Salvador J, Cortés JF, Galindo VG

Language: Spanish
References: 21
Page: 28-37
PDF size: 147.94 Kb.

ABSTRACT

Various investigations indicate that perseveration is a common neuropsychological sign of schizophrenia, resulting from the lack of cognitive flexibility, secondary to the dysfunction of the frontal lobe. However, from a semiological point of view, perseveration may have different neuropsychological meanings. In most of the results obtained by means of the application of the Wisconsin Card Sorting Test (WCST) this sign has been interpreted as a direct consequence of the incapability of patients for making a fast comparative change between the different concepts and for adopting diferent perspectives about a concept without analyzing other possible causes of failure in the fulfillment of this task. The purpose of this work was that of analyzing in detail the different dimensions of the WCST for evaluating, in a semiologic way, the nature of the perseverative answers. This instrument was the applied to a group of 30 paranoid schizophrenic patients, compared to 30 healthy subjects, paired by age, sex and academic education. The group was compared by means of simple ANOVA in the three WCST dimensions, and two matrixes of partial correlations, controlled by the number of asseys used for analyzing the relation between these variables; the correlation coefficients obtained for each group were compared by means of Fisher’s Z contrasts. Finally, the answering trains (positive and negative) were analyzed by means of Grant’s G2 test for tridimensional contingence tables. Results suggest that schizophrenic patients have important deficiencies for confronting this paradigm, and actually commit a significantly higher number of perseverative answers. However, perseveration in these patients, more than reflecting their lack of cognitive flexibility, seem to relate to deffects in the abstraction and comprehension of the problem.

REFERENCES

1. ABBRUZZESE M, FERRI S, SCARONES S: Performance on the Wisconsin Card Sorting Test in schizophrenia: Perseveration in clinical subtypes. Psyquiatry Research, 64:27-33, 1996.

2. ABBRUZZESE M, FERRI S, SCARONES S: The selective breakdown of frontal functions in patientes with obsessive compulsive disorder and in patients with schizophrenia: A double dissociation experimental finding. Neuropsychologia,35(6):907-912, 1997.

3. BERMAN KF, OSTREM JL, RANDOLPH C, GOLD J, GOLDBERG TE, COPPOLA R, CARSON RE, HERSCOVITCH P, WEINBERGUER DR: Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test: A positron emission tomography study. Neuropsychologia, 33(8):1027-1046, 1995.

4. BRAFF D, HEATON R, KUCK J, CULLUM M, MORANVILLE J, GRANT Y, ZISOOK S: The generalized pattern of neuropsychological deficits in outpatients with chronic schizophrenia with heterogeneous Wisconsin Card Sorting Test results. Archives of General Psychiatry, 48: 891-898, 1991.

5. CUESTA MJ, PERALTA V, CARO F, DE LEON J: Schizophrenic syndrome and Wisconsin Card Sorting Test dimensions. Psychiatry Research, 58:45-51, 1995.

6. ESLINGER PJ, GRATTAN LM: Frontal lobe and frontal striatal substrates for different forms of human cognitive flexibility. Neuropsychologia, 31:17-28, 1993.

7. GALINDO G: Evaluación cognoscitiva en pacientes con díagnóstíco de esquízofrenia paranoide: una aproximación neuropsicológica. Tésis de Maestría. Facultad de Estudios Superiores Zaragoza, UNAM, 1998.

8. GOLDBERG E: Varieties of perseveration: a comparison of two taxonomies. J Clinical Experimental Neuropsychology, 8(6):710-726, 1986.

9. HAUT M, CAHILL J, CUTLIP WD, STEVENSON JM, MAKELA E, BLOOMFIELD S: On the nature of Wisconsin Card Sorting Test performance in schizophrenia. Psychiatry Research, 65(1):15-22, 1996.

10. HAUSER MD: Perseveration, inhibition and the profrontal cortex: a new look. Current Opinion Neurobiology, 9:214-222, 1999.

11. KARNATH HO, WALLESCH CW: Inflexibility of mental planning: A characteristic disorder with prefrontal lobe lesions?. Neuropsychología, 30(11):1011-1016, 1992.

12. LYSAKER P, BELL M: Insight and cognitive impairment in schizophrenia. Performance on repeated administrations of the Wisconsin Carda Sorting Test. J Nervous Mental Disorders, 182(1):656-660, 1994.

13. LYSAKER P, BELL M, BEAM-GOULET J: Wisconsin Card Sorting Test and work performance in schizophrenia. Psychiatry Research, 56(2):45-51, 1995.

14. MATTES R, COHEN R, BERG P, CANAVAN AGM, HOPMANN G: Slow cortical potentials (SCPS) in schizophrenic patients during performance of the Wisconsin Card Sorting Test (WCST). Neuropsychología, 29(2):195-205, 1991.

15. MC CARTHY RA, WARRINGTON EK: Cognitive Neuropsychology. Academic Press, Inc. Nueva York, 1990.

16. RAEDLER TJ, KNABLE MB, WEINBERGER DR: Schizophrenia as a developmental disorder of the cerebral cortex. Current Opinion Neurobiology, 8:157-161, 1998.

17. ROSSE R, SCHWARTZ B, MASTROPAOLO J, GOLBERG R, DEUTSCH: Subtype diagnosis in schizophrenia and its relation to neuropsychological and computerized tomography measures. Biological Psychiatry, 30:63-72, 1991.

18. ROSSI A, DANELUZZO E, MATTE P, BUSTINI M, CASACCHIA M, STRATTA P: Wisconsin card sorting test and Stroop Test performances in schizophrenia: a shared construct. Neuroscience Letters, 226(2):87-90, 1997.

19. SANDSON J, ALBERT M: Varieties of perseveration. Neuropsychologia, 22(6):715-732, 1984.

20. SULLIVAN EV, MATHALON DH, ZIPURSKY RB, KERSTEEN- TUCKER Z, KNIGHT RT, PFEFFERBAUM A: Factors of the Wisconsin Card Sorting Test as measures of frontal-lobe function in schizophrenia and in chronic alcoholism. Psychiatry Research, 46:175-199, 1993.

21. WEINBERGER DR, BERMAN KF, ILLOWSKY BP: Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia: A new cohort and evidence for a monoaminergic mechanism. Archives General Psychiatry, 45:609-615, 1988.