Executive attention deficits identified in first-episode schizophrenia

Oct 3 2012

By Ingrid Grasmo, medwireNews Reporter

Patients with first-episode schizophrenia (FES) have impairments in executive attention but not in alerting or orienting attention, suggest findings published in Bipolar Disorders.

The researchers suggest that executive attention deficit may therefore be a primary impairment during the progression of schizophrenia, even when clinical manifestations of the disease are controlled by antipsychotic medication.

They add that deficits in executive attention may underpin a large range of self-regulation disorders, and could explain why FES patients experience difficulties in exerting control over thoughts, feelings, and actions.

"Our results contribute with new data that can potentially facilitate a better understanding of the physiopathology, diagnosis, and rehabilitation of schizophrenia," say Marcela Peña (Pontificia Universidad Catolica de Chile, Santiago) and colleagues.

Evaluation of attention using the Attention Network Test (ANT) among 22 FES patients with a recent history of a single psychotic episode treated only with neuroleptics showed deficits in executive attention compared with 20 mentally healthy individuals.

The study also showed that global cognition was significantly lower in FES participants relative to controls on both the Dementia Rating Scale (DRS; 131.7 vs 141.7) and Raven's Progressive Matrices (RPM; 34.9 vs 55.6). Consistent with FES attention deficits, the mean overall attentional capacity estimated by the DRS' attention subscore was also significantly lower for FES patients.

Furthermore, analysis of attention networks efficiency revealed greater attention efficiency among controls relative to FES patients only in the executive attention network, while alerting and orienting attention were not significantly impaired.

The researchers caution that impairment in executive attention cannot be directly attributed to a global cognition deficiency, as FES patients did not exhibit a significant decrease in reaction time for alerting and orienting networks, or any extrapyramidal problems.

"Further studies with larger samples and cognitive assessment batteries are necessary to pinpoint the exact role of executive attention in specific cognitive problems of FES patients," they conclude.

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