Background: The anterior cingulate cortex plays a central role in altered processes of cognitive control in schizophrenia. However, the cortical foundations of disturbed anterior cingulate cognitive activation are poorly understood. Therefore, this study investigated the association of anterior cingulate cognitive activation and cortical thickness in schizophrenia combining functional magnetic resonance imaging (fMRI) and surface-based morphometry.
Methods: Fifty-three patients with schizophrenia according to DSM-IV and 53 age- and sex-matched healthy subjects were included and underwent fMRI and high-resolution T1-weighted MRI. fMRI data was analyzed using SPM5. Cortical thickness was calculated using an automated computerized algorithm (Freesurfer Software). Statistical cortical maps were created correlating anterior cingulate activation and cortical thickness on a node-by-node basis covering the entire cortex in schizophrenia and healthy control subjects.
Results: Patients demonstrated a significantly reduced anterior cingulate cognitive activation. Significantly differing associations of anterior cingulate activation and cortical thickness were found in a pattern of dorsolateral prefrontal, superior frontal-anterior cingulate, and superior temporal cortical regions, where patients but not healthy control subjects demonstrated a significant association of reduced anterior cingulate activation and cortical thinning. A direct comparison of cortical thickness between the diagnostic groups revealed a significantly reduced cortical thickness of these prefrontotemporal regions in schizophrenia.
Conclusions: To our best knowledge, this is the first study indicating that prefrontotemporal cortical thinning constitutes a relevant cortical pathomechanism for altered cognitive activation in schizophrenia. Our data additionally reveal a profound disruption of structural and functional integration in the prefrontotemporal system in schizophrenia.
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