Neurobiological Basis of Insight in Schizophrenia

Xavier, Rose Mary; Vorderstrasse, Allison

doi:10.1097/nnr.0000000000000159

Cited by 40 publications

(22 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consistent with this, studies employing both structural 99 and functional [100][101][102][103][104][105] neuroimaging have implicated a number of areas and networks in the development and maintenance of insight.…”

Section: Abnormalities In Brain Function As a Root Of Poor Insightmentioning

confidence: 57%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

View full text Add to dashboard Cite

Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

show abstract

Section: Abnormalities In Brain Function As a Root Of Poor Insightmentioning

confidence: 57%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Furthermore, these findings are not surprising given that the precuneus, a part of the superior parietal lobule, plays a role in a wide range of integrated tasks, including visuo-spatial imagery, which is particularly related to representation of other's perspective, episodic and autobiographical memory retrieval and self-processing [49,82]. Additionally, this area seems to be also implicated in self-consciousness, through a hypothetical neurobiological pathway of impaired clinical and cognitive insight in SZ, as recently described by Xavier and Vorderstrasse [83]. …”

Section: Discussionmentioning

confidence: 99%

“…We also assume that self-reflection and reduced self-certainty should be a focal point for poor cognitive insight in psychosis, representing a complex phenotype potentially sustained by a combination of neurobiological vulnerability (genes, neural circuitry formed by prefrontal, cingulate, temporal and parietal cortices, insula, hippocampus) and environment [83]. Understanding cognitive distortions and neural correlates might be of paramount importance in psychosis because they could be a predictor of good prognosis.…”

Section: Discussionmentioning

confidence: 99%

The metabolic basis of cognitive insight in psychosis: A positron emission tomography study

et al. 2017

View full text Add to dashboard Cite

The purpose of this study was to investigate the relationship between cognitive insight and cerebral metabolism in patients suffering from psychosis. The Beck Cognitive Insight Scale (BCIS) was administered to 63 patients with psychosis undergoing Positron Emission Tomography investigation. The sample was divided into two groups considering the BCIS score. Data were analyzed using Statistical Parametric Mapping. Results: patients with low insight, compared to those with high insight, showed decreased metabolism in the right fusiform gyrus, left precuneus, superior temporal gyrus and insula bilaterally, as well as increased metabolism in the left orbito-frontal gyrus (all p<0.005). Our results suggest that reduced posterior (occipito-temporo-insulo-parietal) and increased anterior (orbitofrontal) cerebral metabolism may sustain low cognitive insight in psychosis.

show abstract

“…Current drug treatment mainly acts through classical dopamine hypothesis and related changes in postsynaptic signal transduction or dopaminergic transmission and serotonergic system receptors. Accumulating data support that dysfunction of glutamate transmission regarding N-Methyl-D-Aspartate (NMDA) receptors might be associated with schizophrenia [1].…”

Section: Introductionmentioning

confidence: 99%

Agmatine-attenuated cognitive and social deficits in subchronic MK-801 model of schizophrenia in rats

Ünal

Ateş

Arıcıoğlu

2018

Psychiatry and Clinical Psychopharmacology

View full text Add to dashboard Cite

INTRODUCTION: Schizophrenia is one of the most severe psychiatric disorders with about 1% prevalence. It has been proved that glutamatergic N-methyl-D-aspartate (NMDA) receptor antagonists such as MK-801 and phencyclidine cause schizophrenia-like behaviours in rodents. Agmatine is an endogenous amine synthesized from decarboxylation of arginine and has been thought to be a neurotransmitter/neuromodulator. It binds to imidazoline and alfa adrenergic receptors and blocks cation channelled receptors, such as nicotinic acetylcholine, 5-HT3 serotonergic, and NMDA receptors. It is an endogenous inhibitor of nitric oxide synthase. A limited number of studies showed that agmatine attenuates sensorimotor gating deficit, which is an important parameter for schizophrenia, and improves cognitive deficits in rats. Despite this, it has also been shown that high doses of agmatine impaired sensorimotor gating. Herein, the aim of our study is to investigate the effect of subchronic agmatine treatment on sensorimotor gating, visual recognition memory, and social functions in subchronic MK-801 model of schizophrenia in rats. METHODS: Wistar Hannover rats were divided into four groups as control (dimethyl sulphoxide), MK-801 (0.2 mg/kg), MK-801 + agmatine (20 mg/kg), and MK-801 + risperidone (0.5 mg/kg)(n = 8 per group). MK-801 was subcutaneously injected once a day for 14 days. Agmatine and risperidone were administered intraperitoneally in the last seven days of MK-801 injections. On day 14, agmatine or risperidone was injected 15 minutes before MK-801 and MK-801 15 minutes before prepulse inhibition of the acoustic startle response (PPI) test. After the seven days washout period, social interaction (SI) test and novel object recognition test (NORT) were performed. One-way analysis of variance (ANOVA) or two-way ANOVA was used for statistical evaluation of NORT, SI, and PPI, respectively. Paired Student's t-test was used for the comparison of rat's affinity to a familiar and novel object in NORT. RESULTS: MK-801 administration significantly decreased prepulse inhibition of rats in the PPI test (p < .001). In addition to this, MK-801 decreased startle response to pulse-alone trials and increased basal activity measured by the magnitude of no stimulus trials compared to the control group (p < .05). Agmatine treatment did not improve MK-801-induced PPI, startle response, or basal activity deficits while risperidone blocked the disruptive effect of MK-801 (p < .05). In NORT, the MK-801 group had significantly lower discrimination index (p < .05), whereas both the agmatine and risperidone treatments substantially increased this index (p < .01). Moreover, MK-801 injections not only decreased sniffing (p < .01) and following (p < .01) behaviours but also increased avoiding behaviour (p < .001) in SI. Agmatine partially treated social deficits (p < .001) while risperidone was reversed all of them (p < .01). CONCLUSIONS: Subchronic MK-801 administration revealed sensorimotor gating, social and cognitive deficits in rats. Subchroni...

show abstract

Neurobiological Basis of Insight in Schizophrenia

Cited by 40 publications

References 59 publications

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

The metabolic basis of cognitive insight in psychosis: A positron emission tomography study

Agmatine-attenuated cognitive and social deficits in subchronic MK-801 model of schizophrenia in rats

Contact Info

Product

Resources

About