Rudolf Cohen

Physical Aspects of the EEG in Schizophrenics

Physical and dynamic aspects of the electroencephalogram (EEG) were evaluated in 12 schizophrenic patients and 12 matched healthy control subjects by means of two descriptive measures proposed by Hjorth (complexity and mobility) and by a nonlinear measure, dimensional complexity. These measures were compared to power spectra analyses. EEG was recorded from frontal, central, and parietal leads under resting conditions (eyes open and eyes closed) for 12 epochs each of 25 sec. Patients showed the expected increased activity in the 1-7 Hz band and, furthermore, a scalp distribution of dimensional complexity and Hjorth complexity opposite to the distribution in controls: in patients dimensional complexity yielded higher values at frontal (Fz) than central (Cz) leads, whereas the resemblance to sinusoidal waveshape (Hjorth complexity) was larger at Fz than Cz. Results indicate more dynamic complexity or variables determining the dynamics of brain processes in frontal areas in patients.

Analytical competence and language impairment in aphasia

Abstract Matched groups of Brocas and Wernickes aphasics, brain-damaged patients without aphasia and chronic schizophrenics were tested in a nonverbal matching task where the subject had to indicate which of two pictures was more closely linked to a clue picture. Eight additional verbal and nonverbal reference tasks were administered. Both aphasic groups performed worse than brain-damaged controls when the identification of individual attributes or actions shared by clue and referent was required, but were unimpaired when the two had a set of referential-situational associations in common. Factor analyses resulted for both groups in two factors, one of which represents general Language Impairment. For the Brocas aphasics this factor was closely related to general organic deficit as measured by the Trail Making Test; for the Wernickes aphasics it was associated with tasks which might be considered illustrative of analytical competence in isolating and comparing individual features of objects or concepts.

NEUROLOGICAL SOFT SIGNS IN SCHIZOPHRENIA : ASSESSMENT AND CORRELATES

A German version of the Neurological Evaluation Scale (NES) was administered to 143 schizophrenic patients, 45 of them being severly chronic and disabled. Seventy-eight alcohol-dependent inpatients and 57 healthy volunteers were tested as control groups. Neurological soft signs (NSS) were rated with convincing agreement. Schizophrenic patients are more impaired on all scales than healthy controls. The chronic, severly disabled schizophrenic patients are more impaired compared with the main group of schizophrenic patients and both control groups. A significant patients and alcohol-dependent patients was only found for the subscale “Motor Coordination”. Compared with healthy controls the alcohol-dependent patients show a higher NES total score. The NES total score was related to the relative width of the third ventricle. Total score and subscales were correlated consistently with the level of cognitive functioning as measured by the Raven Standard Progressive Matrices and various neuropsychological tests presumably sensitive to dysfunctions of the prefrontal cortex. The NSS were related to positive as well as to negative symptoms, the correlations with negative symptoms being confined to items of “Cognitive Disorganization”. This close association of psychomotor and cognitive dysfunctions may be seen as related to the frequently discussed dysfunctions of the prefrontal cortex or the neurointegrative deficit postulated by Meehl.

Interhemispheric cooperation during word processing: evidence for callosal transfer dysfunction in schizophrenic patients

Functional lateralization and interhemispheric interaction during word processing were investigated in schizophrenic patients (n=12) and matched healthy controls (n=18). Words and phonologically regular pseudowords were presented tachistoscopically either in the left or right visual field (unilateral conditions), or simultaneously in both visual hemifields (bilateral condition). Consistent with earlier findings, healthy controls showed a right visual field advantage (RVFA), indicating left-hemispheric dominance for language. The patients showed a RVFA similar to that of controls, consistent with normal left-hemispheric language dominance. Importantly, controls performed much better on words presented in the bilateral condition, when two copies of the same word appeared twice, compared to stimulation in only one of the visual hemifields. This bilateral advantage, which has been interpreted as evidence for cooperation between the hemispheres, was absent in schizophrenics. These data show that schizophrenic patients can exhibit similar lateralization patterns as healthy controls. Their specific functional deficit may be a lack of cooperation between the hemispheres.

AFFECTIVE MODULATION OF THE STARTLE REFLEX IN SCHIZOPHRENIC PATIENTS

Startle-elicited blinks were measured during the presentation of affective slides in order to investigate emotional responsiveness in 24 male healthy subjects and 34 male schizophrenic patients. Although the two groups did not differ with regard to their subjective and autonomic responses to the slide stimuli, there was a significant difference between the groups in their responses to the startle probes. Patients rated low in affective expression showed a linear response pattern comparable to that of normal controls with largest amplitudes during unpleasant slides and smallest during pleasant slides. Patients without apparent deficit in affective expression showed a quadratic relationship with smaller blink amplitudes during both pleasant and unpleasant slides. Diminished affective expression rated on the basis of a clinical interview is not associated with a general attenuation of the blink reflex or of its modulation by exposure to emotional slides. Thus, we found no indication of an impairment in the perception of affective stimuli nor of reduced appreciation of pleasant stimuli (anhedonia) in these patients.

Motoric neurological soft signs and psychopathological symptoms in schizophrenic psychoses.

Motoric neurological soft signs (NSS) were investigated by means of the Brief Motor Scale (BMS) in 82 inpatients with DSM-III-R schizophrenic psychoses. To address potential fluctuations of psychopathological symptoms and extrapyramidal side effects, patients were examined in the subacute state, twice at an interval of 14 days on the average. NSS were significantly correlated with severity of illness, lower social functioning, and negative symptoms. Modest, but significant correlations were found between NSS and extrapyramidal side effects as assessed on the Simpson-Angus Scale. Neither the neuroleptic dose prescribed to the patient, nor scores for tardive dyskinesia and akathisia were significantly correlated with NSS. Moreover, NSS scores did not significantly differ between patients receiving clozapine and conventional neuroleptics. Patients in whom psychopathological symptoms remained stable or improved over the clinical course showed a significant reduction of NSS scores. This finding did not apply to those patients in whom psychopathological symptoms deteriorated. Our findings demonstrate that NSS in schizophrenic psychoses are relatively independent of neuroleptic side effects, but they are associated with the severity and persistence of psychopathological symptoms and with poor social functioning.

Electroencephalographic activity over temporal brain areas during phonological encoding in picture naming

OBJECTIVES The present study examined electroencephalographic (EEG) correlates of phonological encoding during picture naming with special emphasis on hemispheric asymmetries of these EEG correlates. We also examined whether a small set of stimuli was sufficient to study the phonological encoding, and to what extent the complexity of the produced message affects the EEG responses. METHODS Event-related electrical brain activity during the covert and overt production of names and nominal phrases derived from 16 variants from 4 different pictures was compared with that during passive viewing of the same pictures. RESULTS Topographical and source analyses of the differential EEG activity (naming versus passive viewing) indicated that the N1 and P2 components of the visual evoked potential resulted from the same brain areas, but were activated stronger during naming as compared to passive viewing. In contrast, the differential EEG activity from 275 to 400 ms suggested the involvement of additional brain areas during naming with more pronounced left- than right-hemispheric activation in middle and posterior temporal regions for both overt and covert naming. CONCLUSIONS Results suggest the involvement of Wernickes area in the phonological encoding of a message during speech production, which can even be obtained with a small set of pictures and a large number of repetitions.

Verbal coding and visual memory in aphasics

Abstract Fluent and non-fluent aphasics, non-aphasic brain-damaged patients, schizophrenics, and normal controls were tested in a non-verbal visual retention task (object-drawings, snowflakes). All groups of neurological and psychiatric patients scored lower than normal controls under a rehearsal condition. Differences levelled off when a distractor task was interpolated. While fluent aphasics were impaired with both the object-drawings and the snowflakes, non-fluent aphasics were impaired only with the latter. Results are discussed with respect to the verbal-encoding hypothesis and other theories of aphasia.

The conceptual structure of aphasic and schizophrenic patients in a nonverbal sorting task

Hierarchical and overlapping cluster methods were applied to the sortings of aphasic, nonaphasic brain-damaged, schizophrenic, and normal subjects presented with 30 pictures of animals. The hierarchical structure solutions were most diffuse for the groups of the schizophrenics and the fluent aphasics. The structure for the nonfluent aphasics showed more clarity, but was also deviant from the structures of the normals and the brain-damaged without aphasia. Fluent aphasics but not nonfluent aphasics tended to sort pictures which they could not name into smaller groups. For the nonfluent aphasics, there was a significant correlation between the commonality of the sortings and the severity of aphasic disturbances as measured by the Token Test. The relationship between conceptual disorganization and language impairment seems to be functionally different for fluent and nonfluent aphasics.

Increased semantic and repetition priming in schizophrenic patients.

Positive and negative priming (PP and NP) in schizophrenia were studied with a lexical-decision task. Probe words, presented 800 ms after the response to the prime (containing a word and a nonword), were either identical to, semantically related to, or unrelated to the prime target word (PP) or to the prime distractor word (NP). Schizophrenic patients displayed stronger semantic and repetition PP than controls after controlling for their slower responses. Significant NP was observed in both groups for word repetition only. The PP findings contrast with results from studies with similar prime-probe intervals but without prime responses. It is proposed that schizophrenic patients, because of impaired (controlled) processes of response selection, strongly benefit from (or rely on) the automatic retrieval of processing episodes containing response information. Related findings indicating automatic response facilitation in schizophrenia are discussed.