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Neuropsychological and clinical correlates of antisaccade task performance in schizophrenia

From the Department of Neurology, Clinical Neurophysiology Unit (D.H. Nieman, Drs. Bour, Goede, Koelman, and Ongerboer de Visser) and the Department of Psychiatry (D.H. Nieman, Drs. Linszen, and Gersons), Academic Medical Center, Amsterdam, the Netherlands.

Address correspondence and reprint requests to Dr. D.H. Nieman, Academic Medical Center, Department of Psychiatry, Tafelbergweg 25, 1105 BC Amsterdam, the Netherlands.

OBJECTIVES: To elucidate pathophysiologic mechanisms involved in abnormal antisaccade task performance in schizophrenia by investigating a possible relationship among antisaccade task performance, neuropsychological test results, and symptomatology in a group of young patients with recent-onset schizophrenia; to compare the effects of olanzapine and risperidone on antisaccades and reflexive saccades.

BACKGROUND: Patients with schizophrenia consistently perform worse than controls on the antisaccade task in which the subject is required to inhibit a reflexive saccade to a suddenly appearing visual target and look in the opposite direction.

METHODS: In 37 young (mean age 21 years), medicated patients with recent-onset schizophrenia the authors assessed antisaccades, reflexive saccades, neuropsychological test performance, and symptomatology. A subgroup of 18 patients was treated with olanzapine, and 15 patients were treated with risperidone. Reflexive-saccade and antisaccade task results were compared with those obtained in 13 control subjects.

RESULTS: The antisaccade error rate was significantly higher in the patients than in the control subjects. In the patients, poor working memory function was related to increased antisaccade error rate. Severity of disorganization symptoms at intake was related to prolonged mean latency of the correct antisaccades. Patients on risperidone had a prolonged mean latency in the reflexive saccade task compared with patients using olanzapine.

CONCLUSIONS: Abnormal antisaccade task performance is already present in early schizophrenia and may reflect working memory dysfunction. In future studies, medication effects should be considered in interpreting eye movement test results of patients with schizophrenia.

Key words: Schizophrenia—Eye movements—Antisaccade task—Neuropsychology

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