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Cerebral Cortex Advance Access published online on July 24, 2009
Cerebral Cortex, doi:10.1093/cercor/bhp146
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Nonlinear Response of the Anterior Cingulate and Prefrontal Cortex in Schizophrenia as a Function of Variable Attentional Control

Giuseppe Blasi1, Paolo Taurisano1, Apostolos Papazacharias1, Grazia Caforio1, Raffaella Romano1, Luciana Lobianco1, Leonardo Fazio1, Annabella Di Giorgio1, Valeria Latorre1, Fabio Sambataro2, Teresa Popolizio3, Marcello Nardini1, Venkata S. Mattay2, Daniel R. Weinberger2 and Alessandro Bertolino1,3

1 Psychiatric Neuroscience Group, Section on Mental Disorders, Department of Neurological and Psychiatric Sciences, University of Bari, Bari 70124, Italy, 2 Genes, Cognition, and Psychosis Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA, 3 Department of Neuroradiology, Istituto di Ricovero e Cura a Carattere Scientifico "Casa Sollievo della Sofferenza," San Giovanni Rotondo 71013, Italy

Address correspondence to Alessandro Bertolino. Email: a.bertolino{at}psichiat.uniba.it.

Previous studies have reported abnormal prefrontal and cingulate activity during attentional control processing in schizophrenia. However, it is not clear how variation in attentional control load modulates activity within these brain regions in this brain disorder. The aim of this study in schizophrenia is to investigate the impact of increasing levels of attentional control processing on prefrontal and cingulate activity. Blood oxygen level–dependent (BOLD) responses of 16 outpatients with schizophrenia were compared with those of 21 healthy subjects while performing a task eliciting increasing levels of attentional control during event-related functional magnetic resonance imaging at 3 T. Results showed reduced behavioral performance in patients at greater attentional control levels. Imaging data indicated greater prefrontal activity at intermediate attentional control levels in patients but greater prefrontal and cingulate responses at high attentional control demands in controls. The BOLD activity profile of these regions in controls increased linearly with increasing cognitive loads, whereas in patients, it was nonlinear. Correlation analysis consistently showed differential region and load-specific relationships between brain activity and behavior in the 2 groups. These results indicate that varying attentional control load is associated in schizophrenia with load- and region-specific modification of the relationship between behavior and brain activity, possibly suggesting earlier saturation of cognitive capacity.

Key Words: attention • cognitive load • fMRI • parametric design


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