Volume 47, Issue 11 , Pages 1299-1310, November 2008
Cerebral Dysfunctions of Emotion—Cognition Interactions in Adolescent-Onset Schizophrenia
Abstract
Objective
Schizophrenia is among the most severe of psychiatric disorders, leading to impairments of affective and cognitive abilities. These dysfunctions affect each other mutually. Adolescent-onset schizophrenia (AOS) constitutes a particularly severe form of the disorder. In this study, possible dysfunctions of the neural correlates underlying the interaction of negative emotion and working memory in AOS were investigated.
Method
During functional magnetic resonance imaging, 12 patients with AOS and 12 non-AOS adolescents performed a verbal n-back task. Intermittently, negative and neutral emotions were induced by olfactory stimulation. Group differences in working memory, emotion, and their interaction were evaluated.
Results
In patients with AOS, lower performance sensitivity was observed, along with dorsolateral prefrontal, anterior cingulate, and inferior parietal hypoactivation during working memory demands. For negative versus neutral emotion induction, patients with AOS mainly showed increased brain activation compared with control subjects in widespread brain regions including the left orbitofrontal cortex and the medial frontal gyrus. Finally, during the interaction of emotion and cognition, altered patterns of activation in patients with AOS were found in the thalamocortical network, including the angular and the middle cingulate gyri extending to the precuneus. These activation differences were further decomposed by parameter estimates.
Conclusions
Our results provide new insights into the neural correlates underlying the mutual influence of affective and cognitive symptoms in AOS. During the n-back task, areas typically associated with working memory performance were found hypoactivated in patients relative to the control subjects, including the dorsolateral prefrontal and parietal cortex and the anterior cingulate. However, patients with AOS mainly demonstrated increased activation in key areas of emotion processing, such as the left orbitofrontal cortex and medial frontal areas, during negative emotion induction. A dysfunctional thalamocortical network during the interaction mainly included regions involved in the integration of converging information—either on the subcortical (thalamus) or on a higher-order cortical level (comprising the angular gyrus). These findings point to dysfunctional emotion-cognition interactions in AOS, which may explain its poor prognosis. J. Am. Acad. Child Adolesc. Psychiatry, 2008;47(11): 1299–1310.
Key Words: early-onset schizophrenia , working memory , emotion , olfaction , emotion-cognition interaction
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This work was supported by the Federal Ministry of Education and Research (Brain Imaging Center West, 01GO0204) and the German Research Foundation (DFG, Schn 362/13-1 and 13-2). It forms part of Ms. Pauly's Ph.D. thesis.The authors thank Beate Herpertz-Dahlmann, Gudrund Ott, Ulrike Bowi, Andreas Lamerz, Kathrin Koch, Martina Reske, Petra Engels, Barbara Elghahwagi, Gabi Oefler, Tony Stöcker, Frank Röhmer, and Claire Ryalls for assistance and support. The authors also thank all of the participants and their legal guardians. Finally, they thank the reviewers for their constructive and helpful comments.This article is the subject of an editorial by Dr. Ellen Leibenluft in this issue.
PII: S0890-8567(08)60121-5
doi:10.1097/CHI.0b013e318184ff16
© 2008 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Volume 47, Issue 11 , Pages 1299-1310, November 2008
