Neuropsychological variability, symptoms, and brain imaging in chronic schizophrenia
We examined variability in performance on widely-used neuropsychological Wechsler tests of intelligence and memory in a large sample of persons with chronic schizophrenia, a subset of whom had also undergone prior studies of magnetic resonance imaging (MRI) of the orbital frontal cortex (OFC) gray matter and diffusion tensor imaging (DTI) of the cingulum bundle (CB) and the uncinate fasiculus (UF) white matter. In comparison to controls, persons with schizophrenia showed lower scores across neuropsychological tests, with most pronounced drops in processing speed and immediate memory, in relation to oral reading. For patients, greater declines in intelligence and memory each correlated with reduced CB white matter fractional anisotropy and reduced OFC gray matter, respectively. However, only memory decline correlated with severity of negative symptoms. Taken together, these data raise the intriguing question as to whether communication and motivational deficits expressed in negative symptoms may contribute to the relationship of auditory memory decline and OFC volume observed in this patient sample.
KeywordsSchizophrenia Cingulum bundle Orbital frontal cortex Intelligence Memory
This work was supported by the National Institute of Health (K02 MH 01110 and R01 MH 50747 to Martha E. Shenton, R01 MH 40799 and P50 080272 to Robert W. McCarley, RO1 MH 63360 to and Margaret Niznikiewicz, R03 MH068464-01 to Marek Kubicki), National Alliance for Research on Schizophrenia and Depression (Marek Kubicki), the Department of Veterans Affairs Merit Awards (Martha E. Shenton, James J. Levitt and Margaret Niznikiewicz, Paul G. Nestor and Robert W. McCarley), and the Department of Veterans Affairs Schizophrenia Center (Robert W. McCarley). This work is also part of the National Alliance for Medical Image Computing (NAMIC), funded by the National Institutes of Health through the NIH Roadmap for Medical Research, Grant U54 EB005149 (Martha E. Shenton and Marek Kubicki).
- Andreasen, N. (1983). The Scale for the Assessment of Negative Symptoms (SANS). Iowa City: The University of Iowa.Google Scholar
- Andreasen, N. (1984). The Scale for the Assessment of Positive Symptoms (SAPS). Iowa City: The University of Iowa.Google Scholar
- Armstrong E, Schleicher A, Omran H, Curtis M, & Zilles K. (1995). The ontogeny of human gyrification. Cerebral Cortex, 5, 56–63.Google Scholar
- Cohen, J., & Cohen, P. (1975). Applied multiple regression/correlational analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates.Google Scholar
- Duvernoy H. M. (1999). The human brain: surface, three-dimensional sectional anatomy with MRI, and blood supply. New York, NY: Springer-Verlag Wien.Google Scholar
- First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2002). Structured clinical interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCIDI/P). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
- Harvey, P. D., Friedman, J. I., Bowie, C., Reichenberg, A., McGurk, S. R., Parrella, M., et al. (2006). Validity and stability of performance-based estimates of premorbid educational functioning in older patients with schizophrenia. Journal of Clinical and Experimental Neuropsychology, 28(2), 178–192.PubMedCrossRefGoogle Scholar
- Kay, S. R., Opler, L. A., & Fiszbein, A. (1986). Positive and Negative Syndrome Scale (PANNS) Manual. North Tonawanda: Mental Health Systems, Inc.Google Scholar
- Kraepelin, E. (1919). In G. M. Robertson (Ed.), Dementia praecox and Paraphrenia (trans: Barclay, R.M.). New York: Robert E. Kriege. reprinted 1971.Google Scholar
- Mesulam M.M. (1985). Principles of behavioral and cognitive neurology. Philadelphia: F.A. Davis.Google Scholar
- Morecraft, R.J., Geula, C., & Mesulam, M.M. (1992). Cytoarchitecture and neural afferents of orbitofrontal cortex in the brain of the monkey. Journal of Comparative Neurology, 323, 341–7358.Google Scholar
- Nestor, P. G., Nakamura, M., Niznikiewicz, M., Thompson, E., Levitt, J. J., Choate, V., et al. (2012). In search of the functional neuroanatomy of sociality: MRI subdivisions of frontal cortex and social cognition. Social, Cognitive, and Affective Neuroscience. doi: 10.1093.
- Pandya, D.N., Van Hoesen, G.W., & Mesulam, M.M (1981). Efferent connections of the cingulate gyrus in the rhesus monkey. Experimental Brain Research, 42, 319–330Google Scholar
- Rakic P. (1988). Specification of cerebral cortical areas. Science, 241, 170–176.Google Scholar
- Seidman, L. J., Faraone, S. V., Goldstein, J. M., Kremen, W. S., Horton, N. J., Makris, N., et al. (2002). Left hippocampal volume as a vulnerability indicator for schizophrenia: a magnetic resonance imaging morphometric study of nonpsychotic first-degree relatives. Archives of General Psychiatry, 59(9), 839–849.PubMedCrossRefGoogle Scholar
- Seidman, L. J., Giuliano, A. J., Smith, C. W., Stone, W. S., Glatt, S. J., Meyer, E., et al. (2006). Neuropsychological functioning in adolescents and young adults at genetic risk for schizophrenia and affective psychoses: results from the Harvard and Hillside Adolescent High Risk Studies. Schizophrenia Bulletin, 32(3), 507–524.PubMedCrossRefGoogle Scholar
- Vogt, B.A., & Pandya, D.N. (1987). Cingulate cortex of the rhesus monkey: II. Cortical afferents. Journal of Comparative Neurology, 262, 271–289Google Scholar
- Wechsler, D. (1997a). Manual for the Wechsler adult intelligence scale (3rd ed.). San Antonio: Psychological Corporation.Google Scholar
- Wechsler, D. (1997b). Wechsler Memory Scale — Third edition (WMS-III). San Antonio: The Psychological Corporation.Google Scholar
- Wilkinson, G. S. (1993). Wide Range Achievement Test Revision 3. Wilmington: Wide Range, Inc.Google Scholar