Schizophrenia has different sub-types linked to problems in different parts of the brain

WASHINGTON -- Schizophrenia may not be one single disease but rather an array of disorders whose psychiatric and cognitive symptoms vary according to which part of the brain is affected and to what degree. That's the conclusion of a study published in the October issue of Neuropsychology, in which a seven-neuroscientist team linked schizophrenic subtypes with different memory problems and different brain anatomies. The scientists say this is a "first step in our efforts to uncover the specific biological mechanisms of the disorder," which they hope will lead to better diagnosis and treatment of people with schizophrenia. Neuropsychology is published by the American Psychological Association (APA).

Bruce Turetsky, M.D., of the University of Pennsylvania Health System, led the study, which examined 116 patients diagnosed with schizophrenia and 129 normal control participants. The researchers used the California Verbal Learning Test to assess different aspects of learning and memory, including overall recall ability, rate of learning over repeated trials, ability to retain learned material over time, and subsequent item recognition. Using MRI and PET scan images, they also studied the brain anatomy and metabolism of participants.

Analysis of the data revealed three clusters of patients with significantly different profiles of memory and brain measures. This means that there may be several different roads to schizophrenia's profoundly disordered cognition. Turetsky et al. identified the two cognitively impaired subtypes as "cortical" and "subcortical," consistent with the types of dementia observed in Alzheimer's and Huntington's disease, respectively.

The cortical subtype, found in 18 percent of the patients, was the most distinctive. These patients were predominantly male, younger, and with a relatively earlier age of illness onset . Their clinical symptoms were similar to those of the psychiatric diagnostic manual's (DSM-IV) "disor

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American Psychological Association

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