-, gender- and education-matched schizophrenic patients (N=20) and normal comparison subjects (N=20) on a battery of cognitive measures.

RESULTS

The data were analyzed using standard statistical methods, including effect sizes. Using a conservative alpha level of 0.01, schizophrenic patients had deficits on many of these measures compared to normal subjects. Although the SPD subjects did not significantly differ from normal comparison subjects at the p < 0.01 level, there were trends (p < 0.019-0.028) toward impairment on measures of working memory and general intellectual functioning. On further effect size analyses, SPD subjects performed intermediate to normals and schizophrenic patients on measures of attention, abstract reasoning, cognitive inhibition, verbal working memory, recognition memory, and general intellectual functioning, with moderate to large effect sizes separating groups.

CONCLUSIONS

These results suggest that SPD subjects have possible widespread cognitive deficits that are of lesser magnitude than those observed in schizophrenic patients.

Symptom correlates of prepulse inhibition deficits in male schizophrenic patients

OBJECTIVE

Information processing, inhibitory, and gating deficits in human and animal model studies of schizophrenia are demonstrated by using prepulse inhibition of the startle reflex. Prepulse inhibition deficits in schizophrenic patients correlate with core cognitive symptoms, such as thought disorder and distractibility, but their relationship to positive and negative symptoms of schizophrenia is less clear.

METHOD

Fifty-one male schizophrenic patients and 26 male normal comparison subjects were tested for prepulse inhibition of the eyeblink component of the startle reflex measured by electromyogram recording. Startling stimuli (118 dB) were presented alone (pulse only) or were preceded 60 msec by discrete prepulse stimuli of 2, 4, 8, or 16 dB above the background 70-dB noise level. In addition, patients were assessed for demographic variables, generalized symptoms (Brief Psychiatric Rating Scale), and positive and negative symptoms.

RESULTS

Schizophrenic and comparison groups differed significantly in the amount of prepulse inhibition produced by the 16-dB prepulse, with schizophrenic patients showing the expected deficient prepulse inhibition. Latency of the eyeblink response was generally slower for the schizophrenic patients, but the prepulse-induced latency facilitation for schizophrenic patients and comparison subjects did not differ significantly. The pattern of prepulse inhibition deficits in schizophrenic patients remained, with age and education controlled, in an analysis of covariance and subgroup matching. Deficient prepulse inhibition correlated with both positive and negative symptoms of schizophrenia.

CONCLUSIONS

Under these experimental conditions, schizophrenia-linked deficits in prepulse inhibition detected with a relatively strong prepulse are correlated with both positive and negative symptoms of schizophrenia. The level of correlation, while significant in this cohort, is not as robust as that in previous reports linking prepulse inhibition deficits with other measures, such as thought disorder. Future work should probably focus on the relationship of prepulse inhibition deficits to measures such as thought disorder rather than positive and negative symptoms.

Is there a critical developmental 'window' for isolation rearing-induced changes in prepulse inhibition of the acoustic startle response?

In a previous study, rats reared in isolation from weaning exhibited normal prepulse inhibition (PPI) before puberty, whilst after puberty (6-8 weeks post weaning) isolation reared rats exhibited deficits in PPI. The developmental timing of the onset of this isolation effect appears to be critical because similar isolation of adult rats has no effect on PPI. The present study examined the time and duration of the period or 'window' of isolation necessary to induce these behavioral changes. Male Sprague-Dawley rats were isolated for either only the first 2 weeks from weaning, only the first 4 weeks from weaning, only weeks 3 and 4, or continuously from weaning (ISO group), and compared with rats reared in normal social conditions (SOC group). Eight weeks after weaning, we compared acoustic and airpuff startle reactivity, acoustic and light PPI, and acoustic and airpuff startle habituation across the groups. There were no significant changes in any of the measures in the groups exposed to 2- or 4-week periods of isolation. In the ISO and SOC groups, acoustic or airpuff startle reactivity was similar, while acoustic PPI was reduced significantly in the ISO group. Airpuff startle habituation was increased significantly in the ISO group compared to SOC controls and there was a similar trend with acoustic startle habituation. These results indicate that only animals isolated for more than 4 weeks after weaning display deficits in PPI, and provide evidence that there is no critical pre-pubertal developmental window for inducing PPI deficits, rather, continuous post-weaning isolation is needed to induce the PPI deficit effect.

Sensorimotor gating and thought disturbance measured in close temporal proximity in schizophrenic patients

BACKGROUND

Sensorimotor gating abnormalities have been previously correlated with thought disturbance in schizophrenic patients. These correlative studies have led to the hypothesis that sensorimotor gating abnormalities may underlie thought disturbance. Several authors have cautioned, however, that this and similar hypotheses are supported by data recorded at different times or during resting states" and therefore incorrectly assume that the observed association represents a concurrent relationship. To address this issue, sensorimotor gating and thought disturbance were measured in close temporal proximity, thus strengthening the evidence for the association of these 2 abnormalities in schizophrenic patients.

METHODS

Twenty-one schizophrenic men were assessed on measures of sensorimotor gating and thought disturbance. Sensorimotor gating was examined operationally via the use of prepulse inhibition. Thought disturbance was assessed via the Rorschach test measures of perceptual inaccuracy, disordered cognition, and the expression of normally repressed contents. Symptom rating scales (the Scale for the Assessment of Positive Symptoms and the alogia subscale of the Scale for the Assessment of Negative Symptoms) were also used.

RESULTS

Deficient prepulse inhibition correlated significantly with 2 of the 3 Rorschach-derived thought disturbance measures. Prepulse inhibition was not correlated significantly with symptom rating scales. The Rorschach measure of impaired perceptual accuracy independently accounted for 60% of the variance in prepulse inhibition measures and contributed 35% of the unique variance beyond the effect attributable to the Scale for the Assessment of Positive Symptoms.

CONCLUSIONS

Assessment of information processing and thought disturbance measures in close temporal proximity resulted in strong evidence that gating deficits correlate highly with measures of perceptual and reasoning disturbances. This relationship may form an important basis for the cognitive dysfunction observed among schizophrenic patients.

Prepulse inhibition and habituation of the startle response are stable neurobiological measures in a normal male population

Prepulse inhibition (PPI) and habituation of the startle response are operational measures of sensorimotor gating and information processing. Changes in the normal inhibition and habituation of the startle response may provide trait markers for illnesses such as schizophrenia that have altered neurotransmitter control of the neural circuitry that modulates these measures. The stability of PPI and habituation was assessed in 10 normal male subjects. Prepulse inhibition was found to be most stable in the more intense prepulse conditions, and habituation was most stable in the early portion of the test session. These data support the hypothesis that PPI and habituation are relatively stable neurobiological markers.

Long-range correlations in choice sequences of schizophrenic patients

Schizophrenic patients significantly greater than normals exhibit long-range correlations in sequences of choices in a simple binary choice task. Moreover, schizophrenic patients also are significantly less influenced by external stimuli than are normal comparison subjects. These effects are not significantly correlated with each other, suggesting that they do not result from a uniform attentional deficit nor are they due to simple perseverative responding or any other uniform process. The interdependence of responses over many trials suggests that the response history of many previous behavioral responses contributes significantly to the temporal architecture of schizophrenic patients. In agreement with others (Lyon et al., 1994), we find that similar organizational principles apply to physical, economical, or biological systems and seem to play an important role in human psychopathology.

Poor P50 suppression among schizophrenia patients and their first-degree biological relatives

OBJECTIVE

This study's goal was to replicate the finding that family members of schizophrenia patients show poor P50 suppression during a paired-click auditory evoked response paradigm.

METHOD

The paired-click paradigm was used to test 44 schizophrenia patients, 60 of their clinically unaffected first-degree relatives, and 45 normal subjects. Two clicks (83 dB[A] over a 60-dB[A] white noise background) separated by 500 msec were presented 60 times to all subjects. P50 responses to the first and second clicks were selected from the digitally filtered data by using standard methods and the Cz recording site.

RESULTS

The schizophrenia patients had smaller P50 responses to click 1 than either their relatives or the normal subjects; the patients and their relatives, who did not significantly differ, had larger P50 responses to click 2 than the normal subjects. Schizophrenia patients had worse P50 suppression than either their family members or the normal subjects; the patients' family members had worse P50 suppression than the normal subjects.

CONCLUSIONS

Family members of schizophrenia patients have worse P50 suppression than normal subjects. To the authors' knowledge, this is the first demonstration independent of the group associated with the University of Colorado that schizophrenia patients' family members have poor P50 suppression. This result is intrinsically important, perhaps especially because a recent report suggests genetic linkage of poor P50 suppression to the cholinergic receptor's alpha7 nicotinic subunit.

A multimethod approach to assessing perseverations in schizophrenia patients

Perseverations have been associated with frontal lobe impairment and are often observed among schizophrenia patients. We assessed perseverations in schizophrenia patients (N = 71) using the Wisconsin Card Sorting Test (WCST) and a new Rorschach perseveration scale which yields three perseveration scores. We also compared the results of the schizophrenia patients with those of a normal comparison group (N = 71). We found that schizophrenia patients demonstrated a high number of perseverations on both the WCST and the Rorschach perseveration scale when compared to the normal comparison subjects. Among schizophrenia patients, WCST perseverative responses were significantly correlated with Rorschach-derived stuck-in-set perseverations, WAIS-R Vocabulary scores and negative symptom ratings. No significant differences in any of the measures of perseveration were found to be associated with diagnostic subtype. Finally, WCST and Rorschach measures for the schizophrenia and normal comparison participants were entered into a logistic regression. The WCST total errors and the three Rorschach perseveration measures resulted in the correct classification of 89.4% of the total cases, with a sensitivity of 91%, specificity of 91% and positive predictive power of 87.8%. These data provide evidence that perseverative behavior is widely observed in schizophrenia patients using a variety of instruments. The authors discuss the benefit of using multiple measures of perseveration in schizophrenia research.

The "incredible shrinking" P50 event-related potential

The P50 component of the auditory evoked response has been utilized in studies of sensory gating in schizophrenia for over 15 years. As P50 gating studies have had a greater impact in neuroscience research, investigators have refined several key variables (e.g., filtering) to enhance signal-to-noise ratios. A comprehensive review of P50 reports suggests P50 amplitude has been steadily decreasing over the years. Certain methodological "advances" are suggested as key reasons for this apparent reduction in P50 amplitude. Gating studies continue to yield interesting findings in neuropsychiatric research, especially when ratio vs. absolute difference scores are used.

Reversal of isolation rearing-induced deficits in prepulse inhibition by Seroquel and olanzapine

BACKGROUND

Prepulse inhibition (PPI) of startle provides an operational measure of sensorimotor gating in which a weak stimulus presented prior to a startling stimulus reduces the startle response. PPI deficits observed in schizophrenia patients can be modeled in rats by individual housing from weaning until adulthood. Deficits in PPI produced by isolation rearing can be reversed by antipsychotics.

METHODS

We evaluated the ability of Seroquel and olanzapine to reverse the isolation-induced disruption of PPI. Rats housed for 8 weeks singly or in groups of 3 were tested every 2 weeks after either Seroquel (0, 5.0 mg/kg) or olanzapine (0, 2.5, 5.0 mg/kg). Startle was elicited by 120-dB pulses presented either with or without prepulses (3, 6, or 12 dB above a 65-dB background).

RESULTS

Isolation rearing repeatedly disrupted PPI and sometimes increased startle reactivity. Seroquel reversed these deficits without affecting PPI in socially reared controls. Olanzapine (2.5 mg/kg) reversed the isolation rearing-induced PPI deficit and tended to increase basal PPI levels. Both antipsychotics antagonized the isolation rearing-induced increase in startle reactivity.

CONCLUSIONS

Isolation rearing produces deficits in sensorimotor gating in rats that are reversible by atypical antipsychotics, and may therefore aid in identifying new treatments for schizophrenia.

Multiple site evaluation of P50 suppression among schizophrenia and normal comparison subjects

Normally, when two brief, non-startling auditory stimuli are presented 500 ms apart, with long (e.g., 10 s) interpair intervals, the positive potential occurring approx. 50 ms after the first stimulus (P50) is relatively large, and the P50 to the second stimulus is smaller. In schizophrenia patients, however, the P50 to the second stimulus is larger than normal. In this study, 36 schizophrenia and 36 normal comparison subjects were tested in a two-click paradigm. Data were recorded from six electrode locations (F3, Fz, F4, C3, Cz, C4). The results support the hypothesis that schizophrenia patients have poor P50 suppression that is not an artifact of differential P50 wave morphology or differences in the number of usable trials between groups. In addition, the vertex location alone (Cz) was equal to, if not better than, any combination of sites for differentiating between groups. These results support the use of the Cz site alone in most investigations of P50 suppression deficits among schizophrenia spectrum patients. Further work investigating the neuropathological correlates of poor P50 suppression among schizophrenia patients by recording from multiple electrode locations, however, could be helpful.

Transient versus sustained visual channels in the visual backward masking deficits of schizophrenia patients

BACKGROUND

Schizophrenia patients have information-processing deficits that can be quantified using visual backward masking. The visual information processing system is divided functionally and structurally into transient and sustained visual channels. When visual stimuli are presented to a subject, the transient pathway detects the presence and location of the stimulus while the sustained pathway is involved in fine discrimination and identification of the stimulus. While independent subcortically, the transient and sustained visual channels converge cortically into the dorsal and ventral processing streams that assess spatial relationships and object recognition respectively.

METHODS

To better understand the underlying mechanisms of the visual backward masking deficits, 16 schizophrenia patients and 17 comparison subjects were tested on two different visual backward masking paradigms that required either locating or identifying a target letter.

RESULTS

Schizophrenia patients had visual backward masking deficits in a task that involved locating a target letter while there were no deficits in the task that involved identification of a target letter.

CONCLUSIONS

The visual backward masking deficits of schizophrenia patients suggest impairment in the processing of spatial information. These deficits are discussed in the context of our current knowledge of visual information processing and the neuropathophysiology of schizophrenia.

Information processing deficits of schizophrenia patients: relationship to clinical ratings, gender and medication status

Information processing deficits were explored in a large cohort of schizophrenia patients (N = 125) and non-psychiatric subjects (N = 52). Gender, medication status and symptom factors were assessed relative to measures of performance in critical stimulus duration (CSD), visual backward masking (VBM) and auditory reaction time (RT) paradigms. Schizophrenia patients exhibited significant impairments in measures of CSD, VBM and both RT speed and RT set. Females in both groups had inflated CSDs relative to males. Female schizophrenia patients showed slower RTs and elevated RT set scores, but comparable VBM performance, when compared to males. This gender difference was not observed in the non-psychiatric subjects. To test the hypothesis that impaired performance in the VBM and RT paradigms would be related to negative symptoms and thought disorder, regression analyses were performed using factor scores derived from a factor analysis of SANS and SAPS items that generated three symptom factors: negative, disorganized, and reality distortion. Significant variance in performance on VBM and RT measures was accounted for only by the negative symptom factor. We conclude that VBM and RT assess information processing deficits in schizophrenia patients that are more related to the negative versus positive or disorganized symptoms of schizophrenia. It is possible that VBM and RT share overlapping or interacting neural substrates.

Neuroanatomy of schizophrenia

The articles that appear in this issue offer a framework of insights about the neuroanatomy of schizophrenia from three learned and creative perspectives. All three articles advance our understanding of schizophrenia from a single locus/specific "lesion" model to more advanced perspectives of neural circuit dysfunction models. Goldman-Rakic and Selemon review their own and others' work on structure-activity relationships of the frontal cortex and related working memory dysfunction. This important but sometimes cloudy and complex area is illuminated by their highly specific, informative research. Jones focuses on thalamic abnormalities hypothetically linked to abnormal oscillations in large arrays of cortical and thalamic neurons, a critically important concept in understanding the functional consequences of abnormal (thalamic) brain structure and function. Graybiel describes her interest in abnormal basal ganglia activity-dependent loops that may access the thalamus and set the tone of thalamo-cortical transmission. This view allows for us to understand the "upward" influences on basal ganglia function (and dysfunction) relevant to schizophrenia. These intriguing articles raise a number of issues that await increased data and continued integrating insights. These issues include the need for more information about (1) the developmental timing of lesions or dysfunctions; (2) the extent and regional distribution of abnormalities; (3) the relationship of brain dysfunction to clinical/cognitive abnormalities; and (4) the variable expression of brain abnormalities across the schizophrenia spectrum. These three articles and their authors are at the forefront of our expanding knowledge about the neuroanatomy of schizophrenia and how complex structural and functional deficits are expressed in individuals in the group of schizophrenias.

P50 suppression among schizophrenia and normal comparison subjects: a methodological analysis

The present report investigated the relationship between P50 suppression and habituation among 20 schizophrenia and 20 normal comparison subjects. Subjects were presented with clicks delivered over headphones in a S1-S2 paradigm (clicks were separated by 500 msec; average intertrial interval was 8 sec). There were 60 total trials; the data were analyzed separately for the first and second 30 trials. The groups did not differ either on the number of usable trials or on the morphology of their P50 responses. Consistent with previous reports, schizophrenia patients demonstrated deficient P50 suppression. The overall suppression effect was not due to a group difference on S1 P50 amplitudes, but was associated with schizophrenia patients having smaller S1-S2 P50 amplitude difference scores than normal comparison subjects. Furthermore, the suppression effect appears to be more pronounced during the first than during the second block of trials. Thus, it may be important to evaluate changes in P50 responses over time among schizophrenia and normal comparison subjects.

Backward versus forward visual masking deficits in schizophrenic patients: centrally, not peripherally, mediated?

OBJECTIVE

Schizophrenic patients have repeatedly demonstrated the inability to rapidly process information when tasks are timed or the processing load is relatively high. Schizophrenic patients show consistent deficits in the visual backward masking paradigm. In visual backward masking, an informational target stimulus is presented, followed after an interstimulus interval by a masking stimulus that interferes with or interrupts target identification.

METHOD

In order to clarify whether the visual backward masking deficits of schizophrenic patients are indeed central rather than peripheral in origin, the authors compared visual backward masking to psychometrically matched visual forward masking performance in 35 normal comparison subjects and then 35 schizophrenic patients. In visual forward masking, the mask precedes the target, and visual forward masking mechanisms are felt to be more peripheral (retinal) than are visual backward masking mechanisms.

RESULTS

For psychometrically matched forward and backward masking tasks, the schizophrenic patients had a selective and differential deficit in the backward masking condition.

CONCLUSIONS

These results support the interpretation that the observed visual backward masking deficits of schizophrenic patients are centrally mediated.

The relationship of information-processing deficits and clinical symptoms in schizotypal personality disorder

Individuals with schizotypal personality disorder (SPD) are thought to be phenotypically related to individuals with schizophrenia. This assumption is partially supported by the fact that SPD patients have deficits on biological markers similar to those found in schizophrenia. Visual backward masking (VBM) performance and critical stimulus duration (CSD), measures of information processing found to be abnormal in schizophrenia patients, were assessed in 14 SPD and 21 comparison subjects. There was no significant difference between groups in VBM performance; however; there were significant correlations between VBM deficits and the number of SPD symptoms, as well as elevated scores on the Ego. Impairment Index (EII). Additionally, there was a trend (p = 056) toward elevations in CSD in the SPD versus the comparison group and CSD inflation appears to be most prominent in individuals with a greater number of social deficit symptoms and elevated physical anhedonia scores. These findings suggest an important relationship between symptoms of SPD and neurophysiologic deficits.

Positive symptoms of psychosis in posttraumatic stress disorder

The possible presence of hallucinations and delusional thoughts in posttraumatic stress disorder (PTSD) was investigated. Other symptom clusters were also assessed in order to further clarify the nature of PTSD. Twenty combat veterans with PTSD were compared to 18 combat veterans without PTSD on symptom rating scales. The subjects with PTSD exhibited a greater degree of depression, anxiety, agitation, anhedonia, and positive symptoms of psychosis than the comparison group. Specifically, the PTSD group manifested increased hallucinations, delusions, and bizarre behavior. Some of these positive symptoms did not appear to be due to reexperiencing of the trauma. The groups were not significantly different on indices of mania, thought disorder, or inertia. The clinical and diagnostic implications of the results are discussed. A diagnosis of PTSD should be considered with patients who have positive symptoms in the absence of thought disorder.

Latent inhibition in schizophrenia

Latent inhibition (LI) refers to the retarded acquisition of a conditioned response that occurs if the subject being tested is first preexposed to the to-be-conditioned stimulus (CS) without the paired unconditioned stimulus (UCS). Because the 'irrelevance' of the to-be-conditioned stimulus is established during non-contingent preexposure, the slowed acquisition of the CS-UCS association is thought to reflect the process of overcoming this learned irrelevance. Latent inhibition has been reported to be diminished in acutely hospitalized schizophrenia patients. If acutely hospitalized schizophrenia patients are preexposed to the CS, they learn the association as fast as, and perhaps faster than, patients who are not preexposed to the CS. This finding has been interpreted as reflecting the inability of acute schizophrenia patients to ignore irrelevant stimuli. In this study, the LI paradigm was identical to the one used in previous reports of LI deficits in schizophrenia patients (Baruch et al., 1988). Latent inhibition was observed in normal control subjects (n = 73), including individuals identified as 'psychosis-prone' based on established screening criteria, and in anxiety (n = 19) and mood disorder (n = 13) patients. Learning scores (trials to criterion) in "acutely' hospitalized as well as "chronic' hospitalized schizophrenia patients (n = 45) were significantly elevated in both preexposed and non-preexposed subjects, compared to controls. Acute schizophrenia patients exhibited intact LI. Separate cohorts of acute and chronic schizophrenia patients (n = 23) and normal controls (n = 34) exhibited intact LI when tested in a new, easier-to-acquire computerized LI paradigm. These results fail to identify specific LI deficits in schizophrenia patients, and raise the possibility that previously observed LI deficits in schizophrenia patients may reflect, at least in part, performance deficits related to learning acquisition.