Various functional imaging studies have demonstrated reduced lateralization of cortical activation during neurocognitive tasks in schizophrenia. -A well-known card game, "concentration", reflects working memory (WM). We compared characteristics of hemodynamic changes in the prefrontal to temporo-parietal areas of the brain during this card game between 24 outpatients with schizophrenia and 24 age- and gender-matched healthy control subjects. Using multi-channel near-infrared spectroscopy, we measured relative changes in oxygenated hemoglobin concentration (oxy-Hb changes), which reflects brain activity during this task. Patients showed reduced lateralization in the midfrontal area, which is involved in executive functions, and in the inferior parietal area, involved in WM subcomponents. We also found a significant negative correlation between left midfrontal region oxy-Hb changes and severity of negative symptoms of schizophrenia. Our results characterized disease-related features, suggesting the usefulness of oxy-Hb change measurement during this card game for assessing functional outcome in schizophrenic patients.