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Stephan Heckers, MD; Donald Goff, MD; Daniel L. Schacter, PhD; Cary R. Savage, PhD; Alan J. Fischman, MD, PhD; Nathaniel M. Alpert, PhD; Scott L. Rauch, MD

Arch Gen Psychiatry. 1999;56:1117-1123.

Background  Neuroimaging studies have provided evidence of abnormal frontal and temporal lobe function in schizophrenia. Frontal cortex abnormalities have been associated with negative symptoms and temporal lobe abnormalities with positive symptoms. The deficit and nondeficit forms of schizophrenia were predicted to differ in prefrontal cortical activity, but not in medial temporal lobe activity.

Methods  Regional cerebral blood flow was studied using oxygen 15 positron emission tomography during 3 different memory retrieval conditions in 8 control subjects, 8 patients with the deficit syndrome, and 8 patients without the deficit syndrome. Behavioral and positron emission tomography data were analyzed using a mixed-effects model to test for population differences.

Results  In all memory conditions, frontal cortex activity was higher in patients without the deficit syndrome than in patients with the deficit syndrome. During the attempt to retrieve poorly encoded words, patients without the deficit syndrome recruited the left frontal cortex to a significantly greater degree than did patients with the deficit syndrome. The 2 schizophrenia subtypes did not differ in the activity or recruitment of the hippocampus during memory retrieval.

Conclusion  Frontal cortex function during memory retrieval is differentially impaired in deficit and nondeficit schizophrenia, whereas hippocampal recruitment deficits are not significantly different between the 2 schizophrenia groups.

From the Psychotic Disorders Unit (Drs Heckers and Goff) and the Psychiatric Neuroimaging Research Group (Drs Heckers, Savage, and Rauch), Department of Psychiatry, and the Positron Emission Tomography Laboratory, Division of Nuclear Medicine, Department of Radiology (Drs Fischman, Alpert, and Rauch), Massachusetts General Hospital, and the Department of Psychology, Harvard University (Dr Schacter), Boston, Mass.

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