Insight in Schizophrenia: Involvement of Self-Reflection Networks?

Meer, Lisette van der; Vos, Annerieke E. de; Stiekema, Annemarie; Pijnenborg, Gerdina H. M.; Tol, Marie-José van; Nolen, Willem A.; David, Anthony S.; Alemán, André

doi:10.1093/schbul/sbs122

Cited by 141 publications

(128 citation statements)

References 43 publications

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“…However a larger study carried out by van der Meer et al (2013) found broadly similar results. Their aim was explicitly to investigate the neural correlates of self-reflective processing and in turn, their relationship with insight in schizophrenia.…”

Section: Cognitive Neurosciencementioning

confidence: 55%

Self-reflection in illness and health: literal and metaphorical?

David

2017

Palgrave Commun

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Self-reflection describes a series of processes whereby a person appraises, evaluates or judges themselves. This appraisal can be in terms of physical, psychological or moral attributes. A number of self-reflection tasks have been designed and applied in experimental psychology and clinical settings. What is not known is whether self-reflection is a valid construct for study and whether it has any clinical implications for psychiatric patients deemed to have impaired self-reflection or "insight". One design is to contrast the appraisal of another person with that of the self. Although it would be useful to measure this appraisal against a gold standard, that is not always possible. Similarly there may be doubt about what the person really thinks as opposed to what they may say. Nevertheless, the simple act of self-reflection can be studied using cognitive neuroscience methods. It appears that a certain brain network, the central midline system (CMS), is engaged in this task. People with mental disorders, especially those at the psychotic end of the spectrum, often see themselves differently from how others see them and the term lack of insight may be used to describe this situation. Recent neuroimaging research has shown that those whose self-appraisal accords most with others, especially their doctors', show greater activation in the CMS and may have a better clinical outcome. One potential therapeutic approach with such patients to encourage self-reflection has been to make use of literal self-reflection through photographs and video.

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Section: Cognitive Neurosciencementioning

confidence: 55%

Self-reflection in illness and health: literal and metaphorical?

David

2017

Palgrave Commun

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“…It has a crucial role not only in internally focused tasks, but also in active regulation of the arousal state and in balancing between internally and externally oriented attention [87] . A lower volume of PCC/retrosplenial cortex has been associated to a poorer outcome in Schizophrenia [88] , and an altered function of this region has been evidenced during semantic [89] , self-evaluation [90,91] and fear-conditioning [92] tasks. The thalamus is a subcortical structure whose integrity is needed to the correct functioning of cognitive processes.…”

Section: Ref Participants Task and Behavioral Results Fmri Methods Amentioning

confidence: 99%

Sustained attention in psychosis: Neuroimaging findings

Sepede¹

2014

WJR

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To provide a systematic review of scientific literature on functional magnetic resonance imaging (fMRI) studies on sustained attention in psychosis. We searched PubMed to identify fMRI studies pertaining sustained attention in both affective and non-affective psychosis. Only studies conducted on adult patients using a sustained attention task during fMRI scanning were included in the final review. The search was conducted on September 10 th , 2013. 15 fMRI studies met our inclusion criteria: 12 studies were focused on Schizophrenia and 3 on Bipolar Disorder Type Ⅰ (BDI). Only half of the Schizophrenia studies and two of the BDI studies reported behavioral abnormalities, but all of them evidenced significant functional differences in brain regions related to the sustained attention system. Altered functioning of the insula was found in both Schizophrenia and BDI, and therefore proposed as a candidate trait marker for psychosis in general. On the other hand, other brain regions were differently impaired in affective and non-affective psychosis: alterations of cingulate cortex and thalamus seemed to be more common in Schizophrenia and amygdala dysfunctions in BDI. Neural correlates of sustained attention seem to be of great interest in the study of psychosis, highlighting differences and similarities between Schizophrenia and BDI. Key words: Sustained attention; Affective psychosis; Non-affective psychosis; Schizophrenia; Bipolar disorder; Functional magnetic resonance imaging; Insula Core tip: In the present paper, we systematically reviewed functional magnetic resonance imaging studies investigating sustained attention in affective and nonaffective psychosis. We found that differences between cases (patients, unaffected relatives of psychotic probands) and controls in terms of functional activation of sustained attention system structures were detectable even when the groups performed comparably. In particular, the insular cortex seems to be a trait marker for psychosis in general, whereas other regions (thalamus, cingulate cortex, amygdala) seem to be differently impaired in affective and non-affective psychosis.

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“…However, disturbances of functional neural networks involving parietal regions have been repeatedly described in schizophrenia patients [69][70][71]. Remarkably, frontoparietal networks including the inferior parietal lobe have been implicated in tasks such as self-recognition, self-referential judgements and self-appraisal [72].…”

Section: Discussionmentioning

confidence: 99%

Genetic variation in the G72 gene is associated with increased frontotemporal fiber tract integrity

Nickl‐Jockschat

Stöcker

Krug

et al. 2014

Eur Arch Psychiatry Clin Neurosci

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G72 (syn. DAOA, D-amino acid oxidase activator) is a susceptibility gene for both schizophrenia and bipolar disorder. Diffusion tensor imaging studies hint at changes in fiber tract integrity in both disorders. We aimed to investigate whether a G72 susceptibility haplotype causes changes in fiber tract integrity in young healthy subjects. We compared fractional anisotropy in 47 subjects that were either homozygous for the M23/M24 risk haplotype (n = 20) or homozygous for M23(rs3918342)/M24(rs1421292) wild type (n = 27) using diffusion tensor imaging with 3 T. Tract-based spatial statistics, a method especially developed for diffusion data analysis, was used to delineate the major fiber tracts. We found clusters of increased FA values in homozygous risk haplotype carriers in the right periinsular region and in the right inferior parietal lobe (IPL). We did not find clusters indicating decreased FA values. The insula and the IPL have been implicated in both schizophrenia and bipolar pathophysiology. Increased FA values might reflect changes in dendritic morphology as previously described by in vitro studies. These findings further corroborate the hypothesis that a shared gene pool between schizophrenia and bipolar disorder might lead to neuroanatomic changes that confer an unspecific vulnerability for both disorders.

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Insight in Schizophrenia: Involvement of Self-Reflection Networks?

Cited by 141 publications

References 43 publications

Self-reflection in illness and health: literal and metaphorical?

Self-reflection in illness and health: literal and metaphorical?

Sustained attention in psychosis: Neuroimaging findings

Genetic variation in the G72 gene is associated with increased frontotemporal fiber tract integrity

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