Abstract
Neurophysiological deficits in the left dorsolateral prefrontal cortex (DLPFC) have been described in positron emission tomography studies of schizophrenia and depression. In schizophrenia and depression this deficit has been associated with the syndromes of psychomotor poverty and psychomotor retardation, respectively. Such findings lead to a prediction that DLPFC dysfunction is symptom rather than disease related. This prediction was empirically tested in a retrospective study that pooled data from 40 patients meeting research diagnostic criteria for depression and 30 patients meeting DSM-III R criteria for schizophrenia. The patients were categorised into those with and without poverty of speech, a symptom that is an observable manifestation of psychomotor impairment. The profile of regional cerebral blood flow (rCBF), measured in all subjects under resting conditions, was subsequently compared in these two groups. Patients with poverty of speech had significantly lower rCBF in the left DLFPC. This reduction of rCBF was independent of diagnosis. The findings support the view that the study of symptoms, or symptom clusters, can provide information additional to that of traditional diagnostic systems in the study of the major psychoses.
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- Baxter L. R., Jr, Schwartz J. M., Phelps M. E., Mazziotta J. C., Guze B. H., Selin C. E., Gerner R. H., Sumida R. M. Reduction of prefrontal cortex glucose metabolism common to three types of depression. Arch Gen Psychiatry. 1989 Mar;46(3):243–250. doi: 10.1001/archpsyc.1989.01810030049007. [DOI] [PubMed] [Google Scholar]
- Bench C. J., Friston K. J., Brown R. G., Frackowiak R. S., Dolan R. J. Regional cerebral blood flow in depression measured by positron emission tomography: the relationship with clinical dimensions. Psychol Med. 1993 Aug;23(3):579–590. doi: 10.1017/s0033291700025368. [DOI] [PubMed] [Google Scholar]
- Bench C. J., Friston K. J., Brown R. G., Scott L. C., Frackowiak R. S., Dolan R. J. The anatomy of melancholia--focal abnormalities of cerebral blood flow in major depression. Psychol Med. 1992 Aug;22(3):607–615. doi: 10.1017/s003329170003806x. [DOI] [PubMed] [Google Scholar]
- Costello C. G. Research on symptoms versus research on syndromes. Arguments in favour of allocating more research time to the study of symptoms. Br J Psychiatry. 1992 Mar;160:304–308. doi: 10.1192/bjp.160.3.304. [DOI] [PubMed] [Google Scholar]
- DeLisi L. E., Holcomb H. H., Cohen R. M., Pickar D., Carpenter W., Morihisa J. M., King A. C., Kessler R., Buchsbaum M. S. Positron emission tomography in schizophrenic patients with and without neuroleptic medication. J Cereb Blood Flow Metab. 1985 Jun;5(2):201–206. doi: 10.1038/jcbfm.1985.26. [DOI] [PubMed] [Google Scholar]
- Endicott J., Spitzer R. L. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry. 1978 Jul;35(7):837–844. doi: 10.1001/archpsyc.1978.01770310043002. [DOI] [PubMed] [Google Scholar]
- Friston K. J., Frith C. D., Liddle P. F., Dolan R. J., Lammertsma A. A., Frackowiak R. S. The relationship between global and local changes in PET scans. J Cereb Blood Flow Metab. 1990 Jul;10(4):458–466. doi: 10.1038/jcbfm.1990.88. [DOI] [PubMed] [Google Scholar]
- Friston K. J., Frith C. D., Liddle P. F., Frackowiak R. S. Comparing functional (PET) images: the assessment of significant change. J Cereb Blood Flow Metab. 1991 Jul;11(4):690–699. doi: 10.1038/jcbfm.1991.122. [DOI] [PubMed] [Google Scholar]
- Friston K. J., Frith C. D., Liddle P. F., Frackowiak R. S. Plastic transformation of PET images. J Comput Assist Tomogr. 1991 Jul-Aug;15(4):634–639. doi: 10.1097/00004728-199107000-00020. [DOI] [PubMed] [Google Scholar]
- Frith C. D., Friston K., Liddle P. F., Frackowiak R. S. Willed action and the prefrontal cortex in man: a study with PET. Proc Biol Sci. 1991 Jun 22;244(1311):241–246. doi: 10.1098/rspb.1991.0077. [DOI] [PubMed] [Google Scholar]
- HAMILTON M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960 Feb;23:56–62. doi: 10.1136/jnnp.23.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hachinski V. C., Iliff L. D., Zilhka E., Du Boulay G. H., McAllister V. L., Marshall J., Russell R. W., Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. doi: 10.1001/archneur.1975.00490510088009. [DOI] [PubMed] [Google Scholar]
- Heilman K. M., Pandya D. N., Geschwind N. Trimodal inattention following parietal lobe ablations. Trans Am Neurol Assoc. 1970;95:259–261. [PubMed] [Google Scholar]
- Ingvar D. H., Franzén G. Abnormalities of cerebral blood flow distribution in patients with chronic schizophrenia. Acta Psychiatr Scand. 1974;50(4):425–462. doi: 10.1111/j.1600-0447.1974.tb09707.x. [DOI] [PubMed] [Google Scholar]
- Johnstone E. C., Crow T. J., Frith C. D., Owens D. G. The Northwick Park "functional" psychosis study: diagnosis and treatment response. Lancet. 1988 Jul 16;2(8603):119–125. doi: 10.1016/s0140-6736(88)90682-4. [DOI] [PubMed] [Google Scholar]
- KLAGES W. Frontale und diencephale Antriebsschwäche. Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr. 1954;191(5):365–387. doi: 10.1007/BF00343348. [DOI] [PubMed] [Google Scholar]
- Kendell R. E., Gourlay J. The clinical distinction between the affective psychoses and schizophrenia. Br J Psychiatry. 1970 Sep;117(538):261–266. [PubMed] [Google Scholar]
- Liddle P. F., Friston K. J., Frith C. D., Hirsch S. R., Jones T., Frackowiak R. S. Patterns of cerebral blood flow in schizophrenia. Br J Psychiatry. 1992 Feb;160:179–186. doi: 10.1192/bjp.160.2.179. [DOI] [PubMed] [Google Scholar]
- Liddle P. F. Schizophrenic syndromes, cognitive performance and neurological dysfunction. Psychol Med. 1987 Feb;17(1):49–57. doi: 10.1017/s0033291700012976. [DOI] [PubMed] [Google Scholar]
- Martinot J. L., Hardy P., Feline A., Huret J. D., Mazoyer B., Attar-Levy D., Pappata S., Syrota A. Left prefrontal glucose hypometabolism in the depressed state: a confirmation. Am J Psychiatry. 1990 Oct;147(10):1313–1317. doi: 10.1176/ajp.147.10.1313. [DOI] [PubMed] [Google Scholar]
- Mountcastle V. B., Lynch J. C., Georgopoulos A., Sakata H., Acuna C. Posterior parietal association cortex of the monkey: command functions for operations within extrapersonal space. J Neurophysiol. 1975 Jul;38(4):871–908. doi: 10.1152/jn.1975.38.4.871. [DOI] [PubMed] [Google Scholar]
- VAN PRAAGH, LEIJNSE B. NEUBEWERTUNG DES SYNDROMS. SKIZZE EINER FUNKTIONELLEN PATHOLOGIE. Psychiatr Neurol Neurochir. 1965 Jan-Feb;68:50–66. [PubMed] [Google Scholar]
- Weinberger D. R., Berman K. F., Zec R. F. Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia. I. Regional cerebral blood flow evidence. Arch Gen Psychiatry. 1986 Feb;43(2):114–124. doi: 10.1001/archpsyc.1986.01800020020004. [DOI] [PubMed] [Google Scholar]
- Widlöcher D. J. Psychomotor retardation: clinical, theoretical, and psychometric aspects. Psychiatr Clin North Am. 1983 Mar;6(1):27–40. [PubMed] [Google Scholar]
- Wik G., Wiesel F. A., Sjögren I., Blomqvist G., Greitz T., Stone-Elander S. Effects of sulpiride and chlorpromazine on regional cerebral glucose metabolism in schizophrenic patients as determined by positron emission tomography. Psychopharmacology (Berl) 1989;97(3):309–318. doi: 10.1007/BF00439443. [DOI] [PubMed] [Google Scholar]
- Wolkin A., Angrist B., Wolf A., Brodie J. D., Wolkin B., Jaeger J., Cancro R., Rotrosen J. Low frontal glucose utilization in chronic schizophrenia: a replication study. Am J Psychiatry. 1988 Feb;145(2):251–253. doi: 10.1176/ajp.145.2.251. [DOI] [PubMed] [Google Scholar]