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Neural correlates of semantic associations in patients with schizophrenia

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Abstract

Patients with schizophrenia have semantic processing disturbances leading to expressive language deficits (formal thought disorder). The underlying pathology has been related to alterations in the semantic network and its neural correlates. Moreover, crossmodal processing, an important aspect of communication, is impaired in schizophrenia. Here we investigated specific processing abnormalities in patients with schizophrenia with regard to modality and semantic distance in a semantic priming paradigm. Fourteen patients with schizophrenia and fourteen demographically matched controls made visual lexical decisions on successively presented word-pairs (SOA = 350 ms) with direct or indirect relations, unrelated word-pairs, and pseudoword-target stimuli during fMRI measurement. Stimuli were presented in a unimodal (visual) or crossmodal (auditory-visual) fashion. On the neural level, the effect of semantic relation indicated differences (patients > controls) within the right angular gyrus and precuneus. The effect of modality revealed differences (controls > patients) within the left superior frontal, middle temporal, inferior occipital, right angular gyri, and anterior cingulate cortex. Semantic distance (direct vs. indirect) induced distinct activations within the left middle temporal, fusiform gyrus, right precuneus, and thalamus with patients showing fewer differences between direct and indirect word-pairs. The results highlight aberrant priming-related brain responses in patients with schizophrenia. Enhanced activation for patients possibly reflects deficits in semantic processes that might be caused by a delayed and enhanced spread of activation within the semantic network. Modality-specific decreases of activation in patients might be related to impaired perceptual integration. Those deficits could induce and increase the prominent symptoms of schizophrenia like impaired speech processing.

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Notes

  1. The use of CPZ equivalents is a common practice to chart the relative antipsychotic potencies of antipsychotic drugs.

  2. As one anonymous reviewer pointed out medication and illness duration might be considered as covariates for the analyses. However, an earlier meta-analysis showed that duration of illness had no effect on results of semantic priming [33]. However, we tried to keep our patient sample as homogeneous as possible via including only moderately ill patients. Medication status clearly influences neurocognitive functions but only patients that were on stable doses of atypical antipsychotic medication were included (e.g., risperidone, aripiprazole, quetiapine). In addition, earlier studies did not found any relation between medication and verbal memory in the treatment of schizophrenia [37].

  3. We thank one anonymous reviewer for this suggestion.

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Acknowledgments

We thank Georg Eder for fMRI data acquisition and Antonia Green for their support during the data collection as well as Franziska Kintzel for her help with data analyses. This work is supported by a grant from the Interdisciplinary Center for Clinical Research “BIOMAT” within the Faculty of Medicine at the RWTH Aachen University (IZKF VV N3) and by the International Research Training Group (IRTG 1328) of the German Research Foundation (DFG). KS funded by a grant from the German Research Foundation (DFG, SA 2221/3-1).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. School of Psychology, University of Queensland, St. Lucia, Brisbane, 4072, Australia

    Katharina Sass

  2. Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    Katharina Sass, Stefan Heim, Frank Schneider & Ute Habel

  3. Institute of Neurosciences and Medicine (INM-1), Research Centre Jülich, Jülich, Germany

    Stefan Heim

  4. Section Neurological Cognition Research, Department of Neurology, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    Stefan Heim

  5. Committee on the Use of Human Subjects, Faculty of Arts and Sciences, Harvard University, Cambridge, MA, USA

    Olga Sachs

  6. Department of Psychiatry und Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Straße, 35039, Marburg, Germany

    Benjamin Straube & Tilo Kircher

  7. JARA, Translational Brain Medicine, Aachen, Germany

    Katharina Sass, Stefan Heim, Frank Schneider & Ute Habel

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  1. Katharina Sass
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Correspondence to Katharina Sass.

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Sass, K., Heim, S., Sachs, O. et al. Neural correlates of semantic associations in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 264, 143–154 (2014). https://doi.org/10.1007/s00406-013-0425-0

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  • DOI: https://doi.org/10.1007/s00406-013-0425-0

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