Brain activation patterns associated with the effects of fearful distractors during working memory maintenance in patients with schizophrenia
Jong-Il Park 1, 2, Gwang-Won Kim 3, Gwang-Woo Jeong 4, Jong-Chul Yang 1, 2*
1Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea, 2Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea, 3Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Korea , 4Department of Radiology, Chonnam National University Hospital, Chonnam Natioanl University Medical School, Gwangju, Korea
Received: May 10, 2017; Revised: July 19, 2017; Accepted: July 19, 2017; Published online: July 19, 2017.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: The neural correlates underlying the effects of emotional distraction during working memory (WM) tasks in patients with schizophrenia have yet to be clearly identified. Thus, the present study employed functional magnetic resonance imaging (fMRI) to investigate the effects of emotional distraction involving fear during WM maintenance in patients with schizophrenia.
Methods: This study included 17 patients with schizophrenia who were diagnosed based on DSM-IV-TR criteria and 17 matched healthy controls. Event-related fMRI data were acquired while the participants performed a delayed-response WM task that included neutral and fearful distractors.
Results: Patients with schizophrenia may have tried to maintain WM function during the presentation of task-irrelevant fearful distractors that induced interruption and required attention. Compared to healthy controls, the schizophrenia patients exhibited significantly increased activity in the dorsolateral prefrontal cortex (DLPFC), medial prefrontal cortex (mPFC), superior temporal gyrus (STG), middle temporal gyrus (MTG), insula, hippocampus, caudate nucleus, and postcentral gyrus in a delayed-response WM task when presented with fearful relative to neutral distractors. In addition to its series of increased brain activations, prefrontal areas exhibited interconnections with more caudal brain regions, including temporal areas and the hippocampus and insula.
Conclusions: The present study identified specific brain areas associated with the interaction between emotional regulation and cognitive functioning during fearful distractors presented while patients with schizophrenia performed a WM maintenance task. These findings further the current understanding of the neural correlates underlying the effects of emotional distraction on cognitive functioning in patients with schizophrenia.
Keywords: Emotional distractor, functional magnetic resonance imaging (fMRI), schizophrenia, working memory


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