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

Published online by Cambridge University Press:  27 April 2020

P. Fuentes-Claramonte ,
L. López-Araquistain ,
S. Sarró ,
B. Sans-Sansa ,
J. Ortiz-Gil ,
T. Maristany ,
R. Salvador ,
P.J. McKenna  and
E. Pomarol-Clotet
P. Fuentes-Claramonte
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM, Spain
L. López-Araquistain
Affiliation:
Benito Menni CASM, Sant Boi, and University of Barcelona, Spain
S. Sarró
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM, Spain
B. Sans-Sansa
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
J. Ortiz-Gil
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM, Spain Hospital de Granollers, Spain
T. Maristany
Affiliation:
Fundació Sant Joan de Déu, Barcelona, Spain
R. Salvador
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM, Spain
P.J. McKenna*
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM, Spain
E. Pomarol-Clotet
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM, Spain
*
Author for correspondence: P.J. McKenna, E-mail: mckennapeter1@gmail.com
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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Executive functionfMRIformal thought disordern-back taskschizophreniaspeech disorder
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 14 , October 2021 , pp. 2446 - 2453
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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