Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc.
World J Radiol. Jun 28, 2014; 6(6): 261-273
Published online Jun 28, 2014. doi: 10.4329/wjr.v6.i6.261
Table 1 Functional magnetic resonance imaging studies of sustained attention in Schizophrenia
Ref.ParticipantsTask and behavioral resultsfMRI methods and results
Volz et al[57], 1999SCZ (n = 14), age 34.1 ± 12.3, males 78.6%, medicated 100%CPT-IP. Type of stimuli: lettersTNS = 720, Target = 25%, SET = 600 ms, ISI = 1200 ms, TET = 30 min1.5 T, block design (4 blocks). baseline: finger tapping Whole brain analysis. Imaging package: SPM96
NC (n = 20), age 28.2 ± 5.7, males 60%Required response: on targets.Behavioral measures: hit rate, mean RT, d’, ln b Results: no between group differencesResults: NC > SCZ in the R mesial PFC, ACC and L TH
Eyler et al[58], 2004SCZ (n = 8)/SCA (n = 1) age 58.9 ± 9.9, males 55.6%, illness duration: 33 yr, medicated 100%CPT-X. Type of stimuli: letters. TNS = 72Target = 33.3% ISI = 500 ms, TET = 6 min 3 s1.5 T, block design. baseline: digit fixation 8 task blocks and 9 baseline blocks Whole brain analysis. Imaging package: AFNI
NC (n = 10), age 59.8 ± 5.7, 12 males 60%Required response: on targets Behavioral measures: mean RT, d’ Results: no between group differencesResults: NC > SCZ in R IFG/insula (BA 47/45)SCZ > NC in R postcentral gyrus (BA 3) and L cerebellum
Salgado-Pineda et al[59], 2004SCZ (n = 14), age 25.5 ± 4.1, males 50%, medicated 100%, illness duration: 1.9 yrCPT-IP. Type of stimuli: numbers. TNS = 900Target = 15% ISI = 1100 ms, TET = 14min1.5 T, block design. baseline: digit response
2 task blocks and 2 baseline blocks. Whole brain analysis. Imaging package: SPM2
NC (n = 14), age 25.1 ± 3.3, males 50%Required response: on targets Behavioral measures: omission errors, commission errors, mean RT, d’, ln bResults: Between group differences-omissions, commission and d’: NC > SCZ-mean RT: SCZ > NCResults:NC > SCZ in R IFG (BA 44), R angular gyrus (BA 39), R STG (BA 37), R MTG (BA 21), R TH
Honey et al[60], 2005N-SCZ: SCZ with both negative and positive symptoms: (n = 11), age 42.6 ± 9.2, males 90.9%, age of onset: 22.2 yr, medicated 100%CPT-X with 2 levels of difficulty: undegraded and degraded stimuli (0% and 40% pixel inverted). Type of stimuli: digits TNS = 280 Target = 25% SET = 42 ms, ISI = 958 ms TET = 6 min3T, block design, baseline: screen fixation 10 task blocks and 10 baseline blocks. Imaging package: SPM2 Masked brain analysis (ROIs involved in attention processing, differentiating the groups and showing a task related activity associated to attentional load). Connectivity analysis (seed ROIs: ACC and cerebellar vermis)
P-SCZ: SCZ with predominant positive symptoms: (n = 11) age 41.1 ± 9.2, males 81.8%, age of onset: 24.7 yr, medicated 100%Required response: on targets Behavioral measures: mean RT, d’Results: N-SCZ were less accurate than NC in target discrimination (d’)Results Task vs baseline:NC > (P-SCZ = N-SCZ) in R and L angular gyrus, MFG, L putamen(P-SCZ = N-SCZ) > NC in R and L SFG, R and L IPL, R SPL, R post central gyrus, L precentral gyrus, R and L TH, ACC, PCC, R MiFG, R IFG, cerebellum; P-SCZ > N-SCZ in R STG, R MiFG and L SPL
NC (n = 12), age 33.3 ± 11.8, 12 males 83.3%Connectivity with ACC:NC > (P-SCZ = N-SCZ) in R and L MSFG, R and L IFG; (P-SCZ = N-SCZ) > NC in R and L precentral gyrus, R postcentral gyrus, cerebellum; P-SCZ > N-SCZ in ACC; N-SCZ > P-SCZ in SMA
Connectivity with cerebellum:NC > (P-SCZ = N-SCZ) in R and L MSFG, L MFG; (P-SCZ = N-SCZ) > NC in L MiFG; P-SCZ>N-SCZ in R and L IFG, ACC, L SPL, R precentral gyrus, L postcentral gyrus
Morey et al[61], 2005UHR (n = 10), age 22.6 ± 4.4, male 50%, medicated 20%,Visual oddball taskType of stimuli: circles (“targets”), squares (frequent non targets-“standards”), objects (rare non targets-“novels”)1.5T, 7 runs. Event-related design. Imaging package: SPM99ROI analysis: ACC, MiFG, IFG, BG, and TH. Conditions: -Targets-Novels-Standards (baseline)
Early SCZ (n = 15) age 24.1 ± 6.5, male 67%, age of onset 22.3 yr, illness duration 1.7 yr, medicated 86.7%TNS = 1400 Target = 3% SET = 500 ms, ISI = 1500 ms, TET = 36 min 24 s Required response: on both targets and non-targetsResultsTargets vs novels activations-in ACC, MiFG and IFC: NC > UHR, Early SCZ and Chronic SCZ-in IFG: (1) NC> Early SCZ and Chronic SCZ; (2) only NC and UHR showed R > L activations, whereas Early SCZ and Chronic SCZ showed a reduced laterality
Chronic SCZ (n = 11) age 38.1 ± 7.7, male 82%, age of onset 22.9 yr, illness duration 15.3 yr, medicated 100%Behavioral measures: hit rate, d’, B’’Target vs baseline activations: -in ACC, MiFG and IFC: NC > Early SCZ and Chronic SCZ -in BG and TH: NC > Early SCZ and Chronic SCZ (results confirmed comparing Chronic SCZ with Older NC)
NC (n = 16) age 28.0 ± 11.6, male 59% Older NC (n = 10) age 34.0 ± 12.1, male 67%Results: Between group differences: -Hit rate: NC > Early SCZ and chronic SCZ -d’: NC > UHR, Early SCZ and Chronic SCZ
Liddle et al[62], 2006SCZ (n = 24)/SCA (n = 4) age 31.6 ± 10.1, males 67.9%, illness duration 7 yr, medicated 96.4%Auditory oddball task Type of stimuli: 1500 Hz tones (“targets”), 1000 Hz tones (frequent non targets-“standards”), noises (rare non targets-“novels”)1.5 T, event related design, whole brain analysis Imaging package: SPM99. Conditions: -correct targets-correct novels-correct standards (baseline)-missed targets-standard false alarms
NC (n = 28), age 28.2 ± 8.9, males 75 %TNS = 488 Target = 10% SET = 200 ms, ISI = 2000 ms, TET = 16 min Required response: on targets Behavioral measures: RT, omissions, commissionsResultsTargets vs baseline activations: NC > SCZ: in L and R amygdala, R hippocampus, R and L STS, L and R insula, R and L orbitofrontal cortex (BA 47), ACC, PCC, L and R SPL, R and L IPL, L and R middle IFG, L and R superior MFG, L and R TH, L and R striatum, L and R cerebellum
Results: SCZ were significantly slower and less accurate than NC
ResultsTargets vs novels activations: NC > SCZ in: L amygdala, L orbitofrontal cortex (BA 47), L anterior insula, rostral ACC and L striatum
Gur et al[63], 2007SCZ (n = 22), age 30.5 ± 9.1, males 59.1%, age of onset 22.5 yr, illness duration 12.4 yr, medicated 95.5%Visual oddball task. Stimuli: colored shapes Type of stimuli: red circles (“targets”), green circles (frequent non targets-“standards”), fractal images (rare non targets-“novels”)4T, event related design, whole brain analysis. Imaging package: FEAT/FMRIB. Conditions: -targets-novels-standards (baseline)
NC (n = 28), age 31.6 ± 8.5, males 57.1 %TNS = 200 Target = 15% SET = 1000 ms, ISI = 2000 ms, TET = 7 minRequired response: on targetsBehavioral measures: hit rate, RTResultsTargets vs baseline activations: NC > SCZ in R and L STG, L insula, R and L putamen, ACC, PCC, L SFG, L THSCZ > NC in R insula, R MiFG, L IPL
Results: no between group differencesNovels vs baseline activations: NC > SCZ in L IOG and L IPL SCZ > NC in L MOG, L fusiform, L precuneus, L IFG, R angular gyrus, SOG, SPL, MiFG
Harrison et al[64], 2007SCZ (n = 12), age 32.2 ± 8.0, males 100%, medicated 100%Multi-Source Interference Task (MSIT). Type of stimuli: digits SET = 2000 ms, ISI = 500 ms TNS = 160, TET = 11 min Required response: on all stimuli Behavioral measures: correct responses, RT3T, block design. Imaging package: SPM5 Conditions: -low difficulty Task (“baseline”)-high difficulty Task (“Task”)-fixation (“Rest”)
Whole brain analysis and ROI analysis of deactivation (“Rest”-“Task”) in medial PCC/rostral ACC and PCC/Precuneus
NC (n = 14), age 31.7 ± 8.0, males 100%Results: no between group differencesResultsSCZ > NC in deactivation of medial PCC/rostral ACC and PCC/Precuneus. In SCZ the magnitude of deactivation correlates with response speed and level of emotional awareness
Wolf et al[65], 2008SCZ (n = 16)/SCA (n = 1) age 31.9 ± 7.1, males 53 %, illness duration 9.9 yr, medicated 94.1%Auditory oddball taskType of stimuli: 2000 Hz tones (“targets”), 1000 Hz tones (frequent non targets-“standards”), sounds (rare non targets-“novels”)4T, event-related whole brain analysis. Imaging package: FEAT/FSL. Conditions:-targets -novels -standards (baseline)
NC (n = 21), age 28.6 ± 7.1, males 52%TNS = 200 Target = 15% SET = 150 ms, ISI = 1850 ms, TET = 6 min and 40 s Required response: on targets Behavioral measures: hit rate, RTResults: SCZ were significantly slower than NCResultsTargets vs baseline activations: SCZ > NC in: L precentral gyrus, ACC/SMA, L and R insula, L hippocampus, L and R STG/MTG, L superior MOGNovels vs baseline activations: SCZ > NC in: L IFG
Filbey et al[66], 2008POC-SCZ (n = 6) age 53, males 33.3% medicated 0% (drug naïve)Sustained attention taskType of stimuli: colored circlesRequired response: on targets Behavioral measures: RT1.5T. Block design. Imaging package: FSL Whole brain analysis baseline condition: circles fixation
NC (n = 8) age 41, males 62.5%Results: no between group differencesResultsNC > POC-SCZ in: R IPL (BA 7), R SPL (BA 7), R MTG (BA 21), R MOG (BA 18), R PCC (BA 31), R SFG (BA 10), R lingual gyrus (BA 18/19), R precentral gyrus (BA 9/43), R parahippocampal gyrus (BA 28), L cuneus (BA 18), L striatum; POC-SCZ > NC in: L STG (BA 21), L SFG (BA9) and R MTG (BA 19)
Carter et al[67], 2010SCZ (n = 9), age 29.8 ± 12.0, males 100%Visual selective attention task Type of stimuli: colored circles4T. Block/event-related mixed design. 10 runs. Imaging package: SPM. Conditions: -target events (3 s before-13.5 s after the event) -transient activation (3 s before-7.5 s after the onset of task block) -sustained activation (15 s before-70.5 s after the onset of task block)
NC (n = 12), age 25.5 ± 4.6, males 100%TNS = 1960 Target = 5 %SET = 500 ms, ISI = 1000 ms TET = 49 minRequired response: on both targets and non-targets Behavioral measures: correct targets, RTMasked brain analysis and ROI analysis in ACC, IFG, MiFG, IPS, BG, caudate and TH
Results-correct target percentage: NC > SCZ-RT: SCZ > NCResults -During transient activation NC > SCZ in: MiFG, IPS, caudate and TH-During target events NC > SCZ in THIn NC: positive correlation between accuracy and TH activation during sustained activation condition; In SCZ: negative correlation between RT and BG activation during target events
Sepede et al[68], 2010REL-SCZ (n = 11), age 34.4 ± 8.8, males 45.5% medicated 0% (drug naïve), smokers 36.4%CPT-X with 3 levels of difficulty: undegraded and degraded stimuli (0%, 25% and 40% pixel inverted). Type of stimuli: digits1.5T, event-related design, 3 runs (0%, 25% and 40% degraded) Whole brain analysis. Imaging package: BrainVoyager QX 1.9
NC (n = 11), age 32.0 ± 5.2, males 45.5%, smokers 36.4%TNT = 210, Target = 16% SET = 200 ms, ISI = 2000 ms, TET = 42 minTask conditions: -correct responses on target -incorrect responses on target -correct responses on non-targets (baseline)
Required response: on targets and non-targets Behavioral measures: correct targets, correct non-targets, RT Results: no between group differencesResults Correct targets vs baseline: NC > REL-SCZ in R precentral gyrus (BA 6/9), R and L insula (BA 13), MFG/dorsal ACC (BA 9/32)REL-SCZ > NC in deactivating PCC/retrosplenial cortex (BA 23/31) Incorrect target vs baseline: REL-SCZ > NC in L insula/IFG (BA 13/47) and R TH
Table 2 Functional magnetic resonance imaging studies of sustained attention in bipolar disorder
Ref.ParticipantsTask and behavioral resultsFMRI methods and results
Strakowski et al[69], 2004BDI (n = 10), age 25.5 ± 8.1, males 40%, euthymic, age of onset 23 yr, illness duration 2.2 yr, medicated 0% (drug free)CPT-IP. Type of stimuli: digits TNS = 400 SET = 700 ms, ISI = 750, TET = 6 min Required response: on targets. Behavioral measures: d’, percent correct, percent false positive3T, block design, 5 task blocks and 5 baseline blocks Baseline: digits fixation Whole brain analysis. Imaging package: CHIPS
NC (n = 10), age25.3 ± 7.3, males 40%Results: no between-group differencesResults:BDI > NC in: R IFG/insula (BA 13/47), R and L ventral PFC (BA 10/47), parahippocampus/amygdala (BA 34), MOG/MTG (BA 18/19/39), R IPL (BA 40), R SPL (BA 7/40), L postcentral gyrus (BA 43), hypothalamus; NC > BDI in: L fusyform gyrus (BA 20) and L MFG (BA 11)
Fleck et al[70], 2012BDI (n = 50), age 30 ± 10, males 30%, manic, medicated 80%CPT-IP. Type of stimuli: digits TNS = 900, Target = 15%, SET = 750 ms, ISI = 1000 ms, TET = 15 min4T, Event-related design, 3 runs (periods) Whole brain analysis. Imaging package: AFNI ROi based analysis: anterior-limbic network (IFG, BG, TH, amygdala, cerebellar vermis) + SFGBaseline: visual count down condition Task conditions: -hits, misses and false alarms -correct rejections on non-targets
NC (n = 34), age 31 ± 9, males 41%Required response: on targets Behavioral measures: A’, B’’, RT, correct rejectionResults: patients performed worse in terms of correct rejections and showed a trend vs a reduced A’Results: In period 1: NC > BD in cerebellum; BD > NC in TH; NC > BD in deactivation of L PCC and R angular gyrusIn period 2: NC > BD in bilateral IFG and L THIn period 3: NC > BD in activation of R IFGOver time: BD activated and NC deactivated L striatum and bilateral amygdala Unmedicated BD > medicated BD in activation of R IFG and cerebellum
Sepede et al[71], 2012BDI (n = 24), age 34.8 ± 8.0, males 41.7%, euthymic, age of onset 29.9, illness duration 4.7 yr, psychotic features during acute phases 95.8%, medicated 83.3%CPT-X with 2 levels of difficulty: undegraded and degraded stimuli (0% and 40% pixel inverted)Type of stimuli: digits TNT = 80, Target = 20%, TNS = 408 ± 30 SET = 200 ms, ISI = 2000 ms, TET = 14 min1.5T, event-related design, 2 runs (0%, and 40% degraded). Whole brain analysis. Imaging package: BrainVoyager QX 1.9.Task conditions: -correct responses on target -incorrect responses on target -correct responses on non-targets (baseline)
REL-BDI (n = 22), age 31.5 ± 7.3, males 31.8% medicated 0% (drug naïve)Required response: on targets and non-targets Behavioral measures: correct target, correct non-targets, incorrect target, incorrect non-target, mean RTResultsCorrect target vs baseline: (NC = REL-BDI) > BDI in R insula (BA13) REL-BDI > (NC = BDI) in deactivating PCC/retrosplenial cortex (BA 23/29) During the 40% degraded run, correct target condition: REL-BDI > (NC = BDI) in R and L IPL (BA 40), L insula/IFG (BA 13/45)
NC (n = 24), age 32.5 ± 6.2, males 33.3%Results: both BDI and REL-BDI were less accurate than NC in target recognition (percent correct target )Incorrect target vs baseline:(BDI = REL-BDI) > NC in middle PCC (BA 31) and R insula/IFG (BA 13/45)BDI > REL-BDI > NC in L insula (BA 13)