SUBTYPING SCHIZOPHRENIA WITH MEMORY TESTS, MRI AND FMRI

描述（改编自申请人的摘要）：精神分裂症是一种 在认知功能障碍方面的异质性障碍。 这 异质性被认为反映了脑病理生理学中的异质性， 尽管这尚未得到实验验证。 的首要目标 本项目是使用功能和结构MRI来证实假设的 两组精神分裂症患者脑功能障碍的差异 在初步研究中， 功能障碍 三项独立的试点研究证明并证实了 子群体的存在。 一组在听觉和语言方面有很大的缺陷， 工作记忆，但在更困难的听觉任务上表现正常 非语言工作记忆 另一组在这两方面都有明显的赤字， 语言和非语言测试以及简单的知觉任务。 每个 约占精神分裂症患者的20%。 的 该项目的第二个目标是进一步表征认知 使用广泛的神经认知测试， 电池 150名患者和50名对照将参加这项研究， 认知. 将选择功能性和结构性MR患者， 在认知测试的基础上，表现符合一项或多项标准， 在初步研究中确定的两个亚组中的另一个亚组（n=25， 每个）。 在性别、年龄和性别上与每个患者组匹配的对照组 父母教育（每组n=25）也将参与MRI。 功能 研究将使用言语和非言语听觉工作记忆激活 任务，专门针对大脑系统的基础认知 两组的功能障碍。 结构核磁共振成像将集中在额叶 和颞叶，两者的体积都较小 在精神分裂症患者中，两者都是大脑的一部分 工作记忆系统。 如果假设两者之间的差异 脑和认知功能障碍的患者群体被证实，它将 支持认知测量在分型中的价值，并帮助表征 两个病理生理学上不同的亚组。 查明这类 亚组是未来病因学和治疗研究的关键。

DESCRIPTION (Adapted from applicant's abstract): Schizophrenia is a disorder heterogeneous with respect to cognitive dysfunctions. This heterogeneity is presumed to reflect heterogeneity in brain pathophysiology, although this has not been experimentally verified. The primary goal of this project is to use functional and structural MRI to confirm hypothesized differences in brain dysfunction between two groups of schizophrenic patients that in preliminary studies differed markedly in cognitive dysfunction. Three independent pilot studies demonstrated and confirmed the existence of the subgroups. One group has large deficits in auditory verbal working memory but normal performance on more difficult tasks of auditory nonverbal working memory. The other group has marked deficits on both the verbal and nonverbal tests as well as on simple perceptual tasks. Each subgroup represents about 20 percent of patients with schizophrenia. The second goal of this project is to characterize further the cognitive differences between the groups using a broad ranging neurocognitive test battery. 150 patients and 50 controls will participate in this study of cognition. Patients will be selected for functional and structural MR who on the basis of cognitive test performance meet criteria for one or the other of the two subgroups identified in the preliminary studies (n=25 in each). Groups of controls matched to each patient group in gender, age and parental education (n=25 in each) will also participate in MRI. Functional studies will use verbal and nonverbal auditory working memory activation tasks to specifically target the brain systems that underlie the cognitive dysfunctions in the two groups. Structural MRI will focus on the frontal and temporal lobes, both of which have been reported to be smaller in volume in patients with schizophrenia and both of which are part of the brain systems of working memory. If hypothesized differences between the two groups of patients in brain and cognitive dysfunction are confirmed, it will support the value of cognitive measures in subtyping and help characterize two pathophysiologically distinct subgroups. Identification of such subgroups is essential for future studies of etiology and treatment.