Increased superior frontal gyrus activation during working memory processing in psychosis: Significant relation to cumulative antipsychotic medication and to negative symptoms.
Impairment in working memory (WM) is a core symptom in schizophrenia. However, little is known about how clinical features influence functional brain activity specific to WM processing during the development of first-episode psychosis (FEP) to schizophrenia (SZ). We compared functional WM-specific brain activity in FEP and SZ patients, including the effects of the duration of illness, psychopathological factors and antipsychotic medication.



Cross-sectional study of male FEP (n=22) and SZ (n=20) patients performing an n-back task when undergoing functional magnetic resonance imaging (fMRI). Clinical features were collected by semi-structured interviews and medical records.



The SZ group performed significantly worse than the FEP group in the 2-back condition. The SZ group also showed significantly higher activation in the left superior frontal gyrus in the 2-back versus 0-back condition (2-back>0-back). This frontal activation correlated positively with negative symptoms and with cumulative antipsychotic medication during the year before the fMRI examination. There were no significant correlations between activation and duration of illness.



There was greater frontal neural activation in SZ than in FEP. This indicated differences in WM processing, and was significantly related to cumulative antipsychotic exposure and negative symptoms, but not to the duration of illness.
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland.
Tobias
T
Vogel
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland; Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics of the University of Basel, Basel, Switzerland; Transfacultary Research Platform, Molecular & Cognitive Neuroscience, University of Basel, Basel, Switzerland.
Renata
R
Smieskova
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland; Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics of the University of Basel, Basel, Switzerland; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Transfacultary Research Platform, Molecular & Cognitive Neuroscience, University of Basel, Basel, Switzerland.
André
A
Schmidt
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland.
Anna
A
Walter
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland; Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics of the University of Basel, Basel, Switzerland; Transfacultary Research Platform, Molecular & Cognitive Neuroscience, University of Basel, Basel, Switzerland.
Fabienne
F
Harrisberger
Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics of the University of Basel, Basel, Switzerland; Transfacultary Research Platform, Molecular & Cognitive Neuroscience, University of Basel, Basel, Switzerland.
Anne
A
Eckert
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland.
Undine E
UE
Lang
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland.
Anita
A
Riecher-Rössler
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland.
Marc
M
Graf
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland; Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics of the University of Basel, Basel, Switzerland; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Transfacultary Research Platform, Molecular & Cognitive Neuroscience, University of Basel, Basel, Switzerland. Electronic address: stefan.borgwardt@upkbs.ch.
Stefan
S
Borgwardt
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001931:Brain Mapping; D003430:Cross-Sectional Studies; D005625:Frontal Lobe / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects / Q000502:physiology*; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents
Antipsychotic medication; Functional MRI; Working memory