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SPET study of verbal fluency in schizophrenia and epilepsy

Published online by Cambridge University Press:  03 January 2018

John D. C. Mellers*
Affiliation:
Department of Neuropsychiatry, Maudsley Hospital, London
Naoto Adachi
Affiliation:
Department of Psychological Medicine, King's College Hospital, London
Noriyoshi Takei
Affiliation:
Section of Genetics, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London
Alice Cluckie
Affiliation:
Department of Nuclear Medicine, King's College Hospital, London
Brian K. Toone
Affiliation:
Department of Psychological Medicine, King's College Hospital, London
W. Alwyn Lishman
Affiliation:
Section of Neuropsychiatry, Institute of Psychiatry, London
*
Dr J. D. C. Meilers, Department of Neuropsychiatry, Maudsley Hospital, Denmark Hill, London SE5 8AZ

Abstract

Background

The association between temporal lobe epilepsy and schizophrenia suggests that the critical abnormality may be pathology within the temporal lobes. People with schizophrenia-like psychosis of epilepsy (SLPE) provide a useful group in which to examine the importance of temporal and frontal lobe dysfunction in schizophrenia.

Method

A verbal fluency activation paradigm and a 99mTc HMPAO SPET were used to study frontotemporal function in people with SLPE (n = 12), schizophrenia (n = 11) and epilepsy (n = 16).

Results

People with SLPE differed from both other groups by showing lower blood flow in the left superior temporal gyrus during performance of a verbal fluency task compared with a word repetition task (F=5.4, P=0.01). During the verbal fluency task people with primary schizophrenia showed a greater increase in blood flow in anterior cingulate (F=4.5, P=0.02) than the other two groups. There were no between-group differences in frontal brain regions.

Conclusion

Our findings support an association between left temporal lobe abnormality and SLPE. The different patterns of activation observed in people with primary schizophrenia and SLPE suggests that different pathophysiological mechanisms may operate in these two groups. In SLPE the pathophysiology may be relatively confined to the dominant temporal lobe.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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