Learned control of slow potential interhemispheric asymmetry in schizophrenia

We report on the feasibility of teaching 16 (DSM-IV) schizophrenic patients, subdivided by syndrome, self-regulation of interhemispheric asymmetry having demonstrated efficient learning of interhemispheric control in normal subjects. Reversal of asymmetry may be important to treatment and recovery in schizophrenia for following improvement on neuroleptic drugs functional hemispheric asymmetries have reversed, with directions of reversal and pre-existing asymmetry dependent on syndrome. Asymmetry reversal in animals, manifested by spatial turning tendencies, has been used as a marker of neuroleptic action and involves striatal dopamine under reciprocal hemispheric control. We gave as feedback the left right asymmetry in slow potential negativity recorded from the sensory motor strip (C3,4). Feedback took the form of a rocket on a screen which rose or fell with leftward or rightward shifts in negativity. Patients were able to learn control (P < 0.01). In those patients with lesser ability this was due to inability to sustain concentration throughout the session rather than slow initial learning. Active syndrome patients were better able to shift negativity rightward and withdrawn patients leftward, directions associated with drug reversal of functional asymmetry and symptom recovery for each syndrome. Accordingly our demonstration that many symptomatic schizophrenic patients are capable of learning control opens the door to electrocortical operant conditioning training in schizophrenia with therapeutic regimens.