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Processing speed impairment in schizophrenia is mediated by white matter integrity

Published online by Cambridge University Press:  15 May 2014

H. Karbasforoushan ,
B. Duffy ,
J. U. Blackford  and
N. D. Woodward
H. Karbasforoushan
Affiliation:
Psychotic Disorders and Psychiatric Neuroimaging Programs, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, USA
B. Duffy
Affiliation:
Psychotic Disorders and Psychiatric Neuroimaging Programs, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, USA
J. U. Blackford
Affiliation:
Psychotic Disorders and Psychiatric Neuroimaging Programs, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, USA
N. D. Woodward*
Affiliation:
Psychotic Disorders and Psychiatric Neuroimaging Programs, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, USA
*
*Address for correspondence: N. D. Woodward, Ph.D., Psychiatric Neuroimaging and Psychotic Disorders Programs, Vanderbilt Psychiatric Hospital, Suite 3057, 1601 23rd Avenue South, Nashville, TN 37212, USA. (Email: [email protected])
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Abstract

Background

Processing speed predicts functional outcome and is a potential endophenotype for schizophrenia. Establishing the neural basis of processing speed impairment may inform the treatment and etiology of schizophrenia. Neuroimaging investigations in healthy subjects have linked processing speed to brain anatomical connectivity. However, the relationship between processing speed impairment and white matter (WM) integrity in schizophrenia is unclear.

Method

Individuals with schizophrenia and healthy subjects underwent diffusion tensor imaging (DTI) and completed a brief neuropsychological assessment that included measures of processing speed, verbal learning, working memory and executive functioning. Group differences in WM integrity, inferred from fractional anisotropy (FA), were examined throughout the brain and the hypothesis that processing speed impairment in schizophrenia is mediated by diminished WM integrity was tested.

Results

WM integrity of the corpus callosum, cingulum, superior and inferior frontal gyri, and precuneus was reduced in schizophrenia. Average FA in these regions mediated group differences in processing speed but not in other cognitive domains. Diminished WM integrity in schizophrenia was accounted for, in large part, by individual differences in processing speed.

Conclusions

Cognitive impairment in schizophrenia was mediated by reduced WM integrity. This relationship was strongest for processing speed because deficits in working memory, verbal learning and executive functioning were not mediated by WM integrity. Larger sample sizes may be required to detect more subtle mediation effects in these domains. Interventions that preserve WM integrity or ameliorate WM disruption may enhance processing speed and functional outcome in schizophrenia.

Keywords

Mediationprocessing speedschizophreniawhite matter
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 1 , January 2015 , pp. 109 - 120
Copyright
Copyright © Cambridge University Press 2014 

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