Neuropsychological correlates of syndromes in schizophrenia | The British Journal of Psychiatry | Cambridge Core (original) (raw)
Abstract
Background
On the basis of Liddle's three-syndrome model of schizophrenia, it was predicted that: (1) symptoms of psychomotor poverty would be particularly correlated with impaired performance on neuropsychological tests likely to reflect functioning of the dorsolateral prefrontal cortex; (2) disorganisation would be particularly correlated with impaired performance on tests sensitive to medio-basal prefrontal functioning; and (3) reality distortion would be particularly correlated with measures sensitive to temporal lobe functioning.
Method
The above hypotheses were tested on 87 subjects with a confirmed diagnosis of schizophrenia. Patients' symptoms were scored for each of the three syndromes. Patients completed six neuropsychological tests designed to measure impairment in specific areas of the brain.
Results
There was no support for the first two hypotheses. There was, however, evidence of a specific relationship between reality distortion and neuropsychological performance usually considered to be related to left temporal lobe functioning.
Conclusions
Although not directly supporting the first two hypotheses; the results are, in general, consistent with there being different cortical-subcortical circuits associated with each of psychomotor poverty and disorganisation. Temporal lobe functioning appears to have particular significance for the reality distortion syndrome.
Information
Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists
Access options
Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)
Article purchase
Temporarily unavailable
References
Alexander, G. E., De Long, M. R. & Strick, R. L. (1986) Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neurosdence, 9, 357–381.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1983) The Scale for Assessnnent of Negative Symptoms (SANS), Iowa City, IA: University of Iowa.Google Scholar
Andreasen, N. C. (1984) The Scale for Assessment of Positive Symptoms (SAPS), Iowa City IA: University of Iowa.Google Scholar
Barta, P. E., Pearlson, G. D., Powers, R. E., et al (1990) Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia. American Journal of Psychiatry, 147, 1457–1462.Google ScholarPubMed
Benton, A. L., Hanay, J. & Varney, N. R. (1975) Visual perception of line direction in patients with unilateral brain disease. Neurology, 25, 907–910.Google Scholar
Berg, E A. (1948) A simple objective treatment for measuring flexibility in thinking. Journol of General Psychology, 39, 15–22.CrossRefGoogle Scholar
Brown, K. W. & White, T. (1992) Syndromes of chronic schizophrenia and some clinical correlates. British Journal of Psychiatry, 161, 317–322.Google Scholar
Cummings, J. L. (1993) Frontal-subcortical circuits and human behavior Archives of Neurology, 50, 873–880.Google Scholar
Delaney, R. C., Rosen, A. J., Mattson, R. J. et al (1980) Memory function in focal epilepsy: a comparison of nonsurgical, unilateral temporal lobe and frontal lobe samples. Cortex, 16, 103–117.Google Scholar
Frith, C. D., Friston, K. J., Silbersweig, D., et al (1995) Regional brain activity in chronic schizophrenic patients during the performance of a verbal fluency task. British Journal of Psychiatry, 167, 343–349.Google Scholar
Guilmetta, T. J. & Rasile, D. (1995) Sensitivity specificity and diagnostic accuracy of three verbal memory measures in the assessment of mild brain injury Neuropsychology, 9, 338–344.CrossRefGoogle Scholar
Jones-Gotman, M. & Milnar, B. (1977) Design fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia, 15, 653–674.CrossRefGoogle ScholarPubMed
Kaplan, R. D., Szechtman, H., Franco, S., et al (1993) Three clinical syndromes of schizophrenia in untreated subjects: relation to brain glucose activity measured by positron emission tomography (PET). Schizophrenia Research, 11, 47–54.Google Scholar
Kolb, B. & Whishaw, I. Q. (1989) Performance of schizophrenic patients on tests sensitive to left or right frontal temporal or parietal function in neurological patients. Journal of Nervous and Mental Disease, 171, 435–443.CrossRefGoogle Scholar
Lezak, M. D. (1995) Neuropsychological Assessment (3rd edn). New York, NY Oxford University Press.Google Scholar
Liddle, P. F. (1987a) The symptoms of chronic schizophrenia: a re-examination of the positive-negative dichotomy British Journal of Psychiatry, 151, 145–151.CrossRefGoogle ScholarPubMed
Liddle, P. F. (1987b) Schizophrenic syndromes, cognitive performance and neurological dysfunction. Psychological Medicine, 17, 49–57.Google Scholar
Liddle, P. F. & Morris, D. L. (1991) Schizophrenic syndromes and frontal tobe performance. British Journal of Psychiatry, 158, 340–345.CrossRefGoogle Scholar
Liddle, P. F. & Morris, D. L., Friston, K. J., Frith, C. D., et al (1992) Patterns of cerebral blood flow in schizophrenia. British Journal of Psychiatry, 160, 179–186.CrossRefGoogle ScholarPubMed
Malla, A. K., Norman, R. M. G., Williamson, P., et al (1993) Three syndrome concept of schizophrenia: a factor analytic study Schizophrenia Research, 10, 143–150.Google Scholar
Meng, X.-L., Rosenthal, R. & Rubin, D. R. (1992) Comparing correlated correlation coefficients. Psychological Bulletin, 3, 172–175.Google Scholar
Milner, B. (1964) Some effects of frontal lobectomy in man. In The Frontal Granular Cortex and Behavior (eds Warren, J. M. & Akert, K.), pp 313–334.Google Scholar
Milner, B. (1975) Psychological aspects of focal epilepsy and its neurotogical management. In Advances in Neurology Vol. 8 (eds Pupura, D R., Penry, J. K. & Walter, R. D.) pp 299–321. New York: Raven Press.Google Scholar
Mogenson, G. J. (1987) Limbic-motor integration. Progress in Psychobiology and Physiological Psychology, 42, 117–170. New York: Academic Press.Google Scholar
Pantelis, C. & Nelson, H. E., (1994) Cognitive functioning and symptomatology in schizophrenia: the role of frontal-subcortical systems. In The Neuropsychology of Schizophrenia (eds David, A. S. & Cotting, J. C.), pp. 215–229. Hove: Lawrence Eribaum.Google Scholar
Pardo, J. V., Perdo, P. J., Janer, K. W., et al (1990) The anterior cingulate mediates processing selection in the Stroop attentional conflict paradigm. Proceedings of the National Academy of Sciences of the USA, 87, 256.CrossRefGoogle ScholarPubMed
Rey, A. (1964) L'examen Clinique en Psychologic, Paris: Presses Universitaires de France.Google Scholar
Robbins, T. W. (1990) The case for frontostriatal dysfunction in schizophrenia. Schizophrenia Bulletin, 16, 391–402.CrossRefGoogle ScholarPubMed
Seidman, L. J., Yurgelun-Todd, D., Kremen, W. S., et al (1994) Relationship of prefrontal and temporal lobe MRI meeasures to neuropsychological perfomnance in chronic schizophrenia. Biological Psychiatry, 35, 235–246.CrossRefGoogle ScholarPubMed
Spitzer, R. L. & Williams, J. B. W. (1985) Structured Clinical Interview for DSM-III-R-Patient Version, New York, NY: New York State Psychiatric Institute.Google Scholar
Stroop, J. R. (1935) Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643–661.CrossRefGoogle Scholar
Stuss, D. T., Guberman, A., Nelson, R., et al (1988) The neuropsychology of paramedian thalamic infarction. Brain and Cognition, 8, 348–378.Google Scholar
Taylor, E. M. (1991) Psychological Appraisal of Children with Cerebral Deficits, Cambridge. MA: Harvard University Press.Google Scholar
Wechsler, D. (1987) Wechsler Memory Scale – Revised Manual, San Antonio, TX: Psychological Corporation.Google Scholar
Weinberger, D. R., Berman, K. F., Suddath, R., et al (1992) Evidence of a prefrontal-limbic network in schizophrenia; a magnetic resonance imaging and regional cerebral blood flow study of discordant monozygotic twins. American Journal of Psychiatry, 149, 890–897.Google Scholar