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I. Regional Cerebral Blood Flow Evidence

Daniel R. Weinberger, MD; Karen Faith Berman, MD; Ronald F. Zec, PhD

Arch Gen Psychiatry. 1986;43(2):114-124.

Abstract
• To evaluate dorsolateral prefrontal cortex (DLPFC) physiology and function simultaneously, 20 medication-free patients with chronic schizophrenia and 25 normal controls underwent three separate xenon Xe 133 inhalation procedures for determination of regional cerebral blood flow (rCBF): first at rest, then while performing an automated version of the Wisconsin Card Sort (WCS), a DLPFC-specific cognitive test, and while peforming a simple number-matching (NM) test. During rest, patients had significantly reduced relative, but not absolute, rCBF to DLPFC. During NM, no specific region differentiated patients from controls. During WCS, however, both absolute and relative rCBF to DLPFC significantly distinguished patients from controls. While controls showed a clear increase in DLPFC rCBF, patients did not. The changes were regionally specific, involving only DLPFC. Furthermore, in patients, DLPFC rCBF correlated positively with WCS cognitive performance, suggesting that the better DLPFC was able to function, the better patients could perform. Autonomic arousal measures, the pattern of WCS errors, and results of complementary studies suggest that the DLPFC finding is linked to regionally specific cognitive function and is not a nonspecific epiphenomenon.

Author Affiliations
From the Section on Clinical Neuropsychiatry, Neuropsychiatry Branch, Intramural Research Program, National Institute of Mental Health, St Elizabeths Hospital, Washington, DC.

Footnotes
Accepted for publication July 25, 1985.

Read in part before the 136th annual meeting of the American Psychiatric Association, New York, May 2, 1983, and the 137th annual meeting of the American Psychiatric Association, Los Angeles, May 10, 1984.

Reprint requests to Section on Clinical Neuropsychiatry, Neuropsychiatry Branch, Intramural Research Program, National Institute of Mental Health, William A. White Building, St Elizabeths Hospital, Washington, DC 20032 (Dr Weinberger).

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