Chapter 26 The prefrontal cortex in schizophrenia and other neuropsychiatric diseases: In vivo physiological correlates of cognitive deficits

This chapter discusses the role of prefrontal cortex in schizophrenia and other neuropsychiatric diseases. The human brain, including neuropsychological tests devised to measure aspects of cognition—such as mental flexibility and concept formation—suggest that, far from being a silent, redundant area, the prefrontal cortex may be at the core of shaping the human attitude and organizing cognitive repertoire to produce the highest order goal-directed behaviors. The prefrontal cortex plays a fundamental role in the hierarchical organization of cognitive control and in human consciousness. The importance of the prefrontal cortex in higher human cognition and behavior is elucidated by the observations of patients with focal cortical lesions. The use of in vivo functional brain imaging by the 133Xe inhalation method for measuring regional cortical blood flow (rCBF) to study frontal lobe function in a variety of neuropsychiatric disorders that may be related to prefrontal dysfunction is described in the chapter. It also focuses on schizophrenia, an illness in which prefrontal cortex is of considerable heuristic interest and is impugned.