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Fernandez VG, Asarnow R, Hodges M, Nuechterlein KH. Linguistic and neurocognitive correlates of probabilistic classification learning in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 26:100209. [PMID: 34354933 PMCID: PMC8321954 DOI: 10.1016/j.scog.2021.100209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 10/25/2022]
Abstract
Individuals with schizophrenia demonstrate impaired implicit learning on cognitively complex tasks and preserved implicit motor learning. However, little is known about how implicit learning may be related to other linguistic and cognitive variables, including development of complex language including comprehension and syntax. This study explored the relationship between probabilistic classification learning, a type of implicit learning style, and linguistic and cognitive skills in schizophrenia. This was done by examining how schizophrenia patients perform on the Weather Prediction Task (WPT) relative to controls, particularly during a dual-task interference condition that assesses task automaticity. Individuals with schizophrenia (N = 34) demonstrated depressed cognitive functioning relative to the controls (N = 18) across nearly all cognitive functions. On the Weather Prediction Task, the schizophrenia group performed less accurately than the control group in later blocks and had a relatively flat learning curve. A significant Group X Block effect when controlling for age and sex suggested differential learning throughout the task. A subgroup of patients did not develop automaticity during the repeated blocks of trials. For those patients who did not develop automaticity over the course of the WPT, linguistic and cognitive skills were strongly correlated with their Block 1 performance. For patients who developed automaticity, overall neurocognitive ability was correlated with their ultimate level of performance on the WPT but not with their Block 1 performance. That language was related to differential learning emphasizes the role of explicit, verbal processes on making initial rapid improvement on the WPT.
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Affiliation(s)
- Vindia G Fernandez
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Robert Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.,Department of Psychology, UCLA, Los Angeles, CA, United States of America
| | - Megan Hodges
- Department of Psychology, UCLA, Los Angeles, CA, United States of America
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.,Department of Psychology, UCLA, Los Angeles, CA, United States of America
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2
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Wolf RC, Rashidi M, Fritze S, Kubera KM, Northoff G, Sambataro F, Calhoun VD, Geiger LS, Tost H, Hirjak D. A Neural Signature of Parkinsonism in Patients With Schizophrenia Spectrum Disorders: A Multimodal MRI Study Using Parallel ICA. Schizophr Bull 2020; 46:999-1008. [PMID: 32162660 PMCID: PMC7345812 DOI: 10.1093/schbul/sbaa007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Motor abnormalities in schizophrenia spectrum disorders (SSD) have increasingly attracted scientific interest in the past years. However, the neural mechanisms underlying parkinsonism in SSD are unclear. The present multimodal magnetic resonance imaging (MRI) study examined SSD patients with and without parkinsonism, as defined by a Simpson and Angus Scale (SAS) total score of ≥4 (SAS group, n = 22) or <4 (non-SAS group, n = 22). Parallel independent component analysis (p-ICA) was used to examine the covarying components among gray matter volume maps computed from structural MRI (sMRI) and fractional amplitude of low-frequency fluctuations (fALFF) maps computed from resting-state functional MRI (rs-fMRI) patient data. We found a significant correlation (P = .020, false discovery rate [FDR] corrected) between an sMRI component and an rs-fMRI component, which also significantly differed between the SAS and non-SAS group (P = .042, z = -2.04). The rs-fMRI component comprised the cortical sensorimotor network, and the sMRI component included predominantly a frontothalamic/cerebellar network. Across the patient sample, correlations adjusted for the Positive and Negative Syndrome Scale (PANSS) total scores showed a significant relationship between tremor score and loadings of the cortical sensorimotor network, as well as between glabella-salivation score, frontothalamic/cerebellar and cortical sensorimotor network loadings. These data provide novel insights into neural mechanisms of parkinsonism in SSD. Aberrant bottom-up modulation of cortical motor regions may account for these specific motor symptoms, at least in patients with SSD.
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Affiliation(s)
- Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mahmoud Rashidi
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), [Georgia State University, Georgia Institute of Technology, Emory University], Atlanta, GA
| | - Lena S Geiger
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany,To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, D-68159 Mannheim, Germany; tel: +49-621-1703-0, fax: +49-621-1703-2305, e-mail:
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Gupta T, Dean DJ, Kelley NJ, Bernard JA, Ristanovic I, Mittal VA. Cerebellar Transcranial Direct Current Stimulation Improves Procedural Learning in Nonclinical Psychosis: A Double-Blind Crossover Study. Schizophr Bull 2018; 44:1373-1380. [PMID: 29301026 PMCID: PMC6192475 DOI: 10.1093/schbul/sbx179] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The present double-blind crossover study examines the effects of cerebellar transcranial direct current stimulation (tDCS) in controls and in an analogue population to psychosis: individuals reporting elevated symptoms of nonclinical psychosis (NCP). A total of 18 controls and 24 NCP individuals were randomized into conditions consisting of 25 minutes of anodal (active) or sham cerebellar tDCS. Following this, both groups completed a pursuit rotor task designed to measure procedural learning performance. Participants then returned 1-week later and received the corresponding condition (either active or sham) and repeated the pursuit rotor task. Results indicate that in the sham condition, control participants showed significantly greater rates of motor learning when compared with the NCP group. In the active condition, the NCP group exhibited significant improvements in the rate of motor learning and performed at a level that was comparable to controls; these data support the link between cerebellar dysfunction and motor learning. Taken together, tDCS may be a promising treatment mechanism for patient populations and a useful experimental approach in elucidating our understanding of psychosis.
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Affiliation(s)
- Tina Gupta
- Department of Psychology, Northwestern University, Evanston, IL,To whom correspondence should be addressed; Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL 60208, US; tel: 847-467-5907, fax: 847-467-5707, e-mail:
| | - Derek J Dean
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO,Center for Neuroscience, University of Colorado Boulder, Boulder, CO
| | | | - Jessica A Bernard
- Department of Psychology, Texas A&M University, College Station, TX,Institute for Neuroscience, Texas A&M University, College Station, TX
| | | | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL,Department of Psychiatry, Northwestern University, Evanston, ILs,Institute of Policy Research, Northwestern University, Evanston, IL,Department of Medical Social Sciences, Northwestern University, Evanston, IL,Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL
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Hirjak D, Kubera KM, Thomann PA, Wolf RC. Motor dysfunction as an intermediate phenotype across schizophrenia and other psychotic disorders: Progress and perspectives. Schizophr Res 2018; 200:26-34. [PMID: 29074330 DOI: 10.1016/j.schres.2017.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/02/2017] [Accepted: 10/06/2017] [Indexed: 02/07/2023]
Abstract
Primary motor abnormalities (PMA), as found in patients with schizophrenia, are quantitatively and qualitatively distinct markers of motor system abnormalities. PMA have been often referred to phenomena that are present across schizophrenia-spectrum disorders. A dysfunction of frontoparietal and subcortical networks has been proposed as core pathophysiological mechanism underlying the expression of PMA. However, it is unclear at present if such mechanisms are a common within schizophrenia and other psychotic disorders. To address this question, we review recent neuroimaging studies investigating the neural substrates of PMA in schizophrenia and so-called "nonschizophrenic nonaffective psychoses" (NSNAP) such as schizophreniform, schizoaffective, brief psychotic, and other unspecified psychotic disorders. Although the extant data in patients with schizophrenia suggests that further investigation is warranted, MRI findings in NSNAP are less persuasive. It is unclear so far which PMA, if any, are characteristic features of NSNAP or, possibly even specific for these disorders. Preliminary data suggest a relationship between relapsing-remitting PMA in hyper-/hypokinetic cycloid syndromes and neurodegenerative disorders of the basal ganglia, likely reflecting the transnosological relevance of subcortical abnormalities. Despite this evidence, neural substrates and mechanisms underlying PMA that are common in schizophrenia and NSNAP cannot be clearly delineated at this stage of research. PMA and their underlying brain circuits could be promising intermediate phenotype candidates for psychotic disorders, but future multimodal neuroimaging studies in schizophrenia and NSNAP patients and their unaffected first-degree relatives are needed to answer fundamental transnosologic questions.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany.
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany; Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
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Hirjak D, Thomann PA, Kubera KM, Wolf ND, Sambataro F, Wolf RC. Motor dysfunction within the schizophrenia-spectrum: A dimensional step towards an underappreciated domain. Schizophr Res 2015; 169:217-233. [PMID: 26547881 DOI: 10.1016/j.schres.2015.10.022] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/09/2015] [Accepted: 10/15/2015] [Indexed: 12/14/2022]
Abstract
At the beginning of the 20th century, genuine motor abnormalities (GMA) were considered to be intricately linked to schizophrenia. Subsequently, however, GMA have been increasingly regarded as unspecific transdiagnostic phenomena or related to side effects of antipsychotic treatment. Despite possible medication confounds, within the schizophrenia spectrum GMA have been categorized into three broad categories, i.e. neurological soft signs, abnormal involuntary movements and catatonia. Schizophrenia patients show a substantial overlap across a broad range of distinct motor signs and symptoms suggesting a prominent involvement of the motor system in disease pathophysiology. There have been several attempts to increase reliability and validity in diagnosing schizophrenia based on behavior and neurobiology, yet relatively little attention has been paid to the motor domain in the past. Nevertheless, accumulating neuroscientific evidence suggests the possibility of a motor endophenotype in schizophrenia, and that GMA could represent a specific dimension within the schizophrenia-spectrum. Here, we review current neuroimaging research on GMA in schizophrenia with an emphasis on distinct and common mechanisms of brain dysfunction. Based on a dimensional approach we show that multimodal neuroimaging combined with fine-grained clinical examination can result in a comprehensive characterization of structural and functional brain changes that are presumed to underlie core GMA in schizophrenia. We discuss the possibility of a distinct motor domain, together with its implications for future research. Investigating GMA by means of multimodal neuroimaging can essentially contribute at identifying novel and biologically reliable phenotypes in psychiatry.
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Affiliation(s)
- Dusan Hirjak
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany.
| | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Nadine D Wolf
- Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Udine, Italy
| | - Robert C Wolf
- Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany
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De Picker LJ, Cornelis C, Hulstijn W, Dumont G, Fransen E, Timmers M, Janssens L, Morrens M, Sabbe BGC. Stable schizophrenia patients learn equally well as age-matched controls and better than elderly controls in two sensorimotor rotary pursuit tasks. Front Psychiatry 2014; 5:165. [PMID: 25505425 PMCID: PMC4241745 DOI: 10.3389/fpsyt.2014.00165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 11/06/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare sensorimotor performance and learning in stable schizophrenia patients, healthy age- and sex-matched controls and elderly controls on two variations of the rotary pursuit: circle pursuit (true motor learning) and figure pursuit (motor and sequence learning). METHOD In the circle pursuit, a target circle, rotating with increasing speed along a predictable circular path on the computer screen, must be followed by a cursor controlled by a pen on a writing tablet. In the eight-trial figure pursuit, subjects learn to draw a complex figure by pursuing the target circle that moves along an invisible trajectory between and around several goals. Tasks were administered thrice (day 1, day 2, day 7) to 30 patients with stable schizophrenia (S), 30 healthy age- and sex-matched controls (C), and 30 elderly participants (>65 years; E) and recorded with a digitizing tablet and pressure-sensitive pen. The outcome measure accuracy (% of time that cursor is within the target) was used to assess performance. RESULTS We observed significant group differences in accuracy, both in circle and figure pursuit tasks (E < S < C, p < 0.01). Strong learning effects were found in each group. Learning curves were similar in circle pursuit but differed between groups in figure pursuit. When corrected for group differences in starting level, the learning gains over the three sessions of schizophrenia patients and age-matched controls were equal and both were larger than those of the elderly controls. CONCLUSION Despite the reduced sensorimotor performance that was found in the schizophrenia patients, their sensorimotor learning seems to be preserved. The relevance of this finding for the evaluation of procedural learning in schizophrenia is discussed. The better performance and learning rate of the patients compared to the elderly controls was unexpected and deserves further study.
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Affiliation(s)
- Livia J. De Picker
- Collaborative Antwerp Psychiatric Research Initiative (CAPRI), University of Antwerp, Antwerp, Belgium
- University Psychiatric Hospital St. Norbertushuis, Duffel, Belgium
| | - Claudia Cornelis
- Collaborative Antwerp Psychiatric Research Initiative (CAPRI), University of Antwerp, Antwerp, Belgium
- University Psychiatric Hospital St. Norbertushuis, Duffel, Belgium
| | - Wouter Hulstijn
- Collaborative Antwerp Psychiatric Research Initiative (CAPRI), University of Antwerp, Antwerp, Belgium
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Glenn Dumont
- Collaborative Antwerp Psychiatric Research Initiative (CAPRI), University of Antwerp, Antwerp, Belgium
- University Psychiatric Hospital St. Norbertushuis, Duffel, Belgium
| | | | - Maarten Timmers
- Janssen Research and Development, Janssen Pharmaceutica N.V., Beerse, Belgium
| | - Luc Janssens
- Janssen Research and Development, Janssen Pharmaceutica N.V., Beerse, Belgium
| | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Initiative (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Bernard G. C. Sabbe
- Collaborative Antwerp Psychiatric Research Initiative (CAPRI), University of Antwerp, Antwerp, Belgium
- University Psychiatric Hospital St. Norbertushuis, Duffel, Belgium
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A Comparison of Implicit Memory Tests in Schizophrenic Patients and Normal Controls. SPANISH JOURNAL OF PSYCHOLOGY 2014; 10:423-9. [DOI: 10.1017/s1138741600006685] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of the current study was to compare the performance of schizophrenic patients and normal controls on implicit memory tests. Two neuropsychological tasks were administered to 29 patients and normal participant samples. The implicit tests were: Word fragment completion and Word production from semantic categories. The priming score was the variable of interest. Priming effects are obtained in normal subjects and schizophrenia patients, regardless of the implicit test used. However, a dissociation in priming between normal and patient groups was observed, depending on the test used. For word fragment test, priming was identical between the two groups. However, for word production, priming obtained in schizophrenics was lower than priming in normal controls. Results confirm a dissociation effect in implicit memory tests. These results could be explained in the context of the Roediger and Blaxton (1987) distinction between data-driven and conceptually-driven processing. This evidence suggests that a complete neuropsychological assessment of memory in schizophrenia should include different kinds of implicit memory tests (procedural, perceptual, and conceptual tasks).
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Dean DJ, Bernard JA, Orr JM, Pelletier-Baldelli A, Gupta T, Carol EE, Mittal VA. Cerebellar Morphology and Procedural Learning Impairment in Neuroleptic-Naive Youth at Ultrahigh Risk of Psychosis. Clin Psychol Sci 2014; 2:152-164. [PMID: 25419496 PMCID: PMC4240519 DOI: 10.1177/2167702613500039] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Despite evidence suggesting a role for cerebellar abnormalities in the pathogenesis of psychosis, the structure has yet to receive attention in individuals at ultrahigh risk for psychosis (UHR). Accumulating research has suggested that the cerebellum helps modulate cognition and movement, domains in which UHR individuals show impairment; understanding putative markers of risk, such as structural abnormalities and behavioral correlates, is essential. In this study, participants underwent a high-resolution structural brain scan and participated in a pursuit rotor experiment. Cerebellar regions associated with movement (anterior cerebellum) and cognition (crus I) were subsequently analyzed. UHR participants showed impaired performance on the pursuit rotor task, learned at a slower rate, and showed smaller cerebellar volumes compared with control participants. Left crus I volume was significantly associated with poor rate of learning. The present results suggest that cerebellar abnormalities and their behavioral correlates (poor learning and motor control) precede the onset of psychosis.
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Affiliation(s)
- Derek J. Dean
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Center for Neuroscience, University of Colorado Boulder
| | | | - Joseph M. Orr
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute for Cognitive Science, University of Colorado Boulder
| | - Andrea Pelletier-Baldelli
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Center for Neuroscience, University of Colorado Boulder
| | - Tina Gupta
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Emily E. Carol
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Vijay A. Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Center for Neuroscience, University of Colorado Boulder
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Li CT, Chou KH, Su TP, Huang CC, Chen MH, Bai YM, Lin CP. Gray matter abnormalities in schizophrenia patients with tardive dyskinesia: a magnetic resonance imaging voxel-based morphometry study. PLoS One 2013; 8:e71034. [PMID: 23967150 PMCID: PMC3744521 DOI: 10.1371/journal.pone.0071034] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 06/26/2013] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The pathophysiological mechanism of TD remains unknown. All previous studies, using the region-of-interest method, focused on basal ganglion areas, were with inconsistent results. This whole-brain voxel-based morphometry (VBM) study investigate the grey matter abnormality of TD and its correlates with clinical ratings. METHOD High resolution T1-weighted brain volumetric MRI from 25 schizophrenia patients with TD (TD group), 25 age-, gender-, and handedness-matched schizophrenia patients without TD (non-TD group), and 25 matched healthy subjects (NC group) were analyzed using a VBM approach. Clinical ratings included the Positive and Negative Symptom Scale (PANSS), Abnormal Involuntary Movement Scale (AIMS), and the Simpson-Angus Scale (SAS). RESULTS The TD group had significantly smaller total gray matter volumes than the NC group (p = 0.05). Compared to the non-TD group, the TD group had significantly higher PANSS negative (p<0.001), SAS (p<0.001), and AIMS (p<0.001) scores; and smaller bilateral inferior frontal gyrus, which correlated negatively with the PANSS negative scores (r = -0.366, p<0.05); and smaller right superior frontal gyrus, which correlated negatively with AIMS scores (r = -0.399, p<0.001), and PANSS general score (r = -0.338, p<0.05). LIMITATIONS The cross-section design can't separate the gray matter change to TD from the context of the illness of schizophrenia, although TD with more severe clinical psychopathology could be a phenotype. CONCLUSIONS The schizophrenia patients with TD had significantly reduced gray matter, mostly at the bilateral inferior frontal gyrus and the right superior frontal gyrus, which correlated with severity of clinical symptoms and involuntary movement, respectively.
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Affiliation(s)
- Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chu-Chung Huang
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
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Mittal VA, Dean DJ, Pelletier A. Dermatoglyphic asymmetries and fronto-striatal dysfunction in young adults reporting non-clinical psychosis. Acta Psychiatr Scand 2012; 126:290-7. [PMID: 22519833 PMCID: PMC3404232 DOI: 10.1111/j.1600-0447.2012.01869.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Growing evidence indicates that non-clinical psychotic-like experiences occur in otherwise healthy individuals, suggesting that psychosis may occur on a continuum. However, little is known about how the diathesis for formal psychosis maps on to individuals at the non-clinical side of this continuum. Our current understanding of the pathophysiology of schizophrenia implicates certain key factors such as early developmental abnormalities and fronto-striatal dysfunction. To date, no studies have examined these core factors in the context of non-clinical psychosis. METHOD A total of 221 young adults were assessed for distressing attenuated positive symptoms (DAPS), dermatoglyphic asymmetries (a marker of early developmental insult), and procedural memory (a proxy for fronto-striatal function). RESULTS Participants reporting DAPS (n = 16; 7.2%) and no-DAPS (n = 205; 92.7%) were split into two groups. The DAPS group showed significantly elevated depression, elevated dermatoglyphic asymmetries, and a pattern of procedural learning consistent with other studies with formally psychotic patients. CONCLUSION The results indicate that the non-clinical side of the psychosis continuum also shares key vulnerability factors implicated in schizophrenia, suggesting that both early developmental disruption and abnormalities in fronto-striatal function are core aspects underlying the disorder.
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Affiliation(s)
- Vijay A. Mittal
- Department of Psychology and Neuroscience, Center for Neuroscience, University of Colorado at Boulder
| | - Derek J. Dean
- Department of Psychology and Neuroscience, University of Colorado at Boulder
| | - Andrea Pelletier
- Department of Psychology and Neuroscience, University of Colorado at Boulder
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Bilgic B, Pfefferbaum A, Rohlfing T, Sullivan EV, Adalsteinsson E. MRI estimates of brain iron concentration in normal aging using quantitative susceptibility mapping. Neuroimage 2011; 59:2625-35. [PMID: 21925274 DOI: 10.1016/j.neuroimage.2011.08.077] [Citation(s) in RCA: 377] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 08/20/2011] [Accepted: 08/25/2011] [Indexed: 01/08/2023] Open
Abstract
Quantifying tissue iron concentration in vivo is instrumental for understanding the role of iron in physiology and in neurological diseases associated with abnormal iron distribution. Herein, we use recently-developed Quantitative Susceptibility Mapping (QSM) methodology to estimate the tissue magnetic susceptibility based on MRI signal phase. To investigate the effect of different regularization choices, we implement and compare ℓ1 and ℓ2 norm regularized QSM algorithms. These regularized approaches solve for the underlying magnetic susceptibility distribution, a sensitive measure of the tissue iron concentration, that gives rise to the observed signal phase. Regularized QSM methodology also involves a pre-processing step that removes, by dipole fitting, unwanted background phase effects due to bulk susceptibility variations between air and tissue and requires data acquisition only at a single field strength. For validation, performances of the two QSM methods were measured against published estimates of regional brain iron from postmortem and in vivo data. The in vivo comparison was based on data previously acquired using Field-Dependent Relaxation Rate Increase (FDRI), an estimate of MRI relaxivity enhancement due to increased main magnetic field strength, requiring data acquired at two different field strengths. The QSM analysis was based on susceptibility-weighted images acquired at 1.5 T, whereas FDRI analysis used Multi-Shot Echo-Planar Spin Echo images collected at 1.5 T and 3.0 T. Both datasets were collected in the same healthy young and elderly adults. The in vivo estimates of regional iron concentration comported well with published postmortem measurements; both QSM approaches yielded the same rank ordering of iron concentration by brain structure, with the lowest in white matter and the highest in globus pallidus. Further validation was provided by comparison of the in vivo measurements, ℓ1-regularized QSM versus FDRI and ℓ2-regularized QSM versus FDRI, which again yielded perfect rank ordering of iron by brain structure. The final means of validation was to assess how well each in vivo method detected known age-related differences in regional iron concentrations measured in the same young and elderly healthy adults. Both QSM methods and FDRI were consistent in identifying higher iron concentrations in striatal and brain stem ROIs (i.e., caudate nucleus, putamen, globus pallidus, red nucleus, and substantia nigra) in the older than in the young group. The two QSM methods appeared more sensitive in detecting age differences in brain stem structures as they revealed differences of much higher statistical significance between the young and elderly groups than did FDRI. However, QSM values are influenced by factors such as the myelin content, whereas FDRI is a more specific indicator of iron content. Hence, FDRI demonstrated higher specificity to iron yet yielded noisier data despite longer scan times and lower spatial resolution than QSM. The robustness, practicality, and demonstrated ability of predicting the change in iron deposition in adult aging suggest that regularized QSM algorithms using single-field-strength data are possible alternatives to tissue iron estimation requiring two field strengths.
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Affiliation(s)
- Berkin Bilgic
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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Gomar JJ, Pomarol-Clotet E, Sarró S, Salvador R, Myers CE, McKenna PJ. Procedural learning in schizophrenia: reconciling the discrepant findings. Biol Psychiatry 2011; 69:49-54. [PMID: 20817152 DOI: 10.1016/j.biopsych.2010.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2009] [Revised: 07/05/2010] [Accepted: 07/15/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Studies of procedural learning in schizophrenia have been inconsistent, sometimes finding it to be preserved and sometimes impaired. This study examined three factors that could account for the variability among findings: type of task, presence of general intellectual impairment, and the extrapyramidal side effects of neuroleptic treatment. METHODS Forty-three patients with schizophrenia and 22 normal control subjects were examined with three different paradigms: the pursuit rotor, mirror reading, and probabilistic learning ("weather prediction"). A subgroup of intellectually preserved patients was also examined. Patients with and without tardive dyskinesia and with and without Parkinsonism were also compared. RESULTS The schizophrenic patients showed learning comparable to the control subjects on the pursuit rotor and mirror reading but were impaired on the probabilistic learning task. However, this last difference disappeared when the subgroup of intellectually preserved patients was compared with a subgroup of matched control subjects. Patients with and without tardive dyskinesia or Parkinsonism showed similar learning on all three tasks, but patients with tardive dyskinesia showed poorer overall performance than those without. CONCLUSIONS Procedural learning tends to be preserved in schizophrenia, and when impairment is found, differences in the overall level of intellectual function might be the determining factor.
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Affiliation(s)
- Jesús J Gomar
- Benito Menni Complex Assistencial en Salut Mental, Universitat Autònoma de Barcelona, Barcelona Spain.
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13
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Kern RS, Hartzell AM, Izaguirre B, Hamilton AH. Declarative and nondeclarative memory in schizophrenia: What is impaired? What is spared? J Clin Exp Neuropsychol 2010; 32:1017-27. [PMID: 20446142 DOI: 10.1080/13803391003671166] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The study's aim was to assess a broad range of declarative and nondeclarative memory functions in schizophrenia to identify areas of impairment versus relative preservation. Participants included 40 schizophrenia outpatients and 30 demographically comparable community residents. All participants were administered a battery assessing declarative memory (verbal learning, working memory, semantic memory, remote memory, verbal retention) and nondeclarative memory (procedural learning, priming). To control for order effects, the battery was divided into three parts of approximately equal length with order of administration counterbalanced across study participants. The results showed persons with schizophrenia to be significantly impaired relative to community residents in verbal learning, working memory, semantic memory, remote memory, and priming. In contrast, the two groups were comparable in verbal retention and procedural learning. In the schizophrenia group, priming ability best discriminated past year's vocational status. In sum, the findings indicate a specific pattern of impairment and preservation of memory functioning in schizophrenia. Skill (procedural) learning and retention of learned, declarative verbal information across a delay appear intact, while all other areas measured appear impaired.
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Affiliation(s)
- Robert S Kern
- David Geffen School of Medicine, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.
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14
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Bai YM, Chou KH, Lin CP, Chen IY, Li CT, Yang KC, Chou YH, Su TP. White matter abnormalities in schizophrenia patients with tardive dyskinesia: a diffusion tensor image study. Schizophr Res 2009; 109:167-81. [PMID: 19261444 DOI: 10.1016/j.schres.2009.02.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 02/05/2009] [Accepted: 02/05/2009] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Tardive dyskinesia (TD) is a severe side effect of antipsychotics. While increasing evidence suggests that damaged brain microcircuitry of white matter (WM) is responsible for the clinical symptoms in schizophrenia, no reports of WM abnormality associated with TD were noted. METHOD Brain white matter abnormalities were investigated among 20 schizophrenia patients with TD (Schizophrenia with TD group), 20 age-, gender-, and handedness-matched schizophrenic patients without TD (Schizophrenia without TD group), and 20 matched healthy subjects with magnetic resonance imaging and diffusion tensor imaging analysis. Voxel-wise analysis was used to compare fractional anisotropy (FA) maps of the white matter following intersubject registration to Talairach space. Clinical ratings included the Positive and Negative Symptoms Scale (PANSS), Abnormal Involuntary Movement Scale (AIMS), and the Simpson-Angus Scale (SAS). RESULTS The study subjects were 75% female with average of 40.1+/-9. 8 years. The Schizophrenia with TD group had significantly higher PANSS total scores (p=0.024), PANSS negative score (p=0.001), SAS (p<0.001) and AIMS (p<0.001) scores; and demonstrated more widespread FA decreases than the Schizophrenia without TD group, especially over the inferior frontal gyrus, temporal sublobar extranuclear WM (around the basal ganglion), parietal precuneus gyrus WM (around somatosensory cortex), and medial frontal gyrus WM (around dorsolateral prefrontal cortex). The AIMS (p<0.01) and SAS (p<0.01) score positively correlated with decreased FA over these areas, and PANSS negative score positively correlated with FA decrease over medial frontal gyrus WM (p<0.01). CONCLUSIONS More widespread abnormality of white matter was noted among schizophrenia patients than those without, especially involved cortico-basal ganglion circuits with clinical symptom correlation of involuntary movements and negative symptoms. Further studies with larger sample size are required to validate the findings.
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Affiliation(s)
- Ya Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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15
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Reiss JP, Campbell DW, Leslie WD, Paulus MP, Ryner LN, Polimeni JO, Foot BJ, Sareen J. Deficit in schizophrenia to recruit the striatum in implicit learning: a functional magnetic resonance imaging investigation. Schizophr Res 2006; 87:127-37. [PMID: 16814986 DOI: 10.1016/j.schres.2006.04.027] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Revised: 04/06/2006] [Accepted: 04/10/2006] [Indexed: 11/27/2022]
Abstract
In schizophrenia, explicit learning deficits have been well established although it is less clear whether these patients have deficits in implicit learning (IL). IL is thought to depend on intact striatal functioning. This study examined the hypothesis that schizophrenia patients show deficient recruitment of striatal activation during an IL paradigm, relative to performance-matched healthy comparison subjects. Ten subjects with schizophrenia on atypical antipsychotic medication and 10 age, gender, education, and performance matched healthy comparison subjects underwent fMRI while performing an IL task. On the basis of whole-brain and striatal region-of-interest analyses, we found a relative lack of striatal activation in schizophrenia patients. This result is consistent with convergent evidence of striatal dysfunction in schizophrenia.
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Affiliation(s)
- Jeffrey P Reiss
- Psychiatric Neuroimaging Research Program, Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
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16
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Exner C, Boucsein K, Degner D, Irle E. State-dependent implicit learning deficit in schizophrenia: evidence from 20-month follow-up. Psychiatry Res 2006; 142:39-52. [PMID: 16580734 DOI: 10.1016/j.psychres.2005.09.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2004] [Revised: 09/22/2005] [Accepted: 09/29/2005] [Indexed: 11/30/2022]
Abstract
Previous research has confirmed stable explicit memory deficits in schizophrenia across disease states. However, little is known about the implicit learning capabilities of individuals with schizophrenia across the course of illness. The current study assessed procedural learning in 19 schizophrenia subjects (DSM-IV criteria) and 19 matched controls using the Serial Reaction-Time Task (SRTT). The severity of negative, positive and disorganized symptoms was assessed using the Scales for the Assessment of Positive and Negative Symptoms. A sub-sample of 11 schizophrenia subjects and 11 controls was reassessed 20 months later when symptoms in the schizophrenia subjects had largely remitted. Schizophrenia subjects were severely impaired on sequence-specific procedural learning during an acute episode. This deficit could not be explained by a general memory or processing speed impairment. Impaired implicit learning scores were significantly related to higher ratings of disorganized symptoms. However, 20 months later, when acute symptoms had remitted, the performance of the schizophrenia subjects on procedural learning had normalized. Our findings might share a conceptual overlap with previous reports of a reduced ability of schizophrenia subjects during an acute episode to adapt ongoing perceptual and behavioral programs to previously experienced regularities in their environment.
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Affiliation(s)
- Cornelia Exner
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Gutenbergstr. 18, D-35032 Marburg, Germany.
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17
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Weickert TW, Goldberg TE. First- and second-generation antipsychotic medication and cognitive processing in schizophrenia. Curr Psychiatry Rep 2005; 7:304-10. [PMID: 16098285 DOI: 10.1007/s11920-005-0085-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Schizophrenia has been consistently characterized by deficits in the cognitive domains of executive function, working memory, attention, and episodic memory. Although some cognitive abnormalities, such as motor slowing, may be associated with antipsychotic medication administration, generally the cognitive deficits shown by patients with schizophrenia can be attributed at least in part to the disease process. Modulation of the dopamine neurotransmitter system, notably through D2 receptor blockade, has been associated with psychotic symptom reduction and cognitive performance improvements in patients with schizophrenia. Although first-generation antipsychotic medication treatment initially was thought not to result in cognitive improvement, recent studies comparing second-generation antipsychotics to low doses of first-generation antipsychotic medication showed cognitive benefits for first-generation drugs, although perhaps not as great as that found after treatment with second-generation medication. Cognitive improvement associated with administration of antipsychotic medication may be a manifestation of improvement in general cortical information processing. Recent work has shown that specific genetic polymorphisms may interact with antipsychotic medication treatment to influence the degree to which cognitive abilities display improvement after treatment. In particular, the catechol-O-methyltransferase val108/158met polymorphism has been shown to predict working memory improvement after administration of antipsychotic medication to patients with schizophrenia.
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Affiliation(s)
- Thomas W Weickert
- Clinical Brain Disorders Branch, Genes, Cognition, and Psychosis Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA
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18
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Manoach DS, Cain MS, Vangel MG, Khurana A, Goff DC, Stickgold R. A failure of sleep-dependent procedural learning in chronic, medicated schizophrenia. Biol Psychiatry 2004; 56:951-6. [PMID: 15601605 DOI: 10.1016/j.biopsych.2004.09.012] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2004] [Revised: 08/12/2004] [Accepted: 09/16/2004] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizophrenia patients have difficulty mastering even rote procedural tasks in rehabilitation settings. Although most studies demonstrate intact procedural learning in schizophrenia, recent findings demonstrate that a critical component of procedural learning is dependent on sleep. This study tested the hypothesis that patients with schizophrenia have a deficit in sleep-dependent procedural learning. METHODS Using a simple, well-characterized test of motor skill learning, the finger tapping motor sequence task (MST), 26 patients with chronic, medicated schizophrenia and 14 demographically matched healthy control subjects were tested on two occasions, 24 hours apart. The main outcome measures were learning of the MST on day 1 (practice-dependent learning) and overnight, sleep-dependent improvement in performance. RESULTS Although schizophrenia patients and control subjects did not differ in practice-dependent learning, patients failed to show overnight improvement (4% deterioration) and differed significantly from control subjects who showed a significant 11% improvement. CONCLUSIONS We present here the first demonstration of a failure of sleep-dependent consolidation of procedural learning in chronic, medicated schizophrenia. This deficit occurred in the context of normal practice-dependent learning within a training session. This behavioral dissociation is consistent with evidence that practice- and sleep-dependent motor learning reflect independent processes and suggests that they are differentially affected in schizophrenia.
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Affiliation(s)
- Dara S Manoach
- Department of Psychiatry, Massachusetts General Hospital-East, Rm. 420, 36 First Avenue, Charlestown, MA 02129, USA.
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Roth RM, Baribeau J, Milovan D, O'Connor K, Todorov C. Procedural and declarative memory in obsessive-compulsive disorder. J Int Neuropsychol Soc 2004; 10:647-54. [PMID: 15327712 DOI: 10.1017/s1355617704105018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2003] [Revised: 10/29/2003] [Indexed: 11/06/2022]
Abstract
Obsessive-compulsive disorder (OCD) has been associated with frontostriatal abnormality. This has led to the hypothesis that the disorder is characterized by abnormality of procedural memory. However, evidence for either procedural or declarative memory disturbance has been mixed, and few studies have directly assessed both of these forms of memory in the same patient group. In the present study, we assessed encoding and retrieval in declarative memory using the Rey Auditory Verbal Learning Test (RAVLT), and procedural memory using the Pursuit Rotor Task, in 27 adults with OCD and 29 matched healthy controls. Groups did not differ with respect to salient demographic characteristics or memory on the RAVLT. In contrast, patients with OCD performed significantly better than controls during the early, but not later trial blocks of the Pursuit Rotor Task. This pattern of results indicates intact encoding and retrieval in declarative memory, but abnormally enhanced procedural memory during the early course of learning in OCD. These findings may be consistent with striatal overactivation observed in neuroimaging studies of OCD, as well as the prominent role of the striatum during early stages of procedural memory.
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Affiliation(s)
- Robert M Roth
- Neuropsychology Program, Department of Psychiatry, Dartmouth Medical School, Lebanon, NH 03756-0001, USA.
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20
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Scherer H, Bedard MA, Stip E, Paquet F, Richer F, Bériault M, Rodriguez JP, Motard JP. Procedural learning in schizophrenia can reflect the pharmacologic properties of the antipsychotic treatments. Cogn Behav Neurol 2004; 17:32-40. [PMID: 15209223 DOI: 10.1097/00146965-200403000-00004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Conventional and atypical antipsychotics have different affinities for D2 receptors, and these receptors are principally located in the striatum. Given that this cerebral structure was previously found to play a major role in procedural learning, the antipsychotic treatment in schizophrenia may be determinant for the procedural learning profile of these patients. OBJECTIVE The current study was aimed at verifying whether procedural learning differs in patients with schizophrenia treated with conventional antipsychotics and patients treated with atypical antipsychotics. METHOD Forty-five patients with schizophrenia were divided into 3 different groups according to their pharmacologic treatment: (1) haloperidol, a classical neuroleptic with high D2 receptor affinity; (2) clozapine, an atypical neuroleptic with practically no D2 receptor affinity; and (3) risperidone, an atypical neuroleptic that nevertheless shows high D2 receptor affinity. Patients were compared to 35 control subjects on a visuomotor procedural learning task (mirror drawing). RESULTS All patients were able to learn the task. However, those treated with haloperidol showed some degree of learning impairment, while those treated with clozapine or risperidone did not show this impairment. In addition, performance per se, regardless of the learning, was found to be affected in the haloperidol and risperidone, but not in the clozapine groups. CONCLUSION Procedural learning in schizophrenia may be differentially affected, depending on the pharmacologic profiles of the antipsychotics used for the treatment of this illness.
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Affiliation(s)
- Hélène Scherer
- Cognitive Neuroscience Center, Université du Québec à Montréal, Canada
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21
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Purdon SE, Woodward N, Lindborg SR, Stip E. Procedural learning in schizophrenia after 6 months of double-blind treatment with olanzapine, risperidone, and haloperidol. Psychopharmacology (Berl) 2003; 169:390-7. [PMID: 12827347 DOI: 10.1007/s00213-003-1505-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2002] [Accepted: 04/04/2003] [Indexed: 10/26/2022]
Abstract
RATIONALE First generation antipsychotics induce extrapyramidal motor symptoms (EPS), presumably through dopamine D(2) receptor blockade at the dorsal striatum. This may also produce impairment of cognitive processes, such as procedural learning, that are dependent on this region. Haloperidol and, to a lesser extent, risperidone, are active in the dorsal striatum and may induce EPS and impairment of procedural learning. In contrast, the prototypical second-generation antipsychotic, clozapine, is less active in the dorsal striatum and does not induce EPS or impair procedural learning. Olanzapine is pharmacologically similar to clozapine and has a low incidence of EPS induction. OBJECTIVES To assess the hypothesis that olanzapine would not have a deleterious effect on procedural learning. METHODS Thirty-nine subjects with early phase schizophrenia were randomly assigned to double blind treatment with haloperidol, risperidone, or olanzapine. They were administered the Tower of Toronto test at an unmedicated baseline and again following 6 weeks and 6 months of treatment. RESULTS Procedural learning, defined as the improvement observed between two blocks of five trials of the Tower of Toronto, was preserved after 6 weeks of all three treatments but showed a substantial decline after 6 months of treatment with haloperidol or risperidone. CONCLUSIONS These data are consistent with the differential activity of the three medications in dorsal striatum structures and suggest that the advantages of olanzapine over haloperidol and risperidone in relation to extrapyramidal syndromes may also generalize to procedural learning. The results also suggest that the procedural learning disadvantages of haloperidol and risperidone accrue slowly but are apparent after 6 months of treatment.
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Affiliation(s)
- Scot E Purdon
- Department of Psychiatry, University of Alberta, CHA-ANE, Box 307, Edmonton, Alberta, Canada T5J 2J7.
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22
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Weickert TW, Terrazas A, Bigelow LB, Malley JD, Hyde T, Egan MF, Weinberger DR, Goldberg TE. Habit and skill learning in schizophrenia: evidence of normal striatal processing with abnormal cortical input. Learn Mem 2002; 9:430-42. [PMID: 12464703 PMCID: PMC187584 DOI: 10.1101/lm.49102] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2002] [Accepted: 08/22/2002] [Indexed: 11/24/2022]
Abstract
Different forms of nondeclarative learning involve regionally specific striatal circuits. The motor circuit (involving the putamen) has been associated with motor-skill learning and the dorsolateral prefrontal cortex (DLPFC) circuit (involving the caudate) has been associated with cognitive-habit learning. Efforts to differentiate functional striatal circuits within patient samples have been limited. Previous studies have provided mixed results regarding striatal-dependent nondeclarative learning deficits in patients with schizophrenia. In this study, a cognitive-habit learning task (probabilistic weather prediction) was used to assess the DLPFC circuit and a motor-skill learning task (pursuit rotor) was used to assess the motor circuit in 35 patients with schizophrenia and 35 normal controls. Patients with schizophrenia displayed significant performance differences from controls on both nondeclarative tasks; however, cognitive-habit learning rate in patients did not differ from controls. There were performance and learning-rate differences on the motor-skill learning task between the whole sample of patients and controls, however, analysis of a subset of patients and controls matched on general intellectual level eliminated learning rate differences between groups. The abnormal performance offset between patients with schizophrenia and controls in the absence of learning rate differences suggests that abnormal cortical processing provides altered input to normal striatal circuitry.
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Affiliation(s)
- Thomas W Weickert
- Clinical Brain Disorders Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892, USA.
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23
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Kumari V, Gray JA, Honey GD, Soni W, Bullmore ET, Williams SCR, Ng VW, Vythelingum GN, Simmons A, Suckling J, Corr PJ, Sharma T. Procedural learning in schizophrenia: a functional magnetic resonance imaging investigation. Schizophr Res 2002; 57:97-107. [PMID: 12165380 DOI: 10.1016/s0920-9964(01)00270-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Procedural learning (PL) is a type of rule-based learning in which performance facilitation occurs with practice on task without the need for conscious awareness. Schizophrenic patients have often (though not invariably) been found to show impaired PL. We performed functional magnetic resonance imaging (fMRI) during a blocked, periodic sequence-learning task with groups of: (i) healthy subjects, and (ii) schizophrenic patients on conventional antipsychotics. Healthy subjects showed significant PL, but patients did not. In healthy subjects, PL was associated with increased activation in the striatum, thalamus, cerebellum, precuneus, medial frontal lobe, and cingulate gyrus. The power of activation in the thalamus, striatum, precuneus, cingulate gyrus and BA 6 was related to the magnitude of PL in these subjects. No regions, except the anterior inferior gyrus, were significantly activated in patients. The caudate nucleus, thalamus, precuneus, and sensorimotor regions were activated significantly differently between the two groups. The findings demonstrate the involvement of the striatum, cerebellum, thalamus, cingulate gyrus, precuneus, and sensorimotor regions in PL. Further fMRI studies of PL in normal subjects treated with conventional antipsychotics, drug naïve patients, and patients given atypical antipsychotics would help to clarify the roles of schizophrenic disease processes and antipsychotic medication in impaired PL and associated brain abnormalities in schizophrenia.
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Affiliation(s)
- Veena Kumari
- Section of Cognitive Psychopharmacology, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK.
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Raz N, Williamson A, Gunning-Dixon F, Head D, Acker JD. Neuroanatomical and cognitive correlates of adult age differences in acquisition of a perceptual-motor skill. Microsc Res Tech 2000; 51:85-93. [PMID: 11002356 DOI: 10.1002/1097-0029(20001001)51:1<85::aid-jemt9>3.0.co;2-0] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The objective of this study was to examine age differences in procedural learning and performance in conjunction with differential aging of central nervous system (CNS) structures. Sixty-eight healthy volunteers (age 22-80) performed a pursuit rotor task (four blocks of 20 15-second trials each). Volumes of the cerebellar hemispheres, neostriatum, prefrontal cortex, and hippocampus were measured from Magnetic Resonance (MR) images. Improvement in pursuit rotor performance was indexed by increase in time on target (TOT). A general improvement trend was evident across the blocks of trials. Overall, younger participants showed significantly longer TOT. The rate of improvement was age-invariant during the initial stages of skill acquisition but became greater in middle-aged participants as the practice progressed. When the influences of regional brain volumes were taken into account, the direct age effect on mean TOT measured during the first day of practice disappeared. Instead, reduced volumes of the cerebellar hemispheres and the putamen and poorer performance on nonverbal working memory tasks predicted shorter TOT. In contrast, neither the volume of the caudate and the hippocampus, nor verbal working memory showed association with motor performance. Pursuit rotor performance at the later stages of practice was unrelated to the reduction in putamen volume and was affected directly by age, cerebellar volume, and nonverbal working memory proficiency. We conclude that in a healthy population showing no clinical signs of extrapyramidal disease, age-related declines in procedural learning are associated with reduced volume of the cerebellar hemispheres and lower nonverbal working memory scores. During initial stages of skill acquisition, reduced volume of the putamen is also predictive of poorer performance.
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Affiliation(s)
- N Raz
- Department of Psychology, The University of Memphis, Memphis, Tennessee 38152-6400, USA.
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Kern RS, Green MF, Marshall BD, Wirshing WC, Wirshing D, McGurk S, Marder SR, Mintz J. Risperidone vs. haloperidol on reaction time, manual dexterity, and motor learning in treatment-resistant schizophrenia patients. Biol Psychiatry 1998; 44:726-32. [PMID: 9798076 DOI: 10.1016/s0006-3223(98)00088-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND The present study compared the effects of risperidone vs. haloperidol on reaction time, manual dexterity, and two types of motor learning in a sample of treatment-resistant schizophrenia patients. METHODS Fifty-six DSM-III-R diagnosed schizophrenia inpatients participated in a randomized, double-blind comparison of risperidone vs. haloperidol. Measures of reaction time, manual dexterity, motor sequence learning, and gross motor learning were administered at baseline, after 4 weeks of fixed-dose medication, and after 4 weeks of flexible-dose medication. RESULTS The results indicated that patients receiving risperidone showed greater improvement in reaction time and manual dexterity than patients receiving haloperidol. After covarying symptom changes and movement disorder ratings, the results remained significant. The two treatment groups did not differ on either measure of motor learning. CONCLUSIONS The differences in performance in reaction time and manual dexterity may be due to a specific beneficial effect of risperidone, as opposed to a general reduction in extrapyramidal symptom liability, compared to haloperidol.
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Affiliation(s)
- R S Kern
- UCLA Department of Psychiatry and Biobehavioral Sciences, USA
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26
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Green MF, Kern RS, Williams O, McGurk S, Kee K. Procedural learning in schizophrenia: evidence from serial reaction time. Cogn Neuropsychiatry 1997; 2:123-34. [PMID: 25420200 DOI: 10.1080/135468097396360] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Although schizophrenic patients, as a group, show deficits on measures of explicit learning, it is unclear whether they also have deficits on measures of implicit learning. The current study assessed procedural learning in a sample of 48 chronic schizophrenic inpatients and 23 normal controls using the serial reaction time test (SRT). In addition, we examined the clinical correlates of procedural learning. The SRT yields indices of total motor learning and two subcomponents: reaction time learning, and sequence learning. Although patients performed comparably to normal controls on total motor learning, they showed significantly less sequence learning (P <.03) than controls. Reaction time learning did not differ between the two groups. None of the symptom or clinical variables was correlated with the indices of learning. Chronic schizophrenic inpatients showed normal levels of procedural learning on the SRT. However, their learning was qualitatively different than that of controls (i.e. patients showed deficits in sequence learning, but not reaction time learning). Reduced sequence learning could reflect dysfunctional cortico-cerebellar circuits.
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27
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Kern RS, Green MF, Wallace CJ. Declarative and procedural learning in schizophrenia: a test of the integrity of divergent memory systems. Cogn Neuropsychiatry 1997; 2:39-50. [PMID: 25420138 DOI: 10.1080/135468097396405] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
A comparison of learning rates between schizophrenia patients and normals on measures tapping different memory systems may provide clues about relatively preserved areas of learning in schizophrenia. The present study assessed declarative (nonsense syllable list learning) and procedural (pursuit rotor tracking) learning in a group of chronic schizophrenia inpatients and a group of normal adults. Approximately equivalent baselines were obtained for the two groups on both measures. The results revealed a significant group trial interaction on the declarative memory measure, exemplified by a shallower learning slope for the patient group. For the procedural learning measure, there was no significant group block interaction; that is, both groups showed similar learning slopes. These findings suggest a relative preservation of selected procedural aspects of learning in schizophrenia.
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Kumari V, Corr PJ, Mulligan OF, Cotter PA, Checkley SA, Gray JA. Effects of acute administration of d-amphetamine and haloperidol on procedural learning in man. Psychopharmacology (Berl) 1997; 129:271-6. [PMID: 9084066 DOI: 10.1007/s002130050190] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The effects of an indirect dopamine-agonist, d-amphetamine, and a non-selective dopamine receptor antagonist, haloperidol, were investigated in normal male volunteers using a between-subjects double-blind design in a procedural learning task, thought mainly to involve unconscious/automatic learning. The results showed: (1) d-amphetamine facilitated response speed, whereas haloperidol inhibited it, in comparison to placebo; (2) the linear increase in procedural learning corresponded with pharmacological manipulation of degree of dopaminergic activity, i.e. subjects given haloperidol showed the least, and subjects given d-amphetamine the greatest, procedural learning. The implications of these findings are discussed in relation to investigation of abnormalities of procedural learning processes in schizophrenia.
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Affiliation(s)
- V Kumari
- Department of Psychology, Institute of Psychiatry, University of London, UK
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29
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Schwartz BL, Rosse RB, Veazey C, Deutsch SI. Impaired motor skill learning in schizophrenia: implications for corticostriatal dysfunction. Biol Psychiatry 1996; 39:241-8. [PMID: 8645770 DOI: 10.1016/0006-3223(95)00130-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We assessed skill learning in young and older schizophrenic patients using the rotary pursuit task. Schizophrenic patients displayed impaired learning on this task compared with normal control subjects, but older patients were not more impaired than young ones. The patients' rotary pursuit learning was not correlated to the severity of abnormal movements or to their treatment with medication, but it was associated to conceptual abilities assessed on the Dementia Rating Scale (Mattis 1988). An impairment in acquiring motor procedures in this task might reflect neuropsychological deficits associated with corticostriatal pathology.
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Affiliation(s)
- B L Schwartz
- Department of Veterans Affairs Medical Center, Psychiatry Service (116A), Washington, DC 20422, USA
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30
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Buckley P, O'Callaghan E, Mulvany F, Larkin C, Stack JP, Redmond O, Ennis JT, Thompson P, Waddington JL. Basal ganglia T2 relaxation times in schizophrenia: a quantitative magnetic resonance imaging study in relation to tardive dyskinesia. Psychiatry Res 1995; 61:95-102. [PMID: 7480392 DOI: 10.1016/0925-4927(95)02591-k] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Transverse, or spin-spin, relaxation times (T2) from magnetic resonance images of basal ganglia structures were compared between control subjects and patients with schizophrenia, who were subdivided on the basis of the presence or absence of tardive dyskinesia. As a group, schizophrenic patients showed evidence of somewhat more prolonged T2 relaxation times in the right putamen and globus pallidus than did control subjects; there were no significant correlations between hemispheric T2 values and corresponding volumes of the lateral ventricles. Overall, there was little difference in T2 values between patients with and without tardive dyskinesia. These data extend the range of evidence for basal ganglia dysfunction in schizophrenia, but they do not support earlier reports of prominent T2 changes associated with tardive dyskinesia.
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Affiliation(s)
- P Buckley
- Department of Psychiatry, Case Western Reserve University, University Hospitals of Cleveland, OH 44106, USA
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31
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Abstract
Recent evidence indicates that the basal ganglia are critical brain structures for motor-skill and habit learning, and may be important for the acquisition of some perceptual and cognitive skills. The cerebellum appears to contribute importantly only to motor-skill learning. Transitory cortical changes occur during motor-skill learning, but perceptual-skill learning may involve a semi-permanent change in neuronal sensitivity in the primary sensory cortex.
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Affiliation(s)
- D P Salmon
- Department of Neurosciences, University of California at San Diego, La Jolla 92093-0948, USA
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32
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Elkashef AM, Egan MF, Frank JA, Hyde TM, Lewis BK, Wyatt RJ. Basal ganglia iron in tardive dyskinesia: an MRI study. Biol Psychiatry 1994; 35:16-21. [PMID: 8167198 DOI: 10.1016/0006-3223(94)91161-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Alterations in brain iron could play an important role in the development of tardive dyskinesia in patients receiving neuroleptic medication. To test this hypothesis, magnetic resonance imaging scans of the brain were performed on 21 chronic schizophrenic patients. Ten patients met research diagnostic criteria for persistent tardive dyskinesia, and 11 were free of tardive dyskinesia. All patients had received long-term neuroleptic treatment and were on a stable neuroleptic dose for at least 3 months before scanning. The signal intensity of basal ganglia structures was obtained as a quantitative estimate of brain iron content. No difference was found in the signal intensity ratios between the two groups. This suggests that iron deposition in the basal ganglia, at least as assessed by this measure, does not play a role in the pathophysiology of tardive dyskinesia.
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Affiliation(s)
- A M Elkashef
- Neuropsychiatry Branch, NIMH, St. Elizabeths Hospital, Washington, DC 20032
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