Abstract
BACKGROUND: Evidence has suggested an association between working memory impairment and violence in people with schizophrenia. However, the neural characteristics of working memory deficit in this patient population remain unclear. This study aimed to examine the neurobiological differences in brain activity using the working memory task in schizophrenia patients with and without a history of violent behavior. METHOD: A total of 194 patients, including 106 with a history of severe violent behavior and 88 without such a history, as well as 66 healthy individuals, were recruited. All the participants were required to complete the n-back task (0-, 1-, and 2-back) under functional near-infrared spectroscopy. RESULTS: Patients with a history of violent behavior, but not those without, exhibited hyperactivity in the left dorsolateral prefrontal gyrus (all p < 0.05) and hypoactivity in the triangular part of the inferior frontal gyrus (all p < 0.05), as compared to healthy individuals. Compared to patient without a violent history, they demonstrated higher accuracy in 0- and 1-back tasks (both p < 0.001), however, their response times were also significantly prolonged (p < 0.001; p = 0.591). CONCLUSION: This study revealed severe damage to the overall working memory in schizophrenia patients with a history of violent behavior, with abnormal activation of brain regions related to working memory and semantic processing, accompanied by compensatory brain responses.