title: Determinants of cerebral hemodynamics during the Trail Making Test in schizophrenia.
abstract: Patients with schizophrenia show deficits in cognitive functioning, and studies on cerebral hemodynamics have revealed aberrant patterns of mean cerebral blood flow velocity (MFV), an equivalent of cerebral blood flow (CBF). Therefore, we carried out a controlled study that assessed MFV in schizophrenia during a well-known neuropsychological task, the Trail Making Test (TMT). We measured MFV in the middle cerebral arteries using functional transcranial Doppler sonography in 15 schizophrenia patients and 15 healthy subjects. In comparison to healthy subjects, patients performed poorer on the TMT-A and the TMT-B, and there was increased cerebral blood flow velocity during the TMT-B. A comparison of subgroups of patients and controls matched in performance on the TMT-B revealed that these patients still showed significantly increased cerebral blood flow velocity. Increased MFV in schizophrenia suggests specific alterations of cerebral hemodynamics during the Trail Making Test, Part B, which are not detectable during visuomotor activity, and which are independent of performance. These findings emphasize the pathophysiological importance of cognitive functioning in schizophrenia, but cast doubts whether performance in this particular test plays a relevant role for CBF abnormalities in schizophrenia.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland; Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Klinikum am Weissenhof, Weinsberg, Germany. Electronic address: d.schuepbach@klinikum-weissenhof.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schuepbach
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland.
authors.forename: Stephan T
authors.initials: ST
authors.lastname: Egger
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland.
authors.forename: Heinz
authors.initials: H
authors.lastname: Boeker
authors.affiliation: Institute of Psychology, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Duschek
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Vetter
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland.
authors.forename: Erich
authors.initials: E
authors.lastname: Seifritz
authors.affiliation: Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Sabine C
authors.initials: SC
authors.lastname: Herpertz
mesh_terms: D000328:Adult; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D012559:Schizophrenia / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014145:Trail Making Test; D017585:Ultrasonography, Doppler, Transcranial
keywords: Akathisia; Cerebral blood flow; Cognition; Performance; Schizophrenia; Trail Making Test