Review Article

Parietal Lobes in Schizophrenia: Do They Matter?

Table 3

Recent functional magnetic resonance imaging (MRI) and positron emission tomography (PET) studies on psychosis and schizophrenia with relevance to the parietal lobe.

InvestigatorSubject groupsAverage ageParadigmTested brain functionMethod of analysisMain findings in patients compared with ctlsConclusion

Arce et al.
2006 [46]
17 csz
17 ctrls
41
40
Visual Go/Nogo task with matched performance accuracy between csz and ctrlsInhibition and cue processingfMRIDuring cued inhibition: greater activation in the left precuneus and left superior temporal gyrus
During inhibition: less ACC and DLPFC activation
Implicit cue trials: greater inferior frontal gyrus activation
Csz have difficulties with inhibition and clue processing

Braus et al.
2006 [47]
11 FE
11 ctrls
25
29
Simultaneous presentation of acoustical and optical inputsBasic sensory input circuitsfMRILess activation of the PL, right thalamus, the right prefrontal cortexAlready at disease onset deficits in information processing are existing

Broome et al.
2009 [48]
17 UHR
10 FEP
15 ctrls
24
26
25
Verbal fluency task and an N-backWMfMRIActivation pattern in UHR was during the N-back task different in dorsolateral prefrontal and parietal cortex compared to ctrlsThe level of regional activation in the UHR group was intermediate between that in the FE group and ctrls

Franck et al.
2002 [49]
87 csz31Instructed to relax and not perform any tasksRandom episodic silent thought (REST)PETSchneiderian score positively correlated with rCBF in right superior parietal cortex and negatively correlated with rCBF in left posterior cingulate gyrus and in left lingual gyrusFindings support hypothesis that cerebral pattern of activation is linked to symptoms of SZ

Henseler et al.
2010 [50]
12 csz
12 ctrls
33
32
Verbal item-recognition task and a visuospatial item-recognition taskWMfMRISZ showed reduced connectivity of the prefrontal cortex with the intraparietal cortex and the hippocampusAltered prefronto-hippocampal and parieto-occipital connectivity was found to be associated with higher positive symptoms

Hugdahl et al.
2004 [51]
csz
depressed pts
ctrls
32
33
31
First task: pressing a response button whenever a specific number was seen
Second task: adding two consecutive numbers
Vigilance task
Mental arithmetic task
fMRILess activation in prefrontal brain regions and greater parietal lobe activation relative compared to ctrls and patients with major depression.In support double dissociation of parietal and frontal lobe activation between SZ and depression

Keedy et al.
2006 [52]
15 FE
24 ctrls
25
25
Eye movement tasks: visually guided saccade, smooth pursuit paradigms and oculomotor delayed response paradigmOculomotor function
Spatial working memory
fMRIReduced activation in sensorimotor areas supporting eye movement control: parietal cortex, frontal eye fields, supplementary eye fields, and cingulated cortexGeneralized pattern of cortical dysfunction already present early SZ

Keshavan et al.
2002 [53]
4 GHR
4 ctrls
13
13
Memory-guided saccade taskSpatial working memoryfMRIDecreased activation in the inferior parietal cortex and the DLPFCDysfunction of prefrontal and parietal regions in GHR

Kim et al.
2003 [54]
12 csz
12 ctrls
26
26
n-back sequential picture taskWMPETDorsolateral prefrontal, ventrolateral prefrontal and bilateral inferior parietal region activation abnormalitiesIndicating that during working memory tasks there could be a parietofrontal disconnection

Öngür et al.
2006 [55]
20 csz
17 ctrls
40
38
Discrimination of previously seen and new pairs of visual stimuliRelational memoryfMRIWhile discriminating novel pairs decreased activation of the right parietal cortex and the anterior cingulate cortexDeficit of relational memory connected to dysfunctional activation of the parietal cortex and the hippocampus

Ojeda et al.
2002 [56]
11 csz drug naive
10 ctrls
28
26
Auditory stimulation task
Counting tasks with or without auditory stimulation
Attention tasksPETInadequate activation of parietal and frontal regions during performance of cognitively emanding tasksEvidence of compensatory mechanisms in frontoparietal regions

Paulus et al.
2003 [57]
15 scz
15 ctrls
42
41
Two-choice prediction taskDecision making with different degrees of uncertaintyfMRIPL less activated in decision making in situations with high uncertain outcomeInadequate processing in situations of uncertainty in the posterior parietal cortex

Quintana et al.
2003 [58]
8 sz
8 ctrls
Anticipatory task
Retention task
WMfMRIAnticipatory task: decreased PFC and increased PPC activation
Retention task: increased PFC activation
PFC shows more hypoactivation than PPC is able to compensate

Sanz et al.
2009 [59]
13 csz
no information about ctrls included
20verbal capacity taskverbal WMfMRILower levels of activation in frontal lobe, PL in the left hemisphereDysfunctional activation during WM processing related to the severity of negative and disorganized symptoms

Schneider et al.
2007 [60]
48 FE
57 ctrls
31
31
2- and 0-back tasksWM
attention connected processes
fMRIWorking memory: parietal hypoactivations, combined with hyperfrontality in VLPFC
Attention-connected processes: hypoactivations in the VLPFC, superior temporal cortex, thalamus
Dysfunctional cerebral network not able to cope with required activation for attention and WM tasks

Sweeney et al.
2003 [61]
8 csz with auditory hallucinations
8 ctrls
31
29
Fast versus slow covert articulation of a word at two self-paced ratesProcessing inner speechfMRIReduced activation in the right superior temporal, inferior parietal, and parahippocampal regionsSZ patients with auditory hallucinations have aberrant activation pattern of brain regions

Spence et al.
1997 [1]
7 d-scz
6 nd-scz
6 ctrls
Not statedPerforming movement task
Second PET 4–6 weeks after first PET
MovementPETIncreased right parietal and cingulate activation in csz with delusions of control but in d-scz with decreased passivity delusion in second scan hyperactivation of right parietal and cingulate remittedCertain brain regions involved in generating delusions of passivity

Thermenos et al.
2005 [62]
14 SZ
22 ctrls
38
38
Visual letter 2-back taskWMfMRIGreater activation in the right medial frontal gyrus and left inferior parietal lobule/medial temporal gyrus regionHeteromodal association cortices show higher activation in SZ during performance of WoM task

Whalley et al.
2006 [63]
4 GHP-S
26 GHR-P
27 GHR-N
21 ctrls
23
26
27
27
Hayling sentence completion testWord retrievalfMRI and ROIGHR-N showed increased activation of the PL and the anterior cingulatePL and the lingual gyrus could be used to discriminate between converts and nonconverts

Whalley et al.
2004 [64]
21 GHR-P
48 GHR-N
21 ctrls
25
27
27
Part of Hayling sentence completion testVerbal initiationfMRIGHR-P: increased activation in the left inferior parietal lobule
GHR-N: less activity in medial prefrontal, thalamic and cerebellar regions
Soonest changes in patients with symptoms may be connected to hyperactivation in the parietal lobe

csz: patients with SZ; ctrls: healthy controls; fMRI: functional magnetic resonance imaging; ACC: anterior cingulate cortex; DLPFC: dorsolateral prefrontal cortex; FE: patients with first-episode schizophrenia; PL: parietal lobe; UHR: ultra-high risk patients with prodromal symptoms of schizophrenia; FEP: first episode psychosis; WM: working memory; PET: positron emission tomography; rCBF: regional cerebral blood flow; pts: patients; GHR: genetically defined high-risk for schizophrenia; PFC: prefrontal cortex; PPC: posterior parietal cortex; VLPC: ventrolateral prefrontal cortex; GHR-N: ultrahigh-risk subjects who remain nonpsychotic; GHR-P: ultra-high-risk subjects who became psychotic; GHP-S: ultra-high-risk subjects who became schizophrenic; nd-scz: schizophrenic patients without delusion of control; d-scz: schizophrenic patients with delusion of control; ROI: region of interest; SZ: schizophrenia.