Modulation of language processing in schizophrenia: Effects of context and haloperidol on the event-related potential

Background: Disturbances in language associations were among the first clinical symptoms reported for individuals described as schizophrenic (Bleuler 1911/ 1950), Currently, associative language disturbance is a diagnostic feature of schizophrenia (American psychiatric Association 1994); however, the mechanisms that produce this symptom remain unknown. In the present study two candidate psychological functions were examined: sensitivity to semantic context and expectancy (attention). Methods: Visual event-related potentials were recorded during a lexical decision task in which semantic relationship and expectancy (relatedness proportions) were varied Semantic priming processes were compared between 34 male normal control subjects tested once and 37 male schizophrenic inpatients evaluated during their participation iii a double-blind haloperidol maintenance therapy and placebo replacement protocol. Results: Schizophrenic patients failed to discriminate between associated and unassociated words, as measured by the amplitude of the N400 component (i.e., absence of the N400 priming effect); however, the overall mean amplitude of N400 did nor differ between patients and control subjects. In addition, patients and control subjects did not differ significantly in the amplitude of N400 elicited to associated words or to unassociated words. Finally, the effect of expectancy-based processing oil the magnitude of the N400 priming effect did nor differ between patients and control subjects. Conclusions: On the basis of these findings, a tentative hypothesis is suggested that schizophrenic patients are characterized by a pattern of indiscriminate or random spread of activation in their semantic network during the processing of single-word semantic contexts. Biol Psychiatry 1999;45:1336-1355 (C) 1999 Society of Biological Psychiatry.