To Study the Frontal Lobe Alterations in Patients of Schizophrenia

Abstract

Background: Schizophrenia is one of the most perplexing of all brain conditions due to its persistent and severe psychotic manifestations with variable cognitive dysfunction. The pathophysiology of schizophrenia being unknown, the fact that brain circuits are involved and the areas frequently affected being the limbic system, forebrain, and the hindbrain becomes a fertile area for exploration. Aim: The aim was to study the frontal lobe alterations in patients of schizophrenia. Materials and Methods: A cross-sectional, analytical, and comparative study was done in a tertiary care medical college and research center. Forty patients of schizophrenia with 40 age- and sex-matched healthy individuals were included in the study after informed consent and an institutional ethical clearance. Self-made demographic and clinical questionnaire, the Positive and Negative Syndrome Scale, Frontal Assessment Battery (FAB), Stroop test, and Wisconsin Card Sorting Test (WCST) were applied to all the subjects. Results: A significant difference in cognitive impairment was found in patients as compared to controls, seen by a poor performance of patients in FAB and WCST along with a higher Stroop effect. Duration of illness, family history of psychiatric illness, number of episodes, and comorbid substance use were found to be positive predictors of higher cognitive impairment. Conclusion: There is a significant level of frontal lobe dysfunction seen in patients of schizophrenia on Stroop test, FAB, and WCST. Family history of psychiatric illness and substance use, especially tobacco, are the factors worsening cognitive dysfunction, while education plays a protective role.