SCHIZOPHRENIA: A POSTULATED A N I M A L MODEL
BARRY B. PERLMAN. Department of Psychiatry, The Mount Sinai School of Medicine, City University of New York, 100 Street and Fifth Ave, New York, NH, 10029, U.S.A.
SUMMARY Studies dealisg wi~ psychiatric concowdtaats of epilepsy and penetrating ~ain injury suggest that phenomena seen may be based on the side of injury. A sep~ate, growklg literature has begun to relate shizophrenia di~etly to problems of interc relation. Expmmental work on aniwml rotation also deals wife. aspects of cerebral ry. The chemical ~ d anatomic systems m ated in the amLmal work are fi-~ same ~ those postulated to ~ eentr~ to a biological understanding of seh . How these disparate subject matters may merge ~ d point to a ~ausible animal mode[ for the sch ~as is ~ e hyq~otth~is presented m this paper.
INTRODUCTION There are severallinesof information which seem to be converging and to be suggestiveof problems of functional articulationof the two hemispheres in schizophrenia.These data which suggest this topic as one for investigation come from several dire~ztions. These include work on psychiatric phenomenology in conn~tion with temporal lobe epilepsy and with penetrating brain injury, A limited literature addressing itself specifically to the problem of hemisphere lateralization and seh!zopkreaia has also emerged. Finally, experiments on rotational behaviour in animals and its relation to brain chemical asymmetries may also bear on the subject. How these seemingly disparate subject matters may merge and point to a plauglble animal model for the schizophrenias is ~he hypothesis p in. this paper.
PSYCHIATRIC
RBANCE AND PENETRATI N G B R A I N INJURY Lishman (1) cx)nducted a five study of the association of psychiatric disturbance with penetratLng brain injury. His material was derived from the Oxford collection of head it~jury records, compiled during World War II and followed by Dr. W, RitchJe Russell. Their data suggest a trend implicating left Sid~ wounds as carrying a higher probability of psychiatric disability. In the left hemisphere it seems that the extent of cerebral damage more closely parallels the degree of psyc~atde disability than in the right hemisphere. More s~ifleally, the left temporal lobe is implieatedwith increasing frequency as the degree of psychiatric disability increases from mild to severe; no such association is found for the right temporal region. Phenomenologic differences in the presentation of psychiatric disturbances are also relat~ to anatomic region. It was found that "intellectual,' disorders as a group occurred more f:v.quenay after damage to the left hemisphere and that affective and behaviour~ disorders as well as somatic complaints were more common after right hemisphere damage, P s of con n seemed related to right sided injury, although ~mingly unrelated to
lobe or extent of inju.D'. Anxiety as a symptom showed no relation to hemispheric side, lobe injured, or extent of brain injury. Hillbom (2) too examined the associations between hemispheric lateratity, lobe of injury, and psychiatric disturbance. He found that 63% of psychoses were leftsided, 11% were bilateral, and 26% were attributed to rightsided wounds. The author did not l ~ k at lobes by side. However~ the temporal lobes were found to have a significantly higher association with psychosis. Many of these psychoses were classified as "schizophreniform'. lahenomenologically H~lbom says that when delusions arid hallucinations are connected to d~erson~zafion and hallucinatory sensations in the body, the pa region is often ~plicatefl. F r o l ~ lesions are often L'nportant in cases in which autism or peculiar behaviour are part of ~ e clinical picture. Paranoid phenomena are not felt ~o ~ localized, but t~ be c o n n e c ~ with ~ e r e inju~. These papers de~-lg wiK~l the psychiatric sequelae of. penetrating brain injurT are thus s of dgu"ferencesof psychiatric pihenomenologyas contingent on the hemisphere and perhaps the lobe damage. Affective upset seemingly occurs more commonly with right-sided injury and cognRive-intellectual deficits more often vA~ left-sided, especially temporo-parietal injury. At least it may be said that damage to the left temporal region increases the vulnerability of the brain-injured patient to psychosis.
PSYCHIATRIC DISTURBANCES AND EPILEPSY Another avenue of approach to the study of the correlationof organic cerebra~dyslSanctionand psychiatric disordersiswork done on epilepsy.~In 1969, P. Flor-Hemy (3) published a paper presenting the r~s~ts of a retrospectivestudy in which 50 temporal lobe epilepticswho had experienced psychotic episodes were compared "~th 50 femoral lobe epilepticsusing 71 variables. He subdivided his temporal l o b e -psychotic group into four : schizophre.nic, ma e, mixed (schizoa.ffeetive), and confus~nai (having features of one or 238
more of the first three subgroups and with a "clouding of consciousness and disorientation"). He found that 44% of the manic-depressive group showed a right unilateral focus, 22% a left unilateral focus, and 33% bilateral fuel The mixed group showed 18% right, 36% left and 46% bilater~ focL The confusional group contained 1I% fight and 44,5% left and 44.5% bilateral. Finally, the schizophrenic group .. had 9.5% right, 43% left and 47.5% bilateral epileptic foei. The most dramatic relation to emerge from this study was a very significant relation (p
BARRY B. PERLMAN. Department of Psychiatry, The Mount Sinai School of Medicine, City University of New York, 100 Street and Fifth Ave, New York, NH, 10029, U.S.A.
SUMMARY Studies dealisg wi~ psychiatric concowdtaats of epilepsy and penetrating ~ain injury suggest that phenomena seen may be based on the side of injury. A sep~ate, growklg literature has begun to relate shizophrenia di~etly to problems of interc relation. Expmmental work on aniwml rotation also deals wife. aspects of cerebral ry. The chemical ~ d anatomic systems m ated in the amLmal work are fi-~ same ~ those postulated to ~ eentr~ to a biological understanding of seh . How these disparate subject matters may merge ~ d point to a ~ausible animal mode[ for the sch ~as is ~ e hyq~otth~is presented m this paper.
INTRODUCTION There are severallinesof information which seem to be converging and to be suggestiveof problems of functional articulationof the two hemispheres in schizophrenia.These data which suggest this topic as one for investigation come from several dire~ztions. These include work on psychiatric phenomenology in conn~tion with temporal lobe epilepsy and with penetrating brain injury, A limited literature addressing itself specifically to the problem of hemisphere lateralization and seh!zopkreaia has also emerged. Finally, experiments on rotational behaviour in animals and its relation to brain chemical asymmetries may also bear on the subject. How these seemingly disparate subject matters may merge and point to a plauglble animal model for the schizophrenias is ~he hypothesis p in. this paper.
PSYCHIATRIC
RBANCE AND PENETRATI N G B R A I N INJURY Lishman (1) cx)nducted a five study of the association of psychiatric disturbance with penetratLng brain injury. His material was derived from the Oxford collection of head it~jury records, compiled during World War II and followed by Dr. W, RitchJe Russell. Their data suggest a trend implicating left Sid~ wounds as carrying a higher probability of psychiatric disability. In the left hemisphere it seems that the extent of cerebral damage more closely parallels the degree of psyc~atde disability than in the right hemisphere. More s~ifleally, the left temporal lobe is implieatedwith increasing frequency as the degree of psychiatric disability increases from mild to severe; no such association is found for the right temporal region. Phenomenologic differences in the presentation of psychiatric disturbances are also relat~ to anatomic region. It was found that "intellectual,' disorders as a group occurred more f:v.quenay after damage to the left hemisphere and that affective and behaviour~ disorders as well as somatic complaints were more common after right hemisphere damage, P s of con n seemed related to right sided injury, although ~mingly unrelated to
lobe or extent of inju.D'. Anxiety as a symptom showed no relation to hemispheric side, lobe injured, or extent of brain injury. Hillbom (2) too examined the associations between hemispheric lateratity, lobe of injury, and psychiatric disturbance. He found that 63% of psychoses were leftsided, 11% were bilateral, and 26% were attributed to rightsided wounds. The author did not l ~ k at lobes by side. However~ the temporal lobes were found to have a significantly higher association with psychosis. Many of these psychoses were classified as "schizophreniform'. lahenomenologically H~lbom says that when delusions arid hallucinations are connected to d~erson~zafion and hallucinatory sensations in the body, the pa region is often ~plicatefl. F r o l ~ lesions are often L'nportant in cases in which autism or peculiar behaviour are part of ~ e clinical picture. Paranoid phenomena are not felt ~o ~ localized, but t~ be c o n n e c ~ with ~ e r e inju~. These papers de~-lg wiK~l the psychiatric sequelae of. penetrating brain injurT are thus s of dgu"ferencesof psychiatric pihenomenologyas contingent on the hemisphere and perhaps the lobe damage. Affective upset seemingly occurs more commonly with right-sided injury and cognRive-intellectual deficits more often vA~ left-sided, especially temporo-parietal injury. At least it may be said that damage to the left temporal region increases the vulnerability of the brain-injured patient to psychosis.
PSYCHIATRIC DISTURBANCES AND EPILEPSY Another avenue of approach to the study of the correlationof organic cerebra~dyslSanctionand psychiatric disordersiswork done on epilepsy.~In 1969, P. Flor-Hemy (3) published a paper presenting the r~s~ts of a retrospectivestudy in which 50 temporal lobe epilepticswho had experienced psychotic episodes were compared "~th 50 femoral lobe epilepticsusing 71 variables. He subdivided his temporal l o b e -psychotic group into four : schizophre.nic, ma e, mixed (schizoa.ffeetive), and confus~nai (having features of one or 238
more of the first three subgroups and with a "clouding of consciousness and disorientation"). He found that 44% of the manic-depressive group showed a right unilateral focus, 22% a left unilateral focus, and 33% bilateral fuel The mixed group showed 18% right, 36% left and 46% bilater~ focL The confusional group contained 1I% fight and 44,5% left and 44.5% bilateral. Finally, the schizophrenic group .. had 9.5% right, 43% left and 47.5% bilateral epileptic foei. The most dramatic relation to emerge from this study was a very significant relation (p
