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Brain functional correlates of formal thought disorder in schizophrenia: examining the frontal/dysexecutive hypothesis.

Authors
  • Fuentes-Claramonte, P1, 2
  • López-Araquistain, L3
  • Sarró, S1, 2
  • Sans-Sansa, B1
  • Ortiz-Gil, J1, 2, 4
  • Maristany, T5
  • Salvador, R1, 2
  • McKenna, P J1, 2
  • Pomarol-Clotet, E1, 2
  • 1 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain. , (Spain)
  • 2 CIBERSAM, Spain. , (Spain)
  • 3 Benito Menni CASM, Sant Boi, and University of Barcelona, Spain. , (Spain)
  • 4 Hospital de Granollers, Spain. , (Spain)
  • 5 Fundació Sant Joan de Déu, Barcelona, Spain. , (Spain)
Type
Published Article
Journal
Psychological Medicine
Publisher
Cambridge University Press
Publication Date
Oct 01, 2021
Volume
51
Issue
14
Pages
2446–2453
Identifiers
DOI: 10.1017/S0033291720001063
PMID: 32338241
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

One hypothesis proposed to underlie formal thought disorder (FTD), the incoherent speech is seen in some patients with schizophrenia, is that it reflects impairment in frontal/executive function. While this proposal has received support in neuropsychological studies, it has been relatively little tested using functional imaging. This study aimed to examine brain activations associated with FTD, and its two main factor-analytically derived subsyndromes, during the performance of a working memory task. Seventy patients with schizophrenia showing a full range of FTD scores and 70 matched healthy controls underwent fMRI during the performance of the 2-back version of the n-back task. Whole-brain corrected, voxel-based correlations with FTD scores were examined in the patient group. During 2-back performance the patients showed clusters of significant inverse correlation with FTD scores in the inferior frontal cortex and dorsolateral prefrontal cortex bilaterally, the left temporal cortex and subcortically in the basal ganglia and thalamus. Further analysis revealed that these correlations reflected an association only with 'alogia' (poverty of speech, poverty of content of speech and perseveration) and not with the 'fluent disorganization' component of FTD. This study provides functional imaging support for the view that FTD in schizophrenia may involve impaired executive/frontal function. However, the relationship appears to be exclusively with alogia and not with the variables contributing to fluent disorganization.

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