title: Heterogeneity of auditory verbal working memory in schizophrenia.
abstract: The heterogeneity of schizophrenia remains an obstacle for understanding its pathophysiology. Studies using a tone discrimination screening test to classify patients have found evidence for 2 subgroups having either a specific deficit in verbal working memory (WM) or deficits in both verbal and nonverbal memory. This study aimed to (a) replicate in larger samples differences between these subgroups in auditory verbal WM; (b) evaluate their performance on tests of explicit memory and sustained attention; (c) determine the relation of verbal WM deficits to auditory hallucinations and other symptoms; and (d) examine medication effects. The verbal WM and tone discrimination performance did not differ between medicated (n = 45) and unmedicated (n = 38) patients. Patients with schizophrenia who passed the tone screening test (discriminators; n = 60) were compared with those who did not (nondiscriminators; n = 23) and healthy controls (n = 47). The discriminator subgroup showed poorer verbal WM than did controls and a deficit in verbal but not visual memory on the Wechsler Memory Scale-Revised (Wechsler, 1987), whereas the nondiscriminator subgroup showed overall poorer performance on both verbal and nonverbal tests and a marked deficit in sustained attention. Verbal WM deficits in discriminators were correlated with auditory hallucinations but not with negative symptoms. The results are consistent with a verbal memory deficit in a subgroup of schizophrenia having intact auditory perception, which may stem from dysfunction of language-related cortical regions, and a more generalized cognitive deficit in a subgroup having auditory perceptual and attentional dysfunction.
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Gerard E
authors.initials: GE
authors.lastname: Bruder
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Daniel M
authors.identifier: 0000-0001-7337-5987
authors.initials: DM
authors.lastname: Alschuler
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Kroppmann
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Shiva
authors.initials: S
authors.lastname: Fekri
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Roberto B
authors.initials: RB
authors.lastname: Gil
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Lars F
authors.initials: LF
authors.lastname: Jarskog
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Jill M
authors.identifier: 0000-0002-1449-0667
authors.initials: JM
authors.lastname: Harkavy-Friedman
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Raymond
authors.initials: R
authors.lastname: Goetz
authors.affiliation: New York State Psychiatric Institute.
authors.forename: Jürgen
authors.identifier: 0000-0001-5309-1573
authors.initials: J
authors.lastname: Kayser
authors.affiliation: Connecticut Mental Health Center.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Wexler
mesh_terms: D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D001307:Auditory Perception / Q000502:physiology*; D006801:Humans; D008570:Memory, Short-Term / Q000502:physiology*; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000503:physiopathology*; D014706:Verbal Learning / Q000502:physiology