Brain, Vol 120, Issue 10 1823-1843, Copyright © 1997 by Oxford University Press
C Pantelis, TR Barnes, HE Nelson, S Tanner, L Weatherley, AM Owen and TW Robbins
Spatial working memory and planning abilities were assessed in 36
hospitalized patients with chronic schizophrenia, using the computerized
Cambridge Neuropsychological Test Automated Battery (CANTAB), and compared
with those of normal subjects and patients with neurological disorders
(frontal lobe lesions; temporal lobe and amygdalohippocampal lesions;
Parkinson's disease), matched for age, sex and National Adult Reading Test
IQ. The patients in the group with temporal lobe lesions were unimpaired in
their performance on these tasks. Patients with schizophrenia were impaired
on visuo-spatial memory span compared with all the other groups, while
severity of Parkinson's disease was correlated with the degree of
impairment on this task. The patients with schizophrenia and those with
frontal lobe lesions were impaired on a 'spatial working memory' task, with
increased 'between-search errors'. Patients with Parkinson's disease
performed this task poorly compared with the younger control subjects.
Patients with schizophrenia were unable to develop a systematic strategy to
complete this task, relying instead on a limited visuo- spatial memory
span. Higher level planning ability was investigated using the CANTAB
'Tower of London'. All groups were equally able to complete the task.
However, the groups of patients with schizophrenia and frontal lobe lesions
made fewer perfect solutions and required more moves for completion.
Movement times were significantly slower in the schizophrenia group,
suggesting impairment in the sensorimotor requirements of the task. The
patients with schizophrenia were not impaired in their 'initial thinking'
(planning) latencies, but had significantly prolonged 'subsequent thinking'
(execution) latencies. This pattern resembled that of the group with
frontal lobe lesions and contrasted with the prolonged 'initial thinking'
time seen in Parkinson's disease. The results of this study are indicative
of an overall deficit of executive functioning in schizophrenia, even
greater than that seen in patients with frontal lobe lesions. However, the
pattern of results in schizophrenia resembled that seen in patients with
lesions of the frontal lobe or with basal ganglia dysfunction, providing
support for the notion of a disturbance of frontostriatal circuits in
schizophrenia. Our findings also indicate that there is a loss of the
normal relationships between different domains of executive function in
schizophrenia, with implications for impaired functional connectivity
between different regions of the neocortex.
ARTICLES
Frontal-striatal cognitive deficits in patients with chronic schizophrenia
Cognitive Neuropsychiatry Unit, Mental Health Research Institute, Parkville, Victoria, Australia.
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