Association between Striatal Reduction and Poor Wisconsin Card Sorting Test Performance in Patients with Schizophrenia

Several findings support the hypothesis that the striatum is implicated in executive functions and in the modulation of goal-directed behavior, and could play a key role in the pathophysiology and in the production of symptoms and signs in schizophrenia. We have studied the relationship between the objective measures of the striatal structures, as evaluated by magnetic resonance imaging (MRI), and the Wisconsin Card Sorting Test (WCST) performance in a schizophrenic sample. Thirty-five schizophrenic patients underwent MRI scans of striatal structure and neuropsychological evaluation of executive functions by WCST. Poor WCST performers had a reduction of the left caudate nucleus and putamen, and right total striatum when compared to 24 healthy controls. Significant correlation coefficients were also observed between neuropsychological indexes and left striatal measures. The findings suggest the existence of a relationship between abnormalities of striatal structure and abnormal executive-type or organizational cognitive functions.

[1]  J. Jaeger,et al.  Neuropsychiatric rehabilitation for persistent mental illness , 1992, The Psychiatric quarterly.

[2]  R. C. Oldfield The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[3]  P. Corr Progress in experimental personality and psychopathology research: L. J. Chapman, J. P. Chapman and D. C. Fowles: New York: Springer Publishing Company (1993). H/b 290pp. Price: $44.95. ISSN 1056-7151 , 1994 .

[4]  S Pollack,et al.  Cerebral morphometry and clozapine treatment in schizophrenia. , 1994, The Journal of clinical psychiatry.

[5]  R. Heaton,et al.  The utility of the Wisconsin Card Sorting Test in detecting and localizing frontal lobe lesions. , 1980, Journal of consulting and clinical psychology.

[6]  M I Posner,et al.  Left striato-pallidal hyperactivity in schizophrenia. Part II: Phenomenology and thought disorder. , 1989, Psychiatric developments.

[7]  B. Milner Effects of Different Brain Lesions on Card Sorting: The Role of the Frontal Lobes , 1963 .

[8]  D. Weinberger,et al.  A connectionist approach to the prefrontal cortex. , 1993, The Journal of neuropsychiatry and clinical neurosciences.

[9]  H. Freund,et al.  Variation of perisylvian and calcarine anatomic landmarks within stereotaxic proportional coordinates. , 1990, AJNR. American journal of neuroradiology.

[10]  H. Freund,et al.  Cerebral Cortical Localization: Application and Validation of the Proportional Grid System in MR Imaging , 1989, Journal of computer assisted tomography.

[11]  Hj Norussis,et al.  SPSS for Windows , 1993 .

[12]  J. Hambley,et al.  Specific and non-specific effects of neuro-excitatory amino acids on learning and other behaviours in the chicken , 1982, Behavioural Brain Research.

[13]  R. Buchanan,et al.  Basal ganglia pathology in schizophrenia and tardive dyskinesia: an MRI quantitative study. , 1994, The American journal of psychiatry.

[14]  Kessler Ka,et al.  Clinical use of the antipsychotics. , 1981 .

[15]  H. Damasio,et al.  Wisconsin Card Sorting Test performance as a measure of frontal lobe damage. , 1991, Journal of clinical and experimental neuropsychology.

[16]  S. Heckers,et al.  Limbic structures and lateral ventricle in schizophrenia. A quantitative postmortem study. , 1990, Archives of general psychiatry.

[17]  S. Siris,et al.  Akinesia: a syndrome common to parkinsonism, retarded depression, and negative symptoms of schizophrenia. , 1992, Comprehensive psychiatry.

[18]  S. Heckers,et al.  Cortex, white matter, and basal ganglia in schizophrenia: A volumetric postmortem study , 1991, Biological Psychiatry.

[19]  Karen F. Berman,et al.  Relations between neuropsychological performance and brain morphological and physiological measures in monozygotic twins discordant for schizophrenia , 1994, Psychiatry Research: Neuroimaging.

[20]  J. Lieberman,et al.  Increase in caudate nuclei volumes of first-episode schizophrenic patients taking antipsychotic drugs. , 1994, The American journal of psychiatry.

[21]  M. Posner,et al.  Hyperactivity of the left striato-pallidal projection. Part I: Lower level theory. , 1989, Psychiatric developments.

[22]  M. Taylor,et al.  Cognitive impairment in schizophrenia. , 1984, The American journal of psychiatry.

[23]  Structure-function relations in schizophrenia: brain morphology and neuropsychology. , 1992, Progress in experimental personality & psychopathology research.

[24]  R. Heaton Wisconsin Card Sorting Test manual , 1993 .

[25]  M. Torrens Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268 , 1990 .

[26]  J. Rawlins,et al.  The neuropsychology of schizophrenia , 1991, Behavioral and Brain Sciences.

[27]  C. Marsden,et al.  The enigma of the basal ganglia and movement , 1980, Trends in Neurosciences.

[28]  S. Berent,et al.  Analysis of executive functioning in schizophrenics using the Wisconsin Card Sorting Test. , 1991, The Journal of nervous and mental disease.

[29]  C. Marsden The mysterious motor function of the basal ganglia , 1982, Neurology.

[30]  T M Peters,et al.  Anatomical interpretation of MR scans of the brain , 1987, Magnetic resonance in medicine.

[31]  R. C. Oldfield THE ASSESSMENT AND ANALYSIS OF HANDEDNESS , 1971 .

[32]  C. Frith,et al.  Towards a Neuropsychology of Schizophrenia , 1988, British Journal of Psychiatry.

[33]  Marija J. Norusis,et al.  SPSS for Windows Base System User''s Guide , 1992 .

[34]  D. Weinberger,et al.  Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia. I. Regional cerebral blood flow evidence. , 1986, Archives of general psychiatry.

[35]  R. McCarley,et al.  Neuropsychological probes of fronto-limbic system dysfunction in schizophrenia Olfactory identification and Wisconsin Card Sorting Performance , 1991, Schizophrenia Research.

[36]  D L Braff,et al.  Sensorimotor gating and schizophrenia. Human and animal model studies. , 1990, Archives of general psychiatry.

[37]  P. McKenna Pathology, Phenomenology and the Dopamine Hypothesis of Schizophrenia , 1987, British Journal of Psychiatry.

[38]  P. Stratta,et al.  Magnetic resonance imaging findings of amygdala- anterior hippocampus shrinkage in male patients with schizophrenia , 1994, Psychiatry Research.

[39]  J. Fisher,et al.  Neuropsychological Assessment, 2nd Ed , 1985 .

[40]  H. Meltzer,et al.  Effects of clozapine on cognitive function in schizophrenia. , 1994, The Journal of clinical psychiatry.