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Neuropsychological deficits in adolescents and adult schizophrenics
THURSDAI~,MAY 19
73. NEUROPSYCHOLOGICAL DIFFERENCES BETWEEN SCHIZOPHRENIA AND TEMPORAL LOBE EPILEPSY J. Gold, T. Blaxton, B. Hermann, T. Goldberg, A. Wyler, W. Theodore, & D. Weinberger NIMH Neuroscience Center at St. Elizabeths The neuropsychological comparison of patients w~th focal temporal lobe epilepsy (TIE) and patients with schizophrenia (SC) allows for an examination of lateralized temporal lobe models of schizophrenic cognitive dysfunction. The present study was undertaken to replicate and extend our prior fmdings that schizophrenic patients demonstrate superior semantic memory compared to left temporal epileptics (LTLE) but worse attentional performance than patients with either left or right TLE using new subject samples and additional language measures. Method: We examined the presurgery WAlS-R data from 33 LTLE, 45 RTLE patients and 48 patients with a DSM-lii diagnosis of schizophrenia. We examined the Multilingual Aphasia Exam in different patient samples composed of 24 DSM-lll-R schizophrenics, 48' LTLE, and 53 RTLE patients. TLE pa. tients received comprehensive EEG and neuroimaging studies to determine laterality of seizure focus. Results: On the WAIS-R, we found generally superior performance in the RTLE group. When the analysis was limited to the SC and LTLE groups who were matched on FS IQ, we found that the SC patients had superior semantic memory (information, vocabulary) and worse attention (digit symbol arithmetic). On the Multilingual Aphasia Examination, both the RTLE and SC patients had superior visual naming and reading comprehension when compared with the LTLE group. The pattern of impaired attention coupled with relatively intact semantic knowledge appears to reliably distinguish patients with schizophrenia from patients with LTLE, and suggests limitations of lateralized modes of schizophrenic cognitive impairment. The data suggest that the cognitive impairment in schizophrenia likely involves extra-temporal structures.
74. A SUBGROUP OF SCHIZOPHRENICS MAY SHOW "HYPERPRIMING" ON A SEMANTIC PRIMING EXPERIMENT S. Vinogradov 1,2,B.A. Ober 3,4, G.K. Shenaut3,4, & H. Skinner tUniversity of California, San Francisco, San Francisco, CA 94143; 2Department of Veterans Affairs Medical Center, San Francisco, CA 94121; 3University of California, Davis, Davis, CA 95616; 4Department of Veterans Affairs Medical Center, Martinez CA 94550 A number of investigators have proposed that schizophrenia may be characterized by faster or "stronger" than normal automatic information processing combined with impaired attentional mechanisms, and that this might account for some of the abnormalities of thought and language observed in this disorder. We performed a series of semantic priming experiments on a sample of schizophrenics and matched normal controls in order to examine the hypothesis that subjects with schizophrenia show greater- than-normal priming effects on a task which examines mainly automatic information processing (spread of activation in the semantic memory network). Semantic priming effects are experimental findings which relate to the phenomenon that subjects respond faster to a word, such as lemon, when it is preceded by a related word (such as lime) than when it is preceded by an unrelated word (such as chair). The study of semantic priming effects has provided a useful experimental tool for uncovering structural and processing characteristics of the semantic memory
BIOL PSYCHIATRY 635 1994;35:615-747
system in normals---including basic information processing mechanisms such as spreading activation and attentional operations-but has been applied in only a limited manner in schizophrenia research. We performed a lexical detection task with painvise priming trials using high associate category co-members as stimuli, a stimulus onset asynchrony of 250 ms, and a low relatedness proportion of 10%. These latter two conditions minimized subjects' ability to employ attentional processes and therefore allowed for the contribution of mainly automatic processes (spread of activation in the semantic memory network) to any obtained semantic priming effects. We studied 22 DSM-Ili-R schizophrenic subjects who were medication-free for one week prior to testing and 19 age, IQ, and sexmatched controls. Mean priming effects and sd were: normal controls19.6 ms (22.7), disorganized/undifferentiated schizophrenics-61.33 (25.1), paranoid schizophrenics-2.9 (25.7). This finding suggests that a subgroup of schizophrenics may show "hyperpriming".
75. NEUROPSYCHOLOGICAL DEFICITS IN ADOLESCENTS AND ADULT SCHIZOPHRENICS A. Smith, L.Wolf, M. Obuchowski, A. Stewart, D. Schnur, S. Smith, V. Marte, & B. Cornblatt Mr. Sinai School of Medicine, New York, NY 10029 Nenropsychological deficits, particularly on frontally mediated tasks, have been described in adult schizophrenics. The question remains as to whether these deficits are present at illness onset or represent deterioration from a prior level of functioning. We addressed this question by comparing cognitive symptoms in adolescent schizophrenic patients with those of chronic adult patients. Comparability between these two groups suggests that the neuropsychological deficits under study are not a product of chronic illness. Nenropsychological measures selected from a battery used in the Elmhurst Adolescent Project, including the Wisconsin Card Sort Test (WEST), Trail Making Part B (TMB), Verbal Fluency, and Finger Tapping were administered to neuroleptic stabilized DSM-lllR diagnosed schizophrenic patients. Age standardized scores generated for i 2 adolescents (Mean age ! 5.3) in the first episode of illness were compared to 13 adult (Mean age 30.7) chronic patients. Both first episode and chronic patients had premorbid and current IQ in the low average range. Finger tapping was within normal limits. Both groups evidenced moderate.severe impairment on the TMB and mild impairment on the WCST. Verbal fluency was significantly more impaired in the adult sample. Adolescent first episode schizophrenics display deficits comparable to those characterizing adult chronic patients on two of the three tasks thought to measure frontal lobe function. These deficits are not attributable to diminished motor speed or IQ. However, one of the three tasks, verbal fluency, showed a different pattern and may involve some deterioration due to chronic illness.
76. WITHDRAWN 77. IS FRONTAL LOBE DYSFUNCTION REALLY GENERALIZED DEFICIT IN SCHIZOPHRENIA? L. Bell i,2, R.M. Bilder I, U. Kirk2, & J.A. Lieberman' tHillside Hospital - Long Island Jewish Medical Center, Glen Oaks, NY 11004; 2Columbia University - Teachers College, New York, NY 10027
73. NEUROPSYCHOLOGICAL DIFFERENCES BETWEEN SCHIZOPHRENIA AND TEMPORAL LOBE EPILEPSY J. Gold, T. Blaxton, B. Hermann, T. Goldberg, A. Wyler, W. Theodore, & D. Weinberger NIMH Neuroscience Center at St. Elizabeths The neuropsychological comparison of patients w~th focal temporal lobe epilepsy (TIE) and patients with schizophrenia (SC) allows for an examination of lateralized temporal lobe models of schizophrenic cognitive dysfunction. The present study was undertaken to replicate and extend our prior fmdings that schizophrenic patients demonstrate superior semantic memory compared to left temporal epileptics (LTLE) but worse attentional performance than patients with either left or right TLE using new subject samples and additional language measures. Method: We examined the presurgery WAlS-R data from 33 LTLE, 45 RTLE patients and 48 patients with a DSM-lii diagnosis of schizophrenia. We examined the Multilingual Aphasia Exam in different patient samples composed of 24 DSM-lll-R schizophrenics, 48' LTLE, and 53 RTLE patients. TLE pa. tients received comprehensive EEG and neuroimaging studies to determine laterality of seizure focus. Results: On the WAIS-R, we found generally superior performance in the RTLE group. When the analysis was limited to the SC and LTLE groups who were matched on FS IQ, we found that the SC patients had superior semantic memory (information, vocabulary) and worse attention (digit symbol arithmetic). On the Multilingual Aphasia Examination, both the RTLE and SC patients had superior visual naming and reading comprehension when compared with the LTLE group. The pattern of impaired attention coupled with relatively intact semantic knowledge appears to reliably distinguish patients with schizophrenia from patients with LTLE, and suggests limitations of lateralized modes of schizophrenic cognitive impairment. The data suggest that the cognitive impairment in schizophrenia likely involves extra-temporal structures.
74. A SUBGROUP OF SCHIZOPHRENICS MAY SHOW "HYPERPRIMING" ON A SEMANTIC PRIMING EXPERIMENT S. Vinogradov 1,2,B.A. Ober 3,4, G.K. Shenaut3,4, & H. Skinner tUniversity of California, San Francisco, San Francisco, CA 94143; 2Department of Veterans Affairs Medical Center, San Francisco, CA 94121; 3University of California, Davis, Davis, CA 95616; 4Department of Veterans Affairs Medical Center, Martinez CA 94550 A number of investigators have proposed that schizophrenia may be characterized by faster or "stronger" than normal automatic information processing combined with impaired attentional mechanisms, and that this might account for some of the abnormalities of thought and language observed in this disorder. We performed a series of semantic priming experiments on a sample of schizophrenics and matched normal controls in order to examine the hypothesis that subjects with schizophrenia show greater- than-normal priming effects on a task which examines mainly automatic information processing (spread of activation in the semantic memory network). Semantic priming effects are experimental findings which relate to the phenomenon that subjects respond faster to a word, such as lemon, when it is preceded by a related word (such as lime) than when it is preceded by an unrelated word (such as chair). The study of semantic priming effects has provided a useful experimental tool for uncovering structural and processing characteristics of the semantic memory
BIOL PSYCHIATRY 635 1994;35:615-747
system in normals---including basic information processing mechanisms such as spreading activation and attentional operations-but has been applied in only a limited manner in schizophrenia research. We performed a lexical detection task with painvise priming trials using high associate category co-members as stimuli, a stimulus onset asynchrony of 250 ms, and a low relatedness proportion of 10%. These latter two conditions minimized subjects' ability to employ attentional processes and therefore allowed for the contribution of mainly automatic processes (spread of activation in the semantic memory network) to any obtained semantic priming effects. We studied 22 DSM-Ili-R schizophrenic subjects who were medication-free for one week prior to testing and 19 age, IQ, and sexmatched controls. Mean priming effects and sd were: normal controls19.6 ms (22.7), disorganized/undifferentiated schizophrenics-61.33 (25.1), paranoid schizophrenics-2.9 (25.7). This finding suggests that a subgroup of schizophrenics may show "hyperpriming".
75. NEUROPSYCHOLOGICAL DEFICITS IN ADOLESCENTS AND ADULT SCHIZOPHRENICS A. Smith, L.Wolf, M. Obuchowski, A. Stewart, D. Schnur, S. Smith, V. Marte, & B. Cornblatt Mr. Sinai School of Medicine, New York, NY 10029 Nenropsychological deficits, particularly on frontally mediated tasks, have been described in adult schizophrenics. The question remains as to whether these deficits are present at illness onset or represent deterioration from a prior level of functioning. We addressed this question by comparing cognitive symptoms in adolescent schizophrenic patients with those of chronic adult patients. Comparability between these two groups suggests that the neuropsychological deficits under study are not a product of chronic illness. Nenropsychological measures selected from a battery used in the Elmhurst Adolescent Project, including the Wisconsin Card Sort Test (WEST), Trail Making Part B (TMB), Verbal Fluency, and Finger Tapping were administered to neuroleptic stabilized DSM-lllR diagnosed schizophrenic patients. Age standardized scores generated for i 2 adolescents (Mean age ! 5.3) in the first episode of illness were compared to 13 adult (Mean age 30.7) chronic patients. Both first episode and chronic patients had premorbid and current IQ in the low average range. Finger tapping was within normal limits. Both groups evidenced moderate.severe impairment on the TMB and mild impairment on the WCST. Verbal fluency was significantly more impaired in the adult sample. Adolescent first episode schizophrenics display deficits comparable to those characterizing adult chronic patients on two of the three tasks thought to measure frontal lobe function. These deficits are not attributable to diminished motor speed or IQ. However, one of the three tasks, verbal fluency, showed a different pattern and may involve some deterioration due to chronic illness.
76. WITHDRAWN 77. IS FRONTAL LOBE DYSFUNCTION REALLY GENERALIZED DEFICIT IN SCHIZOPHRENIA? L. Bell i,2, R.M. Bilder I, U. Kirk2, & J.A. Lieberman' tHillside Hospital - Long Island Jewish Medical Center, Glen Oaks, NY 11004; 2Columbia University - Teachers College, New York, NY 10027