Working memory and DLPFC inefficiency in schizophrenia: The FBIRN Study
Source: Schizophr Bull
2009 Jan;35(1):19-31.
Author: Potkin SG, Turner JA, Brown GG, McCarthy G, Greve DN, Glover GH, Manoach DS, Belger A, Diaz M, Wible CG, Ford JM, Mathalon DH, Gollub R, Lauriello J, O'Leary D, van Erp TG, Toga AW, Preda A, Lim KO PubMed ID: 19042912
Abstract:
The Functional Imaging Biomedical Informatics
Network is a consortium developing methods for
multisite functional imaging studies. Both prefrontal hyperor
hypoactivity in chronic schizophrenia have been found
in previous studies of working memory. Methods: In this
functional magnetic resonance imaging (fMRI) study of
working memory, 128 subjects with chronic schizophrenia
and 128 age- and gender-matched controls were recruited
from 10 universities around the United States. Subjects
performed the Sternberg Item Recognition Paradigm1,2
with memory loads of 1, 3, or 5 items. A region of interest
analysis examined the mean BOLD signal change in an atlas-
based demarcation of the dorsolateral prefrontal cortex
(DLPFC), in both groups, during both the encoding and
retrieval phases of the experiment over the various memory
loads. Results: Subjects with schizophrenia performed
slightly but significantly worse than the healthy volunteers
and showed a greater decrease in accuracy and increase in
reaction time with increasing memory load. The mean
BOLD signal in the DLPFC was significantly greater in
the schizophrenic group than the healthy group, particularly
in the intermediate load condition. A secondary analysis
matched subjects for mean accuracy and found the
same BOLD signal hyperresponse in schizophrenics. Conclusions:
The increase in BOLD signal change from minimal
to moderate memory loads was greater in the
schizophrenic subjects than in controls. This effect
remained when age, gender, run, hemisphere, and performance
were considered, consistent with inefficient DLPFC
function during working memory. These findings from
a large multisite sample support the concept not of hyperor
hypofrontality in schizophrenia, but rather DLPFC inefficiency
that may be manifested in either direction
depending on task demands. This redirects the focus of research
from direction of difference to neural mechanisms of
inefficiency.