Nonliteral language comprehension and schizophrenia: More than one deficit?

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ABSTRACTS / Schizophrenia Research 98 (2008) 3–199

(to the contralateral hemisphere) during processing of simple somatosensory stimuli is diminished in schizophrenia and that diminished lateralization is accompanied by decreased focalization of activation within the contralateral hemisphere. Methods: Functional images were obtained using with a Philips 3 T scanner, during vibrotactile stimulation of the right index finger, in 21 patients and matched controls. Laterality Quotient (difference between activities in the two hemispheres divided by the sum of activity in both) was determined for the primary somatosensory cortex using the procedure of Bertolino (2004). An analogous procedure was used to derive a focalization quotient based the difference between activation within a small region centred on the site peak activation and that in a surrounding region. Results: Patients with schizophrenia exhibited significantly lower laterality quotient (MWU = 155, p = 0.029) and focalization quotient (MWU = 143, p = 0.026) compared with controls. Conclusions: Diminished lateralization and diminished focalization of cerebral function occurs during simple sensory processing, suggesting diminished regional specialization of function for a diverse range of functions from somato-sensation to language, in schizophrenia. References: Ngan, ETC et al (2003) Neuroimage, 20, 889–897. Bertolino et al (1984) Biological Psychiatry 56, 190–197. doi:10.1016/j.schres.2007.12.038

NONLITERAL LANGUAGE COMPREHENSION AND SCHIZOPHRENIA: MORE THAN ONE DEFICIT? A.M. Rapp 1, M. Hensler 1, K. Markert 2, I. Lengsfeld 1, M. Bartels 1. 1 University of Tuebingen, Department of General Psychiatry, Tuebingen, Germany 2 University of Leeds, Leeds, UK

Presenting Author details: [email protected] Osianderstrasse 26, 72076 Tuebingen, Germany, Tel.: +49 707 12982311; fax: +49 707 1294141. Background: The inability to identify and use nonliteral expressions correctly is a long-known and important symptom of schizophrenia. Mainly based on lesion research for some types of nonliteral language, the deficit was seen as evidence for a right hemisphere deficit in schizophrenia (Mitchell and Crow, 2005). However, nonliteral language is a heterogeneous linguistic entity that includes irony, metaphors, metonymy, idioms and sarcasm. Nonliteral “concretistic” deficits in schizophrenia are mostly seen as one entity; however newer imaging research in healthy subjects suggests different comprehension processes for different types of nonliteral language, including marked differences in laterality. Methods: The aim of this study is to: (a) systematically investigate nonliteral language comprehension skills in a schizophrenia sample using different types of nonliteral stimuli and (b) demonstrate relationship to psychopathology and Theory-of-Mind. 30 probands with ICD-10 schizophrenia and 20 healthy control subjects (matched for age, gender, education, verbal-IQ, CPT-performance) completed a nonliteral language comprehension battery (irony comprehension, metonymy comprehension, proverb comprehension and proverb

explanation), psychopathology (Scale for the Assessment of Negative Symptoms [SANS], Scale for the Assessment of Positive Symptoms [SAPS], Positive and Negative Syndrome Scale [PANSS], Global Assessment of Functioning [GAF] scale and neuropsychology (picture sequencing/TOM, verbal IQ, short version CPT, digit span). Results: Irony comprehension was significantly impaired in schizophrenia relative to the CPT-matched controls, although not all patients showed the deficit. SAPS total score was significantly correlated with irony comprehension. In contrast, metonymy comprehension was more associated with negative thought disorder. Intercorrelation between different types of nonliteral language was lower than expected. Conclusions: This is good compatible with a number of recent functional imaging studies which suggest different functional neuroanatomy for different types and tasks of nonliteral language and suggests more than one pathophysiological pathway. doi:10.1016/j.schres.2007.12.039

VERBAL, NONVERBAL AND PSYCHOPHYSIOLOGICAL VARIABLES IN FIRST EPISODE PSYCHOTIC PATIENTS BEFORE AND AFTER NEUROLEPTIC MEDICATION AND NORMAL VOLUNTEERS A. Altorfer 1, M.L. Kaesermann 1, S. Begré 2, M. Merlo 3, C. Thomke 1, O. Würmle 1. 1 University of Bern, Department of Psychiatric Neurophysiology, Bern, Switzerland 2 University of Bern, Department of Psychosomatic Medicine, Bern, Switzerland 3 HUG, Department of Psychiatry, Geneva, Switzerland

Presenting Author details: [email protected] Bolligenstrasse 111, 3000 Bern 60, Switzerland, Tel.: +41 31 9309756. Background: Social interaction is a key-feature for human beings. Every disturbance of elements needed for effective social exchange caused by situational aspects, psychopatholgical symptoms, pathophysiological mechanisms, or biological interventions (e.g. neuroleptic medication) is crucial for an adequate integration in a social and personal network. Verbal and nonverbal skills are transmitters of a present emotional and cognitive condition which will be interpreted by relevant respective partners. In the context of schizophrenic patients, verbal, nonverbal, and psychophysiological variables may be altered due to psychophathological symptoms, biological markers or side effects of neuroleptic medication. Methods: 13 first episode psychotic patients without neuroleptic medication (drug naive), 13 first episode psychotic patients medicated with Risperidone (2/4 mg) and normal volunteers are investigated during social interaction in a 20-min conversation task. Verbal communication is recorded, head-movement behavior is measured and cardiovascular activity is analyzed simultaneously and timecoordinated. Results: Neuroleptic medication with Risperidone, even with low dosages, has a great impact on the quantity and quality of communicative signs in social interaction. A highly significant reduction of head movement activity and complexity of head