摘要BACKGROUND: Go, a traditional Chinese chess-like game, requires many unknown functions of the brain including attention, imaging, problem solving and processing of spatial working memory. To date, it remains uncertain whether the intellectual activities required to play Go are related to the frontal lobe.OBJECTIVE: To investigate various patterns of brain region activity while schizophrenic patients and normal subjects engaged in memorizing piece placement in the Chinese game of Go. Spatial working memory was measured in order to validate whether the prefrontal lobe participates in this memory process.DESIGN, TIME AND SETTING: Non-randomized, concurrent control trial was performed at Second Xiangya Hospital of Central South University, between May and December 2004.PARTICIPANTS: A total of nine Chinese schizophrenic patients with no brain or bodily diseases and not undergoing electroshock treatment, who were in accordance with the DSM-IV criteria for schizophrenia, as well as thirteen healthy staffs and students with matched age, sex, and education were included. Patients and control subjects had no neurological disorders or mental retardation. In addition, all participants were right-handed.METHODS: The cognitive task for functional magnetic resonance imaging was a block design experiment. Both groups were asked to remember the placement of pieces in the Chinese game of Go on a computer screen. A brain activation map was analyzed in SPM99.MAIN OUTCOME MEASURES: Brain responses were compared with regard to activation region size, volume, and asymmetry indices.RESULTS: Compared with the control group, the reaction time was significantly delayed in schizophrenics performing the working memory task (P < 0.05). When performing the tasks, normal subjects showed significant activation of the bilateral dorsolateral prefrontal lobe with left dominance; the asymmetry indices were: frontal lobe, +0.32; temporal lobe, -0.58; parietal lobe, 0.41 ; and occipital lobe, -0.34. On the other hand, schizophrenics showed right dominance and had a broader activation region of the prefrontal lobe (asymmetry indices: frontal lobe, 0.10; temporal lobe, +0.38; parietal lobe, +0.24; and occipital lobe, 0.00). When comparing the normal group subtracted with the schizophrenic group, no significant lateralization was found in the frontal lobes but significant activation was found in the left anterior central gyrus, left middle frontal gyrus and in both sides of the cingulate gyrus. Comparing the schizophrenic group subtracted with the normal group, there was significant right lateralization of the frontal lobe and abnormally activated regions on both sides of the anterior central gyrus, middle frontal gyrus, left inferior frontal gyrus, right medial frontal gyrus and the right insular lobe.CONCLUSION: Different brain activation regions are involved in memorizing the placement of pieces in Chinese Go between schizophrenia and healthy subjects. Schizophrenics showed right dominance and border activation range, indicating that the prefrontal cortex plays an important role in memory information processing and resource allocation when remembering piece placement in the game of Go.