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Pathophysiology of ‘positive’ thought disorder in schizophrenia

Published online by Cambridge University Press:  03 January 2018

Philip McGuire ,
Digby Quested ,
Sean Spence ,
Robin Murray ,
Christopher Frith  and
Peter Liddle
Philip McGuire
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
Digby Quested
Affiliation:
Warneford Hospital, Oxford OX3 7JX
Sean Spence
Affiliation:
MRC Cyclotron Unit, Hammersmith Hospital, London
Robin Murray
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
Christopher Frith
Affiliation:
Wellcome Department of Cognitive Neurology, Institute of Neurology, London
Peter Liddle
Affiliation:
MRC Cyclotron Unit, Hammersmith Hospital, London
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Abstract

Background

Formal thought disorder is a characteristic feature of psychosis, but little is known of its pathophysiology. We have investigated this in schizophrenia using positron emission tomography (PET).

Method

Regional cerebral blood flow was measured using H215O and PET while six people with schizophrenia were describing a series of 12 ambiguous pictures which elicited different degrees of thought-disordered speech. In a within-subject design, the severity of positive thought disorder was correlated with cerebral blood flow across the 12 scans in each subject.

Results

Verbal disorganisation (‘positive’ thought disorder) was inversely correlated with activity in the inferior frontal, cingulate and left superior temporal cortex, and positively correlated with activity in the parahippocampal/anterior fusiform region bilaterally, and in the body of the right caudate (P<0.001). The total amount of speech produced (independent of thought disorder) was positively correlated with activity in the left inferior frontal and left superior temporal cortex.

Conclusions

The severity of positive thought disorder was inversely correlated with activity in areas implicated in the regulation and monitoring of speech production. Reduced activity in these regions may contribute to the articulation of the linguistic anomalies that characterise positive thought disorder. The positive correlations between positive thought disorder and parahippocampal/anterior fusiform activity may reflect this regions role in the processing of linguistic anomalies.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 3 , September 1998 , pp. 231 - 235
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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