Neuropsychological variability, symptoms, and brain imaging in chronic schizophrenia.

We examined variability in performance on widely-used neuropsychological Wechsler tests of intelligence and memory in a large sample of persons with chronic schizophrenia, a subset of whom had also undergone prior studies of magnetic resonance imaging (MRI) of the orbital frontal cortex (OFC) gray matter and diffusion tensor imaging (DTI) of the cingulum bundle (CB) and the uncinate fasiculus (UF) white matter. In comparison to controls, persons with schizophrenia showed lower scores across neuropsychological tests, with most pronounced drops in processing speed and immediate memory, in relation to oral reading. For patients, greater declines in intelligence and memory each correlated with reduced CB white matter fractional anisotropy and reduced OFC gray matter, respectively. However, only memory decline correlated with severity of negative symptoms. Taken together, these data raise the intriguing question as to whether communication and motivational deficits expressed in negative symptoms may contribute to the relationship of auditory memory decline and OFC volume observed in this patient sample.