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Prefrontal functional imaging — MRCPsych Paper A MCQ

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HardNeuroimaging, neuroendocrinology and psychoneuroimmunologyPrefrontal functional imagingMRCPsych Paper A

During an n-back functional MRI experiment, participants with schizophrenia are performance-matched to healthy controls. The investigators select an a priori lateral frontal region of interest because its activation normally varies with working-memory load, whereas schizophrenia may be associated with inefficient recruitment as task demand approaches capacity. The region is centred on the middle frontal gyrus and supports the online maintenance and manipulation of information. Which region is being studied?

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Correct answer: E — Dorsolateral prefrontal cortex

The correct answer is **B, the dorsolateral prefrontal cortex (DLPFC)**. The DLPFC, principally involving the middle frontal gyrus, is a key node in the network responsible for maintaining and manipulating information during working-memory and executive tasks. Functional-imaging studies in schizophrenia repeatedly demonstrate abnormal DLPFC recruitment, although whether relative hypoactivation or hyperactivation is observed depends partly on task load and performance. The ventrolateral prefrontal cortex is more closely associated with response selection, retrieval and inhibitory processes. The anterior cingulate contributes to conflict monitoring and cognitive control but is medial rather than the specified lateral middle-frontal region. Ventromedial and orbitofrontal areas are more strongly associated with valuation, affective decision-making and reward-related processing.

Reference: Minzenberg MJ, Laird AR, Thelen S, Carter CS, Glahn DC. Meta-analysis of 41 functional neuroimaging studies of executive function in schizophrenia. Archives of General Psychiatry. 2009;66:811–822. https://pubmed.ncbi.nlm.nih.gov/19652121/