ANOMALOUS LANGUAGE PERCEPTION AND SPEECH OF SCHIZOPHRENIA
Lynn E. DeLisi, MD
Department of Psychiatry; New York University and Associate Director of the Center for Advanced Brain Imaging, The Nathan S Kline Institute, 140 Old Orangeburg Road, Orangeburg, New York 10962; DeLisi76@Aol.com

Schizophrenia is a uniquely human brain disorder that involves misperceptions of speech and disturbance in its complex structure. The symptoms characteristic of this disorder are commonly described as auditory hallucinations, delusions, formal thought disorder, and/or reduced thought, speech, emotions and withdrawal, but can all have their basis in language disturbance [1]. Numerous studies have found patients with schizophrenia to be deficient in various measures of sentence complexity and semantic associations [2]. In addition, several functional imaging studies using language paradigms as stimuli have found that patients with schizophrenia have less lateralized focused activity [e.g. 3]. Structural imaging studies taken together show that brain cortical regions specifically known to be responsible for components of language are reduced in size and reduced in the normal left greater than right asymmetries (i.e. prefrontal cortex, superior temporal gyrus, planum temorale [4,5]). It is proposed that the underlying cerebral basis for schizophrenia comes from anomalies in the neuronal connections between these crucial structures for normal human language functioning and that these anomalies are genetically controlled and develop slowly over time [6]. From late adolescence to early adulthood as these connections reach maturity and a peak level of myelination, a threshold is reached whereby normal language pathways are disrupted. Is then the origin of schizophrenia associated with the extreme end of language evolution gone wrong (similar to hypothesis expressed previously by Crow [7]? If so, can new treatments be developed to reverse these brain anomalies or to prevent their formation? That is the challenge we face.

REFERENCES:
[1] Crow TJ. Nuclear schizophrenic symptoms as a window on the relationship between thought and speech. British Journal of Psychiatry. 173:303-9, 1998.
[2] DeLisi LE. Speech disorder in schizophrenia: review of the literature and exploration of its relation to the uniquely human capacity for language. Schizophrenia Bull. 27(3):481-96, 2001.
[3] Sommer IE. Ramsey NF. Mandl RC. Kahn RS. Language lateralization in female patients with schizophrenia: an fMRI study. Schizophrenia Res. 60(2-3):183-90, 2003.
[4] Shenton ME. Dickey CC. Frumin M. McCarley RW. A review of MRI findings in schizophrenia. Schizophrenia Research. 49(1-2):1-52, 2001.
[5] DeLisi LE. Sakuma M. Kushner M. Finer DL. Hoff AL. Crow TJ. Anomalous cerebral asymmetry and language processing in schizophrenia.[erratum appears in Schizophr Bull 1997;23(3):536]. Schizophrenia Bulletin. 23(2):255-71, 1997.
[6] Kasai K. Shenton ME. Salisbury DF. Hirayasu Y. Onitsuka T. Spencer MH. Yurgelun-Todd DA. Kikinis R. Jolesz FA. McCarley RW. Progressive decrease of left Heschl gyrus and planum temporale gray matter volume in first-episode schizophrenia: a longitudinal magnetic resonance imaging study. Archives of General Psychiatry. 60(8):766-75, 2003.
[7] Crow TJ. Is schizophrenia the price that Homo sapiens pays for language?. Schizophrenia Research. 28(2-3):127-41, 1997.