Abstracts

RATIONALE: Symptoms of schizophrenia are commonly grouped into positive (e.g., hallucinations and delusions) and negative (e.g., alogia, anhedonia, affective flattening, inattention, avolition) symptoms. Within the schizophrenia literature, positive symptoms have not been found to be reliably associated with cognition or specific brain abnormalities; however, schizophrenic patients with negative symptoms have been found to present with either focal frontal or more generalized cognitive deficits, with concordant findings in neuroimaging studies. Negative symptoms in schizophrenics have also been found to be associated with poorer psychosocial adjustment, such as higher unemployment and rehospitalization rates. Recent studies have begun to explore negative symptoms in non-schizophrenic neurological and neuropsychiatric populations, including Alzheimer[ssquote]s disease, Bipolar disorder, and stroke. However, the incidence and correlates of negative symptoms within temporal lobe epilepsy (TLE), a population often characterized by psychiatric disturbances, is not known. The purpose of the present study was to identify the rate of negative symptoms in TLE and to examine the relationship between these symptoms and neuroanatomical, neuropsychological, and psychosocial factors.
METHODS: A sample of 84 TLE patients were identified as having none or more than none negative symptoms using the Scale for the Assessment of Negative Symptoms (SANS). These two groups were compared in terms of quanitative MRI volumetrics, neuropsychological test performance, and psychosocial variables including current rates of marital and employment status, receipt of government financial assistance, quality of life, family medical/psychiatric history, and clinical epilepsy variables. The two TLE groups were also compared with a healthy control group (n=74) on MRI and neuropsychological data.
RESULTS: The TLE group with negative symptoms was found to present with a trend toward reduced brain volumes coupled with elevations in cerebrospinal fluid (CSF) levels, significant generalized cognitive impairments, and significantly higher rates of social, economic, and functional difficulties relative to control groups.
CONCLUSIONS: Our findings are commensurate with those of similar studies conducted within the schizophrenia population identifying a relationship within the TLE population between negative symptoms and mild cortical atrophy, cognitive dysfunction, and psychosocial dysfunction. Treatment targeting negative symptoms may translate into less need for government assistance within the TLE population.
Support: Supported in part by NIH Grant No.37738 and NARSAD.