Brain structure and function correlates of cognitive subtypes in schizophrenia.
Stable neuropsychological deficits may provide a reliable basis for identifying etiological subtypes of schizophrenia. The aim of this study was to identify clusters of individuals with schizophrenia based on dimensions of neuropsychological performance, and to characterize their neural correlates. We acquired neuropsychological data as well as structural and functional magnetic resonance imaging from 129 patients with schizophrenia and 165 healthy controls. We derived eight cognitive dimensions and subsequently applied a cluster analysis to identify possible schizophrenia subtypes. Analyses suggested the following four cognitive clusters of schizophrenia: (1) Diminished Verbal Fluency, (2) Diminished Verbal Memory and Poor Motor Control, (3) Diminished Face Memory and Slowed Processing, and (4) Diminished Intellectual Function. The clusters were characterized by a specific pattern of structural brain changes in areas such as Wernicke's area, lingual gyrus and occipital face area, and hippocampus as well as differences in working memory-elicited neural activity in several fronto-parietal brain regions. Separable measures of cognitive function appear to provide a method for deriving cognitive subtypes meaningfully related to brain structure and function. Because the present study identified brain-based neural correlates of the cognitive clusters, the proposed groups of individuals with schizophrenia have some external validity.
Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Daniel
D
Geisler
Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Esther
E
Walton
Pritzker School of Medicine, University of Chicago, Chicago, IL, United States of America.
Melissa
M
Naylor
Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Veit
V
Roessner
Minneapolis VA Health Care System & Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States of America.
Kelvin O
KO
Lim
Minneapolis VA Health Care System & Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States of America.
S
S
Charles Schulz
MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States of America; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.
Randy L
RL
Gollub
Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, United States of America; The MIND Research Network, Albuquerque, NM, United States of America.
Vince D
VD
Calhoun
Minneapolis VA Health Care System & Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States of America.
Scott R
SR
Sponheim
Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States of America; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America. Electronic address: KJP-AG-Ehrlich@uniklinikum-dresden.de.
Stefan
S
Ehrlich
D000328:Adult; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D055815:Young Adult
Cluster analysis; Cognitive subtypes; Cortical thickness; Neural correlates; Neuropsychological performance; Schizophrenia; Subcortical volume; Working memory