title: Anterior cingulate cortex activation is related to learning potential on the WCST in schizophrenia patients.
abstract: The remediation of executive function in patients with schizophrenia is important in rehabilitation because these skills affect the patient's capacity to function in the community. There is evidence that instructional techniques can improve deficits in the Wisconsin Card Sorting Test (WCST) in some schizophrenia patients. We used a standard test/training phase/standard test format of the WCST to classify 36 schizophrenia patients as high-achievers, learners or non-retainers. All healthy controls performed as high-achievers. An event-related fMRI design assessed neural activation patterns during post-training WCST performance. Patients showed a linear trend between set-shifting related activation in the anterior cingulate cortex and learning potential, i.e. increased activation in high-achievers, a trend for increased activation in learners, and no activation in non-retainers compared to controls. In addition, activation in the temporoparietal cortex was highest in patients classified as learners, whereas in non-retainers activation was increased in the inferior frontal gyrus compared to controls and high-achieving patients. These results emphasize the relevance of the ACC's neural integrity in learning set-shifting strategies for patients with schizophrenia. Also, our results support the hypothesis that compensatory neural activation in patients with schizophrenia helps them to catch up with healthy controls on cognitive tasks.
authors.affiliation: Department of Psychiatry, School of Medicine, University of Muenster, Germany.
authors.forename: Anya
authors.initials: A
authors.lastname: Pedersen
authors.forename: Andreas
authors.initials: A
authors.lastname: Wilmsmeier
authors.forename: Karl H
authors.initials: KH
authors.lastname: Wiedl
authors.forename: Jochen
authors.initials: J
authors.lastname: Bauer
authors.forename: Kerstin
authors.initials: K
authors.lastname: Kueppers
authors.forename: Katja
authors.initials: K
authors.lastname: Koelkebeck
authors.forename: Waldemar
authors.initials: W
authors.lastname: Kohl
authors.forename: Harald
authors.initials: H
authors.lastname: Kugel
authors.forename: Volker
authors.initials: V
authors.lastname: Arolt
authors.forename: Patricia
authors.initials: P
authors.lastname: Ohrmann
mesh_terms: D000328:Adult; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007858:Learning / Q000502:physiology*; D008297:Male; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000503:physiopathology* / Q000534:rehabilitation; D012720:Severity of Illness Index; D055815:Young Adult