Department of Psychiatry, School of Medicine, University of Muenster, Germany.
Brain Cogn. 2012 Aug;79(3):245-51. doi: 10.1016/j.bandc.2012.03.007. Epub 2012 May 1.
The remediation of executive function in patients with schizophrenia is important in rehabilitation because these skills affect the patient's capacity to function in the community. There is evidence that instructional techniques can improve deficits in the Wisconsin Card Sorting Test (WCST) in some schizophrenia patients. We used a standard test/training phase/standard test format of the WCST to classify 36 schizophrenia patients as high-achievers, learners or non-retainers. All healthy controls performed as high-achievers. An event-related fMRI design assessed neural activation patterns during post-training WCST performance. Patients showed a linear trend between set-shifting related activation in the anterior cingulate cortex and learning potential, i.e. increased activation in high-achievers, a trend for increased activation in learners, and no activation in non-retainers compared to controls. In addition, activation in the temporoparietal cortex was highest in patients classified as learners, whereas in non-retainers activation was increased in the inferior frontal gyrus compared to controls and high-achieving patients. These results emphasize the relevance of the ACC's neural integrity in learning set-shifting strategies for patients with schizophrenia. Also, our results support the hypothesis that compensatory neural activation in patients with schizophrenia helps them to catch up with healthy controls on cognitive tasks.
在精神分裂症患者的康复中，矫正执行功能非常重要，因为这些技能影响着患者在社区中的功能能力。有证据表明，在一些精神分裂症患者中，教学技术可以改善威斯康星卡片分类测试（WCST）的缺陷。我们使用 WCST 的标准测试/训练阶段/标准测试格式，将 36 名精神分裂症患者分为高成就者、学习者或非保留者。所有健康对照组都表现为高成就者。事件相关 fMRI 设计评估了训练后 WCST 表现期间的神经激活模式。患者在前扣带皮层与学习潜能相关的转变相关激活方面表现出线性趋势，即高成就者的激活增加，学习者的激活趋势增加，而非保留者与对照组相比没有激活。此外，学习者被归类为患者的颞顶叶皮层的激活最高，而非保留者的激活与对照组和高成就者相比，在前额下回增加。这些结果强调了 ACC 的神经完整性在学习转换策略方面对精神分裂症患者的相关性。此外，我们的结果支持这样一种假设，即精神分裂症患者的代偿性神经激活有助于他们在认知任务上赶上健康对照组。
