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SPET study of verbal fluency in schizophrenia and epilepsy

Published online by Cambridge University Press:  03 January 2018

John D. C. Mellers*
Affiliation:
Department of Neuropsychiatry, Maudsley Hospital, London
Naoto Adachi
Affiliation:
Department of Psychological Medicine, King's College Hospital, London
Noriyoshi Takei
Affiliation:
Section of Genetics, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London
Alice Cluckie
Affiliation:
Department of Nuclear Medicine, King's College Hospital, London
Brian K. Toone
Affiliation:
Department of Psychological Medicine, King's College Hospital, London
W. Alwyn Lishman
Affiliation:
Section of Neuropsychiatry, Institute of Psychiatry, London
*
Dr J. D. C. Meilers, Department of Neuropsychiatry, Maudsley Hospital, Denmark Hill, London SE5 8AZ

Abstract

Background

The association between temporal lobe epilepsy and schizophrenia suggests that the critical abnormality may be pathology within the temporal lobes. People with schizophrenia-like psychosis of epilepsy (SLPE) provide a useful group in which to examine the importance of temporal and frontal lobe dysfunction in schizophrenia.

Method

A verbal fluency activation paradigm and a 99mTc HMPAO SPET were used to study frontotemporal function in people with SLPE (n = 12), schizophrenia (n = 11) and epilepsy (n = 16).

Results

People with SLPE differed from both other groups by showing lower blood flow in the left superior temporal gyrus during performance of a verbal fluency task compared with a word repetition task (F=5.4, P=0.01). During the verbal fluency task people with primary schizophrenia showed a greater increase in blood flow in anterior cingulate (F=4.5, P=0.02) than the other two groups. There were no between-group differences in frontal brain regions.

Conclusion

Our findings support an association between left temporal lobe abnormality and SLPE. The different patterns of activation observed in people with primary schizophrenia and SLPE suggests that different pathophysiological mechanisms may operate in these two groups. In SLPE the pathophysiology may be relatively confined to the dominant temporal lobe.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM—III—R). Washington, DC: APA.Google Scholar
Chua, S. E. & McKenna, P. J. (1995) Schizophrenia — a brain disease? A critical review of structural and functional cerebral abnormality in the disorder. British Journal of Psychiatry, 166, 563582.Google Scholar
Devous, M. D. Leroy, R. F. & Homan, R. W. (1990) Single photon emission computed tomography in epilepsy. Seminars in Nuclear Medicine, 20, 325341.Google Scholar
Dolan, R. J. Fletcher, P. Frith, C. D. et al (1995) Dopaminergic modulation of impaired cognitive activation in the anterior cingulate cortex in schizophrenia. Nature, 378, 180182.Google Scholar
Flor-Henry, P. (1969) Psychosis and temporal lobe epilepsy: a controlled investigation. Epilepsia, 10, 363369.Google Scholar
Frith, C. D. Friston, K. J. Herald, S. et al (1995) Regional brain activity in chronic schizophrenic patients during the performance of a verbal fluency task. British Journal of Psychiatry, 167, 343349.Google Scholar
Gunn, J. & Fenton, G. W. (1969) Epilepsy in prisons: a diagnostic survey. British Medical Journal, iv, 326328.CrossRefGoogle Scholar
Kawasaki, Y. Maeda, Y. Suzuki, M. et al (1993) SPECT analysis of regional cerebral blood flow changes in patients with schizophrenia during the Wisconsin Card Sorting Test. Schizophrenia Research, 10, 109116.CrossRefGoogle ScholarPubMed
Kristensen, O. & Sindrup, E. H. (1978) Psychomotor epilepsy and psychosis. 11. Electroencephalographic findings. Acta Neurologica Scandinavica, 57, 370379.CrossRefGoogle Scholar
Marshall, E. J. Syed, G. M. S. Fenwick, P. B. C. et al (1993) A pilot study of schizophrenia-like psychosis in epilepsy using single photon emission computerised tomography. British Journal of Psychiatry, 163, 3236.Google Scholar
Mendel, M. F. Grau, R. Doss, R. C. et al (1993) Schizophrenia in epilepsy: seizure and psychosis variables. Neurology, 43, 10731077.Google Scholar
Nelson, H. E. (1982) The National Adult Reading Test Manual. Windsor: NFER-Nelson.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Research, 10, 799812.Google Scholar
Ron, M. A. & Harvey, I. (1990) The brain in schizophrenia. Journal of Neurology, Neurosurgery and Psychiatry, 53, 725726.Google Scholar
Schoneil, F. (1942) Backwardness in the Basic Subjects. London: Oliver and Boyd.Google Scholar
Shedlack, K. J. Hunter, R. Wyper, D. et al (1991) The pattern of cerebral activity underlying verbal fluency as shown by split-dose single photon emission tomography (SPETor SPECT) in normal volunteers. Psychological Medicine, 21, 687696.Google Scholar
Talairach, J. & Tournoux, P. (1988) A Coplanar Stereotactic Atlas of Human Brain. Stuttgart: Thieme Verlag.Google Scholar
Toone, B. K. Dawson, J. & Driver, M. V. (1982) Psychoses of epilepsy: A radiological evaluation. British Journal of Psychiatry, 140, 244248.Google Scholar
Warburton, E. Wise, R. J. S. Price, C. J. et al (1996) Noun and verb retrieval by normal subjects. Studies with PET. Brain, 119, 159179.Google Scholar
Weinberger, D. R. Berman, K. F. Suddath, R. et al (1992) Evidence of dysfunction of a prefrontal-limbic network in schizophrenia: a magnetic resonance imaging and regional cerebral blood flow study of discordant monozygotic twins. American Journal of Psychiatry, 149, 890897.Google Scholar
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