title: Neural dysfunction and violence in schizophrenia: an fMRI investigation.
abstract: Contemporary theories and evidence implicate frontal lobe dysfunction in violent behaviour as well as in schizophrenia. We applied functional magnetic resonance imaging (fMRI) to investigate and compare brain activation during an 'n-back' working memory task in groups of men with (i) schizophrenia and a history of serious physical violence (VS; n=13), (ii) schizophrenia without a history of violence (NVS: n=12), (iii) antisocial personality disorder (APD) and a history of serious physical violence (n=10), and (iv) no history of violence or a mental disorder (n=13). We observed comparable performance in all four groups during the control (0-back) condition. Subtle working memory deficits were seen in the NVS and APD groups but severe deficits emerged in the VS group relative to the healthy group. The VS group showed activation deficit bilaterally in the frontal lobe and precuneus when compared to the healthy group, and in the right inferior parietal region when compared to the NVS group during the working memory load condition. Frontal (bilateral) as well as right inferior parietal activity was negatively associated with the ratings of violence across all schizophrenia patients, with the right parietal region showing this association most strongly. APD patients, relative to healthy subjects, showed activation deficit in the left frontal gyrus, anterior cingulate and precuneus. It is concluded that reduced functional response in the frontal and inferior parietal regions leads to serious violence in schizophrenia perhaps via impaired executive functioning.
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London, London, UK. v.kumari@iop.kcl.ac.uk
authors.forename: Veena
authors.initials: V
authors.lastname: Kumari
authors.forename: Ingrid
authors.initials: I
authors.lastname: Aasen
authors.forename: Pamela
authors.initials: P
authors.lastname: Taylor
authors.forename: Dominic H
authors.initials: DH
authors.lastname: Ffytche
authors.forename: Mrigen
authors.initials: M
authors.lastname: Das
authors.forename: Ian
authors.initials: I
authors.lastname: Barkataki
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Goswami
authors.forename: Paul
authors.initials: P
authors.lastname: O'Connell
authors.forename: Michael
authors.initials: M
authors.lastname: Howlett
authors.forename: Steven C R
authors.initials: SC
authors.lastname: Williams
authors.forename: Tonmoy
authors.initials: T
authors.lastname: Sharma
mesh_terms: D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology; D001921:Brain / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005625:Frontal Lobe / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology; D010296:Parietal Lobe / Q000503:physiopathology; D015995:Prevalence; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D012720:Severity of Illness Index; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data*