New perspectives on schizotypal personality disorder

Abstract

Schizotypal personality disorder is the prototype of the schizophrenia-related personality disorders and has been demonstrated to have phenomenologic, biologic, treatment, and outcome characteristics similar to those of schizophrenic patients. These studies suggest that patients with schizotypal personality disorder, like schizophrenic patients, show cognitive impairment, but the impairment is more focal and involves primarily working memory, verbal learning, and sustained attention rather than generalized intellectual deficits. Schizotypal patients, like schizophrenic patients show reductions in temporal lobe volume, but seem to be spared the frontal volume reductions found in some studies of schizophrenic patients and in our laboratory. Better frontal "buffering" may prevent the more severe cognitive and social deterioration associated with schizophrenia. Furthermore, schizotypal patients appear to show less susceptibility to psychotic symptoms, in part perhaps because of better buffered subcortical dopaminergic activity as suggested by recent data from a SPECT/amphetamine paradigm, glucose metabolic study, and structural studies of basal ganglia. These findings are discussed in terms of a model of schizotypal personality disorder where schizotypal patients have better capacity for compensatory buffering in lateral and subcortical brain regions, protecting them from the more severe symptoms of chronic schizophrenia.

Cingulate and temporal lobe fractional anisotropy in schizotypal personality disorder

“…The pattern of disrupted cingulum FA in the present study is complex but generally consistent with prior work in schizophrenia. Our finding of reduced FA in posterior cingulum (BA31 and BA23) is consistent with schizophrenia work showing similar reductions 4, 8, 11 and posterior cingulum is implicated in visuo-spatial function, memory function and self-referential processing which are areas where SPD individuals evidence deficiencies 65 . The finding of increased FA in anterior cingulum (BA25) is supported by work showing increased FA in left subgenual anterior cingulum white matter (and some other regions) in individuals at high genetic risk for schizophrenia 64 .…”

Regional gray matter volume of dopaminergic system associate with creativity: Evidence from voxel-based morphometry

“…For example, a number of studies (cf. Kline & Cooper, 1986;O'Reilly et al, 2001;Eysenck and Furnham, 1993;Gianotti et al, 2001;Merten and Fischer, 1999;Poreh et al, 1993) reported a positive relationship between creativity and schizotypy, which is associated with dopamine-related genes (Ettinger et al, 2006) and overactivity of subcortical dopaminergic systems (Kirrane and Siever, 2000). Furthermore, dopamine antagonists, generally used as antipsychotics, suppress creativity (Flaherty, 2005).…”

Smaller superior temporal gyrus volume specificity in schizotypal personality disorder

“…While both SPD and BPD patients exhibit symptoms that have been linked to temporal and frontal lobe abnormalities, these symptoms differ phenomenologically from one another. Specifically, emotion dysregulation and impulsivity are hallmark features of BPD (Skodol et al, 2002), while blunted affect and executive dysfunction are frequently associated with SPD (Kirrane and Siever, 2000). In this sense, abnormal volume in prefrontal and temporal regions may underlie affect-related symptoms in BPD (Soloff et al, 2008); in SPD, abnormal frontal and temporal lobe volume may be associated with cognitive and/or executive functioning deficits (McCloskey et al, 2005).…”