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Visual Perceptual and Working Memory Impairments in Schizophrenia
Cenk Tek, MD;
James Gold, PhD;
Teresa Blaxton, PhD;
Christopher Wilk, MSc;
Robert P. McMahon, PhD;
Robert W. Buchanan, MD
Arch Gen Psychiatry. 2002;59:146-153.
Background Impairments in working memory have been proposed to underlie a broad
range of cognitive deficits seen in schizophrenia. Visual working memory impairments
are frequently reported in schizophrenia. Investigations of visual working
memory generally assume intact visual information processing, despite evidence
of visual perceptual impairments in schizophrenia. In this study, we evaluated
the integrity of the perceptual system for object and spatial visual information
and the relevant working memory system, after adjusting for individual perceptual
performance differences.
Methods Thirty patients with schizophrenia and 20 healthy control subjects underwent
testing using a task of perceptual discrimination of spatial and object visual
stimuli. For testing visual working memory, a delay was introduced to the
perceptual discrimination task. A thresholding procedure was used so that
each subject adequately perceived the information during the working memory
test.
Results Subjects with schizophrenia exhibited impaired performance relative
to controls for object and spatial visual perceptual discrimination. The extent
of impairment was greater for the object than for the spatial test. After
controlling for perceptual impairments, the subjects with schizophrenia exhibited
impaired performance relative to controls for the spatial working memory test
but not the object working memory test.
Conclusions Findings implicate dysfunction of posterior brain areas that mediate
visual perceptual processing and the prefrontal areas involved in the active
maintenance of information during delay intervals. However, the systems that
govern object and spatial visual perception and working memory appear to be
affected differentially by schizophrenia.
From the Maryland Psychiatric Research Center, Department of Psychiatry,
University of Maryland, Baltimore.
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