Functional neuroanatomy of auditory working memory in schizophrenia: Relation to positive and negative symptoms

Functional brain imaging studies of working memory (WM) in schizophrenia ha ve yielded inconsistent results regarding deficits in the dorsolateral pref rontal (DLPFC) and parietal cortices. In spite of its potential importance in schizophrenia, there have been few investigations of WM deficits using a uditory stimuli and no functional imaging studies have attempted to relate brain activation during auditory WM to positive and negative symptoms of sc hizophrenia. We used a two-back auditory WM paradigm in a functional MRI st udy of men with schizophrenia (N = 11) and controls (N = 13). Region of int erest analysis was used to investigate group differences in activation as w ell as correlations with symptom scores from the Brief Psychiatric Rating S cale. Patients with schizophrenia performed significantly worse and were sl ower than control subjects in the WM task. Patients also showed decreased l ateralization of activation and significant WM related activation deficits in the left and right DLPFC, frontal operculum, inferior parietal, and supe rior parietal cortex but not in the anterior cingulate or superior temporal gyrus. These results indicate that in addition to the prefrontal cortex, p arietal cortex function is also disrupted during WM in schizophrenia. Withd rawal-retardation symptom scores were inversely correlated with frontal ope rculum activation. Thinking disturbance symptom scores were inversely corre lated with right DLPFC activation. Our findings suggest an association betw een thinking disturbance symptoms, particularly unusual thought content, an d disrupted WM processing in schizophrenia. (C) 2001 Academic Press.