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Schizophrenia Bulletin 1998 24(2):203-218;
© 1998 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

"Cognitive Dysmetria" as an Integrative Theory of Schizophrenia: A Dysfunction in Cortical-Subcortical-Cerebellar Circuitry?

Nancy C. Andreasen, M.D., Ph.D., Sergio Paradiso, M.D. and Daniel S. O'Leary, Ph.D.
Andree H. Woods Chair of Psychiatry, The University of Iowa College of Medicine Iowa City, IA
Fellow Associate, The University of Iowa College of Medicine Iowa City, IA
Associate Researh Scientist, The University of Iowa College of Medicine Iowa City, IA

Reprint requests should be sent to Dr. N.C. Andreasen, Mental Health Clinical Research Center, The University of Iowa College of Medicine and Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA 52242

Earlier efforts to localize the symptoms of schizophrenia in a single brain region have been replaced by models that postulate a disruption in parallel distributed or dynamic circuits. Based on empirical data derived from both magnetic resonance and positron emission tomography, we have developed a model that implicates connectivity among nodes located in prefrontal regions, the thalamic nuclei, and the cerebellum. A disruption in this circuitry produces "cognitive dysmetria," difficulty in prioritizing, processing, coordinating, and responding to information. This "poor mental coordination" is a fundamental cognitive deficit in schizophrenia and can account for its broad diversity of symptoms.

Keywords: Cognitive dysmetria / cerebellum / thalamus / prefrontal cortex


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