ABNORMALITIES IN THE DISTRIBUTED NETWORK OF SUSTAINED ATTENTION PREDICT NEUROLEPTIC TREATMENT RESPONSE IN SCHIZOPHRENIA

The regional cerebral metabolic rates of 19 male medication-withdrawn schizophrenic patients were determined by positron emission tomography (PET) while performing an auditory discrimination task (CPT). Regardl ess gf the accuracy of their CPT performance, the schizophrenic patien ts had lower metabolic rates in their prefrontal cortex and higher rat es in their posterior putamen compared to 41 healthy males. Abnormally low right anterior midprefrontal cortex metabolic rates predicted bet ter clinical response while high basal ganglia rates and low mid-cingu late rates predicted poor treatment response to neuroleptics. The find ings imply that the sustained attention pathway and its distributed ne twork of brain structures are likely to play an important role in the expression of psychotic symptoms and the mediation of their response t o antipsychotics. Published by Elsevier Science Inc.