title: Procedural learning in schizophrenia: a functional magnetic resonance imaging investigation.
abstract: Procedural learning (PL) is a type of rule-based learning in which performance facilitation occurs with practice on task without the need for conscious awareness. Schizophrenic patients have often (though not invariably) been found to show impaired PL. We performed functional magnetic resonance imaging (fMRI) during a blocked, periodic sequence-learning task with groups of: (i) healthy subjects, and (ii) schizophrenic patients on conventional antipsychotics. Healthy subjects showed significant PL, but patients did not. In healthy subjects, PL was associated with increased activation in the striatum, thalamus, cerebellum, precuneus, medial frontal lobe, and cingulate gyrus. The power of activation in the thalamus, striatum, precuneus, cingulate gyrus and BA 6 was related to the magnitude of PL in these subjects. No regions, except the anterior inferior gyrus, were significantly activated in patients. The caudate nucleus, thalamus, precuneus, and sensorimotor regions were activated significantly differently between the two groups. The findings demonstrate the involvement of the striatum, cerebellum, thalamus, cingulate gyrus, precuneus, and sensorimotor regions in PL. Further fMRI studies of PL in normal subjects treated with conventional antipsychotics, drug naïve patients, and patients given atypical antipsychotics would help to clarify the roles of schizophrenic disease processes and antipsychotic medication in impaired PL and associated brain abnormalities in schizophrenia.
authors.affiliation: Section of Cognitive Psychopharmacology, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK. v.kumari@iop.kcl.ac.uk
authors.forename: Veena
authors.initials: V
authors.lastname: Kumari
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Gray
authors.forename: Garry D
authors.initials: GD
authors.lastname: Honey
authors.forename: William
authors.initials: W
authors.lastname: Soni
authors.forename: Edward T
authors.initials: ET
authors.lastname: Bullmore
authors.forename: Steven C R
authors.initials: SC
authors.lastname: Williams
authors.forename: Virginia Wk
authors.initials: VW
authors.lastname: Ng
authors.forename: Goparlen N
authors.initials: GN
authors.lastname: Vythelingum
authors.forename: Andrew
authors.initials: A
authors.lastname: Simmons
authors.forename: John
authors.initials: J
authors.lastname: Suckling
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Corr
authors.forename: Tonmoy
authors.initials: T
authors.lastname: Sharma
mesh_terms: D000328:Adult; D001921:Brain / Q000002:abnormalities*; D006801:Humans; D007858:Learning / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D011897:Random Allocation; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology*; D017603:Signal Detection, Psychological / Q000502:physiology