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Abstract
BackgroundSchizophrenia is a severe mental disorder involving impairments in executive functioning, which are important cognitive processes that can be assessed by planning tasks such as the Stockings of Cambridge (SOC), and tasks of rule learning/abstraction such as the Wisconsin Card Sorting Test (WCST). We undertook this study to investigate the association between performance during separate phases of SOC and WCST, including mean cerebral blood flow velocity (MFV) measurements in chronic schizophrenia.MethodsFunctional transcranial Doppler sonography (fTCD) was used to assess bilateral MFV changes in the middle (MCA) and anterior (ACA) cerebral arteries. Twenty-two patients with chronic schizophrenia and 20 healthy subjects with similar sociodemographic characteristics performed SOC and WCST during fTCD measurements of the MCA and the ACA. The SOC was varied in terms of easy and difficult problems, and also in terms of separate phases, namely mental planning and movement execution. The WCST performance was assessed separately for maintaining set and set shifting. This allowed us to examine the impact of problem difficulty and the impact of separate phases of a planning task on distinct intervals of WCST. Simultaneous registration of MFV was carried out to investigate the linkage of brain perfusion during the tasks.ResultsIn patients, slowing of movement execution during easy problems (SOC) was associated with slowing during maintaining set (WCST) (P < 0.01). In healthy subjects, faster planning and movement execution during predominantly difficult problems were associated with increased performance of WCST during set shifting (P < 0.01). In the MCA, patients showed a significant and positive correlation of MFV between movement execution and WCST (P < 0.01).ConclusionThe results of this study demonstrate performance and brain perfusion abnormalities in the association pattern of two different tasks of executive functioning in schizophrenia, and they support the notion that executive functions have a pathological functional correlate predominantly in the lateral hemispheres of the brain. This study also underpins the scientific potential of fTCD in assessing brain perfusion in patients with schizophrenia.
Highlights
Schizophrenia is a severe mental disorder involving impairments in executive functioning, which are important cognitive processes that can be assessed by planning tasks such as the Stockings of Cambridge (SOC), and tasks of rule learning/abstraction such as the Wisconsin Card Sorting Test (WCST)
To the best of our knowledge, there are no studies to date that have investigated the association of performance/brain perfusion between separate phases of a planning task and an abstraction/rule generation task such as the WCST in schizophrenia
Associations of performance: Zero-order correlation analyses using Pearson's product moment correlation coefficient were applied to assess the linkage between SOC and WCST. a) SOC variables: adjusted planning time, movement execution time, b) WCST variables: Reaction time (RT) before and during set shifting
Summary
Schizophrenia is a severe mental disorder involving impairments in executive functioning, which are important cognitive processes that can be assessed by planning tasks such as the Stockings of Cambridge (SOC), and tasks of rule learning/abstraction such as the Wisconsin Card Sorting Test (WCST). To the best of our knowledge, there are no studies to date that have investigated the association of performance/brain perfusion between separate phases of a planning task and an abstraction/rule generation task such as the WCST in schizophrenia. The examination of such relationships is interesting because the WCST is a complex multidimensional task that has frequently been applied in schizophrenia [5]. Morice and Delahunty [2], examining WCST, TOL and other tasks of working memory (WM) in schizophrenia, suggested a failure to acquire the ability to process complex information
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