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2 - Functional imaging of schizophrenia

from Section I - Schizophrenia

Published online by Cambridge University Press:  10 January 2011

By
Godfrey D. Pearlson
Edited by
Martha E. Shenton  and
Bruce I. Turetsky
Godfrey D. Pearlson
Affiliation:
Olin Neuropsychiatry Research Center Institute of Living Hartford, CT, USA and Department of Psychiatry Yale University School of Medicine New Haven, CT, USA
Martha E. Shenton
Affiliation:
VA Boston Healthcare System and Brigham and Women's Hospital, Harvard Medical School
Bruce I. Turetsky
Affiliation:
University of Pennsylvania
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Summary

Introduction

Functional magnetic resonance imaging (fMRI) neuroimaging investigations in schizophrenia have been used for a variety of purposes. These include shedding light on the underlying pathophysiology of the illness, understanding the neural basis of characteristic symptoms, aiding with diagnostic classification, predicting treatment outcome, and understanding the effects of risk genes for the disorder.

Many of these efforts have been complicated by the fact that no central etiopathology is known for the disorder, which is non-uniform in clinical presentation, and overlaps symptomatically with other psychiatric disorders. As well, there are many associated challenges and confounds that add variance to functional imaging data in schizophrenia, including the fact that many patients are chronically ill and routinely take multiple medications known to affect functional brain response. Due to both positive and negative schizophrenia symptoms, they may be unwilling or unable to engage fully with test procedures, especially on complex tasks requiring sustained attention. Much of the existing functional MRI literature is based on blood oxygen level-dependent (BOLD) activation differences gathered during the performance of cognitive tasks, most often those on which patients are known characteristically to perform poorly outside of the scanner. Such an approach has undoubtedly been valuable and produced a large and rich literature. However, none of the fMRI abnormalities recorded in this manner to date has proved diagnostic, and as we discuss below, illness-related performance differences can introduce unavoidable confounds in such task designs.

Keywords

cognitive neuroscience tasksfMRIfunctional network connectivityschizophreniapositive-symptom-based approachesMorris water taskparallel independent component analysis
Type
Chapter
Information
Understanding Neuropsychiatric Disorders
Insights from Neuroimaging
 , pp. 30 - 47
Publisher: Cambridge University Press
Print publication year: 2010

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