title: Neural correlates of planning performance in patients with schizophrenia--relationship with apathy.
abstract: Patients with schizophrenia often suffer from apathy: a quantitative reduction of voluntary, goal-directed behaviors that impairs daily functioning. We hypothesized that schizophrenia patients with high levels of apathy would show decreased activation in brain regions involved in planning and goal-directed behavior. Patients with schizophrenia or psychotic spectrum disorder (n=47) and healthy controls (n=20) performed the Tower of London (ToL) task during fMRI scanning using arterial spin labeling. To investigate the relationship between apathy and planning in patients, a proxy measure of apathy based on the Positive and Negative syndrome Scale was regressed against the task-related brain activation. Brain activation was also compared between patients and healthy controls. Higher levels of apathy were associated with less task-related activation within the inferior parietal lobule precuneus and thalamus. Compared to controls, patients showed lower activation in lateral prefrontal regions, parietal and motor areas, and a higher activation of medial frontal areas. Apathy was related to abnormal activation in thalamus and parietal regions during the ToL task. This supports the hypothesis that impaired function of brain regions involved in planning and goal-directed behavior may underlie apathy in schizophrenia. Moreover, impaired lateral prefrontal activation in schizophrenia patients compared to controls is consistent with the hypofrontality model of schizophrenia. In contrast, stronger medial frontal activation in patients may be related to increased effort to perform a task with conflicting task solutions.
authors.affiliation: Department of Neuroscience, and BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, FA32, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands; Rob Giel Research Centrum, University of Groningen, University Medical Center Groningen, CC72, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: E.J.Liemburg@umcg.nl.
authors.forename: Edith J
authors.initials: EJ
authors.lastname: Liemburg
authors.affiliation: Department of Neuroscience, and BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, FA32, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands. Electronic address: J.J.L.A.S.N.Dlabac@umcg.nl.
authors.forename: Jozarni J L A S
authors.initials: JJ
authors.lastname: Dlabac-De Lange
authors.affiliation: Department of Neuroscience, and BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, FA32, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands; Lentis Research, Center for Mental Health, Hereweg 80, 9725 AG Groningen, The Netherlands. Electronic address: L.Bais@umcg.nl.
authors.forename: Leonie
authors.initials: L
authors.lastname: Bais
authors.affiliation: Department of Neuroscience, and BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, FA32, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands; Rob Giel Research Centrum, University of Groningen, University Medical Center Groningen, CC72, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: H.Knegtering@lentis.nl.
authors.forename: Henderikus
authors.initials: H
authors.lastname: Knegtering
authors.affiliation: Department of Radiology, Leiden University Medical Center, Postzone C2S, Postbox 9600, 2300 RC, Leiden, The Netherlands. Electronic address: M.J.P.van_Osch@lumc.nl.
authors.forename: Matthias J P
authors.initials: MJ
authors.lastname: van Osch
authors.affiliation: Department of Neuroscience, and BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, FA32, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands. Electronic address: R.J.Renken@umcg.nl.
authors.forename: Remco J
authors.initials: RJ
authors.lastname: Renken
authors.affiliation: Department of Neuroscience, and BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, FA32, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands; Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands. Electronic address: A.Aleman@umcg.nl.
authors.forename: André
authors.initials: A
authors.lastname: Aleman
mesh_terms: D000328:Adult; D057565:Apathy; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006040:Goals; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: Apathy; Parietal; Planning; Prefrontal; Schizophrenia