Disrupted functional brain connectivity during verbal working memory in children and adolescents with schizophrenia

Children and adolescents who develop schizophrenia tend to have greater symptom severity than adults who develop the illness. Since the brain continues to mature into early adulthood, developmental differences in brain structure and function may provide clues to the underlying neurobiology of schizophrenia. With an emerging body of evidence supporting disrupted connectivity contributing to the underlying pathophysiology of schizophrenia, it was our goal to assess differences in functional connectivity in children and adolescents who develop schizophrenia. Participants included a total of 28 children and adolescents (14 patients with schizophrenia and 14 age- and gender-matched controls). All subjects underwent a functional magnetic resonance imaging scan involving a modified Sternberg Item Recognition Paradigm with 3 working memory (WkM) loads. Patients had poorer performance at all 3 WkM loads without a load by diagnosis interaction. Functional imaging results demonstrated 3 specific brain networks disrupted in children and adolescents with schizophrenia. These networks include 1) the anterior cingulate and the temporal lobes, bilaterally; 2) the cerebellum with subcortical regions; and 3) the occipital lobe and the cerebellum. Patients with early-onset schizophrenia demonstrate abnormal functional connectivity in networks involving limbic, temporal lobe, cerebellum, and early visual processing streams.