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April 1990

What Is Left of Attention in Schizophrenia?-Reply

Author Affiliations

Department of Psychology University of Oregon Eugene, OR 97403 TERRENCE S. EARLY, MD Department of Psychiatry Washington University School of Medicine 4940 Audubon Ave Box 8134 St Louis, MO 63110

Arch Gen Psychiatry. 1990;47(4):394-395. doi:10.1001/archpsyc.1990.01810160094015

In Reply.—  Dr Bracha's finding of left-ward turning preferences in schizophrenic patients does support our own demonstration of right-sided visual neglect in these patients. The fact that results in both studies were also found in neuroleptic-naive patients and that no patients in either study had an opposite asymmetry adds strong support to the hypothesis of lateralized abnormalities in schizophrenia. We differ in the interpretation of the result. Dr Bracha argues that rightsided dopaminergic hyperactivity1 is responsible and we have suggested elsewhere2-4 that a left-sided dopminergic deficiency (or a similar lesion) is responsible.A dopaminergic-deficiency hypothesis of schizophrenia has been discussed by other authors5-7 and is not incompatible with available data. We base our conclusion on the following: (1) We have also observed hyperactivity of the left globus pallidus in neuroleptic-naive schizophrenic patients,8 a finding seen following the appearance of selective unilateral dopaminergic lesions.9 This

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