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Functional hypofrontality and working memory dysfunction in schizophrenia

C S Carter1, W Perlstein, R Ganguli

  • 1Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, PA 15213, USA. cscarter+@pitt.edu

The American Journal of Psychiatry
|September 12, 1998
PubMed
Summary
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Schizophrenia patients show reduced prefrontal cortex activity during demanding working memory tasks. This hypofrontality is reliably detected using functional neuroimaging and cognitive challenges like the N-back task.

Area of Science:

  • Neuroscience
  • Psychiatry

Background:

  • Hypofrontality, or reduced prefrontal cortex activity, is inconsistently observed in schizophrenia research.
  • Previous studies may have lacked specific cognitive demands to reliably detect these abnormalities.

Purpose of the Study:

  • To investigate prefrontal cortex (PFC) function in schizophrenia using a task that specifically engages working memory.
  • To determine if specific cognitive challenges can reveal reliable patterns of hypofrontality in schizophrenia.

Main Methods:

  • Eight patients with schizophrenia and eight healthy controls underwent [(15)O]H2O positron emission tomography (PET).
  • Participants completed the N-back task, a working memory challenge that increases cognitive load on the PFC.
  • Regional cerebral blood flow (rCBF) was measured to assess PFC activity.

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Main Results:

  • Both groups performed equally at low working memory loads.
  • Schizophrenia patients showed significantly greater performance decline than controls as memory load increased.
  • A reduced rCBF response to increased working memory load was observed in the right dorsolateral prefrontal cortex of patients.

Conclusions:

  • The findings underscore the necessity of employing tasks with specific cognitive demands for studying brain-behavior relationships in schizophrenia.
  • Hypofrontality is a reliable finding in schizophrenia when utilizing tasks that engage the working memory functions of the prefrontal cortex.