Frontal and anterior cingulate activation during overt verbal fluency in patients with first episode psychosis.
OBJECTIVE
Functional neuroimaging studies using phonological verbal fluency tasks allow the assessment of neural circuits relevant to the neuropsychology of psychosis. There is evidence that the prefrontal cortex and anterior cingulate gyrus present different activation patterns in subjects with chronic schizophrenia relative to healthy controls. We assessed the functioning in these brain regions during phonological verbal fluency in subjects with recent-onset functional psychoses, using functional magnetic resonance imaging (FMRI).


METHODS
Seven patients with functional psychoses (3 schizophreniform, 4 affective) and 9 healthy controls were studied. We compared functional magnetic resonance images acquired during articulation of words beginning with letters classified as easy for word production in Portuguese. Statistical comparisons were performed using non-parametric tests.


RESULTS
There were no differences between patients and controls in task performance. Controls showed greater activation than patients in the left rostral anterior cingulate gyrus and right inferior prefrontal cortex, whereas patients showed stronger activation than controls in a more dorsal part of the anterior cingulate gyrus bilaterally and in a more superior portion of the right prefrontal cortex.


CONCLUSIONS
Our preliminary findings of attenuated engagement of inferior prefrontal cortex and anterior cingulate gyrus in patients with recent onset psychosis during phonological verbal fluency are consistent with those of previous studies. The greater activation found in other parts of the anterior cingulate gyrus and prefrontal cortex in patients may be related to a compensatory response that is required to maintain normal task performance, and suggests a pattern of disorganized activity of different functional anterior cingulate gyrus units in association with psychotic conditions.
Schaufelberger
Maristela
M
Department of Psychiatry, Universidade de São Paulo, São Paulo, SP, Brazil.
Senhorini
Maurien C T
MC
Barreiros
Maria Angela
MA
Amaro
Edson
E
Menezes
Paulo R
PR
Scazufca
Marcia
M
Castro
Claudio C
CC
Ayres
Adriana M
AM
Murray
Robin M
RM
McGuire
Philip K
PK
Busatto
Geraldo F
GF
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000503:physiopathology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D014705:Verbal Behavior / Q000502:physiology*