Prefrontal–thalamic–cerebellar gray matter networks and executive functioning in schizophrenia

Rüsch, Nicolas; Spoletini, Ilaria; Wilke, Marko; Bria, Pietro; Di Paola, Margherita; Di Iulio, Fulvia; Martinotti, Giovanni; Caltagirone, Carlo; Spalletta, Gianfranco

doi:10.1016/j.schres.2007.01.029

« Previous Next »Schizophrenia Research
Volume 93, Issue 1 , Pages 79-89, July 2007

Prefrontal–thalamic–cerebellar gray matter networks and executive functioning in schizophrenia

Nicolas Rüsch
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychiatry and Psychotherapy, University of Freiburg, Germany
- Corresponding author. Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, D-79104 Freiburg, Germany. Tel.: +49 761 270 6501; fax: +49 761 270 6619.
Ilaria Spoletini
- IRCCS Fondazione Santa Lucia, Rome, Italy
Marko Wilke
- Department of Pediatric Neurology, University Children's Hospital, Tübingen, Germany
Pietro Bria
- Institute of Psychiatry, Catholic University of the Sacred Heart, Rome, Italy
Margherita Di Paola
- IRCCS Fondazione Santa Lucia, Rome, Italy
Fulvia Di Iulio
- IRCCS Fondazione Santa Lucia, Rome, Italy
Giovanni Martinotti
- Institute of Psychiatry, Catholic University of the Sacred Heart, Rome, Italy
- Casa di Cura Neuropsichiatrica Villa Maria Pia, Rome, Italy
Carlo Caltagirone
- IRCCS Fondazione Santa Lucia, Rome, Italy
Gianfranco Spalletta
- IRCCS Fondazione Santa Lucia, Rome, Italy

Received 19 December 2006; received in revised form 31 January 2007; accepted 31 January 2007. published online 31 March 2007.

Abstract

Objective

Poor executive functioning is a core deficit in schizophrenia and has been linked to frontal lobe alterations. We aimed to identify (1) prefrontal cerebral areas in which decreased volume is linked to executive dysfunction in schizophrenia; and (2) areas throughout the brain that are volumetrically related to the prefrontal area identified in the first analysis, thus detecting more extended volumetric networks associated with executive functioning.

Method

Fifty-three outpatients with schizophrenia and 62 healthy controls, matched for age, gender and handedness, were recruited. High-resolution images were acquired on a 1.5 tesla scanner and regional gray and white matter volumes were analyzed by voxel-based morphometry within SPM5 (statistical parametric mapping, University College London, UK). Executive functioning was assessed using the Wisconsin Card Sorting Test (WCST).

Results

Twenty-one patients with poor executive functioning showed reduced dorsolateral prefrontal and anterior cingulate gray matter volume as compared to 30 patients with high WCST performance, with a maximum effect in the left dorsolateral prefrontal cortex. Left dorsolateral prefrontal gray matter volume predicted WCST performance after controlling for possible confounding effects of global cognitive functioning, verbal attention span, negative symptoms, illness duration and education. In this area, both patient groups had less gray matter than healthy controls. Left dorsolateral prefrontal gray matter volume was positively related to dorsal prefrontal, anterior cingulate and parietal gray matter volume; and negatively related to thalamic, cerebellar, pontine and right parahippocampal gray matter volume.