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Neural Circuits in Schizophrenia

Robert W. McCarley, MD; Martha E. Shenton, PhD; Brian F. O'Donnell, PhD; Paul G. Nestor, PhD
Arch Gen Psychiatry. 1994;51(7):515-516. doi:10.1001/archpsyc.1994.03950070007003.
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T point made in the article by Carpenter et al1 about the need for multiple assessment modalities in differentiating the neural circuits that are abnormal in subgroups of the schizophrenia syndrome is well taken. However, an important and well-documented neural circuit is omitted in their compilation of the "predicted pattern of neural circuit involvement" for subtypes of schizophrenia. There are strong data indicating that the neocortical superior temporal gyrus (STG) is a key circuit related to positive symptoms ("nondeficit schizophrenia," using the terminology of Carpenter et al1), with abnormalities being linked to auditory hallucinations, thought disorder, certain memory tasks, and altered metabolic and electrophysiological functional activity.

The presence of auditory hallucinations has been found to be associated with both structural and metabolic STG abnormalities. Barta et al2 report correlations with magnetic resonance imaging volume reductions and Cleghorn et al3 note correlations with abnormal regional metabolism in a fluorodeoxyglucose

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