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Neuronale Korrelate "negativer" formaler Denkstörungen

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Zusammenfassung

Formale Denkstörungen (FDS) sind ein Kernsymptom der Schizophrenie. Diese können als "positive" (z. B. Zerfahrenheit, Neologismen) und "negative" Denkstörungen (z. B. Sprach/Gedankenarmut) konzeptualisiert werden. Die neuronalen Korrelate "negativer" FDS sind bisher nicht bekannt. Der Blood-Oxygenation-Level-Dependent (BOLD)-Kontrast wurde mittels funktioneller Magnetresonanztomographie (fMRT) gemessen, während 6 Patienten mit Schizophrenie und 6 gesunde Kontrollpersonen jeweils 3 min lang über 7 Rorschach-Tintenkleckse sprachen. Das Ausmaß an "negativen" FDS, konzeptualisiert als "Spracharmut", wurde mit dem BOLD-Kontrast für jene beiden Durchläufe, welche die höchste Varianz an "negativen" FDS aufwiesen, korreliert. Bei den Patienten fanden sich positive Korrelationen mit dem Ausmaß an "Spracharmut" vor allem im rechten Lobulus parietalis inferior (BA 40), Gyrus frontalis medius (BA 46) und Kuneus (BA 18) sowie dem linken posterioren Zingulum/Präkuneus (BA 31). Negative Korrelationen zeigten sich hauptsächlich im linken Gyrus hippocampalis/Gyrus fusiformis (BA 35/36/37). Das Ausmaß an "negativen" FDS korreliert mit Aktivierungen in Arealen, die mit autobiographischen Gedächtnisleistungen in Zusammenhang gebracht wurden. Psychopathologisch als "negativ" bezeichnete Symptome wie Spracharmut, können also mit reichen Assoziationen und Erinnerungen einhergehen, die sich mit fMRT darstellen lassen.

Summary

Formal thought disorder (FTD) is a core feature of schizophrenia, but its pathophysiology is poorly understood. It can be conceptualised as 'positive' (e.g. incoherence, neologisms) or 'negative' (e.g. poverty of thought) thought disorder. We investigated the neural correlates of negative FTD. Blood oxygenation level-dependent (BOLD) contrast was measured using functional magnetic resonance imaging (fMRI) while six patients with schizophrenia and six healthy control subjects spoke about seven Rorschach inkblots for 3 min each. Varying degrees of thought-disordered speech were elicited during each run. In a within-subject design, the degree of negative thought disorder, conceptualised as 'poverty of speech' (Liddle et al. (2002) Thought and Language Index. Br J Psychiatry) was correlated with BOLD contrast in the two runs per patient showing the highest variance in this phenomenon. The degree of poverty of speech correlated positively mainly with activation in the right inferior parietal lobe (BA 40), middle frontal gyrus (BA 46), cuneus (BA 18), and the left posterior cingulate (BA 31). Negative correlations were evident in the left hippocampal/fusiform gyrus (BA 35/36/37). The severity of negative FTD correlates with activation in areas previously implicated in autobiographic episodic memory. During symptoms behaviourally characterised as negative, patients may experience rich memories and associations.

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Danksagung

Die Studie wurden im Rahmen eines DFG-Forschungsstipendiums des Erstautors durchgeführt. Die Autoren danken C. Andrew, S. Williams, A. Simmons, M. Bartels und G. Buchkremer für ihre Hilfe.

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Authors and Affiliations

  1. Klinik für Psychiatrie und Psychotherapie, Universität Tübingen

    T. Kircher

  2. Institute of Psychiatry and GKT School of Medicine, De Crespigny Park London SE5 8AF

    T. Kircher, M. Brammer, R. Murray & P. McGuire

  3. Department of Psychiatry, University of Nottingham England

    P. Liddle

  4. Universitätsklinik für Psychiatrie und Psychotherapie, Osianderstraße 24, 72076 , Tübingen

    T. Kircher

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  1. T. Kircher
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Correspondence to T. Kircher.

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Kircher, T., Liddle, P., Brammer, M. et al. Neuronale Korrelate "negativer" formaler Denkstörungen. Nervenarzt 74, 748–754 (2003). https://doi.org/10.1007/s00115-003-1497-2

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