Functional neuroanatomical correlates of episodic memory impairment in early phase psychosis
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Studies have demonstrated that episodic memory (EM) is often preferentially disrupted in schizophrenia. The neural substrates that mediate EM impairment in this illness are not fully understood. Several functional magnetic resonance imaging (fMRI) studies have employed EM probe tasks to elucidate the neural underpinnings of impairment, though results have been inconsistent. The majority of EM imaging studies have been conducted in chronic forms of schizophrenia with relatively few studies in early phase patients. Early phase schizophrenia studies are important because they may provide information regarding when EM deficits occur and address potential confounds more frequently observed in chronic populations. In this study, we assessed brain activation during the performance of visual scene encoding and recognition fMRI tasks in patients with earlyphase psychosis (n = 35) and age, sex, and race matched healthy control subjects (n = 20). Patients demonstrated significantly lower activation than controls in the right hippocampus and left fusiform gyrus during scene encoding and lower activation in the posterior cingulate, precuneus, and left middle temporal cortex during recognition of target scenes. Symptom levels were not related to the imaging findings, though better cognitive performance in patients was associated with greater right hippocampal activation during encoding. These results provide evidence of altered function in neuroanatomical circuitry subserving EM early in the course of psychotic illness, which may have implications for pathophysiological models of this illness.
KeywordsEpisodic memory Encoding Recognition Early phase psychosis fMRI Cognition
The authors thank Megan Gaunnac, Teresa Kulig, Emmalee Metzler, Heidi Hedrick, John West, Yang Wang, Kelsey Benson, Kami Walters, Katie White, Joan Showalter, and David Spradley for their technical support and recruitment efforts. The authors would also like to thank the Eskenazi Health Midtown Community Mental Health Center for its continued research support.
The authors would like to thank the Stanley Medical Research Institute, grant #10T-002, for providing funding for this study. Additional support was obtained from grant #UH3TR000955, supported by the National Center For Advancing Translational Sciences of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Stanley Medical Research Institute or the National Institutes of Health.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation. Informed consent was obtained from all patients for being included in the study.
Drs. Francis, Hummer, Vohs, Liffick, Radnovich, McDonald, Saykin, and Breier and Ms. Mehdiyoun and Mr. Yung declare that they have no conflict of interest.
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