PMID- 26467308
OWN - NLM
STAT- MEDLINE
DCOM- 20161006
LR  - 20200613
IS  - 1097-0193 (Electronic)
IS  - 1065-9471 (Print)
IS  - 1065-9471 (Linking)
VI  - 36
IP  - 12
DP  - 2015 Dec
TI  - Insight and psychosis: Functional and anatomical brain connectivity and 
      self-reflection in Schizophrenia.
PG  - 4859-68
LID - 10.1002/hbm.22955 [doi]
AB  - Impaired insight into illness, associated with worse treatment outcome, is common 
      in schizophrenia. Insight has been related to the self-reflective processing, 
      centred on the medial frontal cortex. We hypothesized that anatomical and 
      functional routes to and from the ventromedial prefrontal cortex (vmPFC) would 
      differ in patients according to their degree of impaired insight. Forty-five 
      schizophrenia patients and 19 healthy subjects performed a self-reflection task 
      during fMRI, and underwent diffusion tensor imaging. Using dynamic causal 
      modelling we observed increased effective connectivity from the posterior 
      cingulate cortex (PCC), inferior parietal lobule (IPL), and dorsal mPFC (dmPFC) 
      towards the vmPFC with poorer insight and decrease from vmPFC to the IPL. 
      Stronger connectivity from the PCC to vmPFC during judgment of traits related to 
      self was associated with poorer insight. We found small-scale significant changes 
      in white matter integrity associated with clinical insight. Self-reflection may 
      be influenced by synaptic changes that lead to the observed alterations in 
      functional connectivity accompanied by the small-scale but measurable alterations 
      in anatomical connections. Our findings may point to a neural compensatory 
      response to an impairment of connectivity between self-processing regions. 
      Similarly, the observed hyper-connectivity might be a primary deficit linked to 
      inefficiency in the component cognitive processes that lead to impaired insight. 
      We suggest that the stronger cognitive demands placed on patients with poor 
      insight is reflected in increased effective connectivity during the task in this 
      study.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Curcic-Blake, Branislava
AU  - Curcic-Blake B
AD  - Department of Neuroscience, University of Groningen, BCN Neuroimaging Center 
      (NIC), University Medical Center, Groningen, The Netherlands.
FAU - van der Meer, Lisette
AU  - van der Meer L
AD  - Department of Neuroscience, University of Groningen, BCN Neuroimaging Center 
      (NIC), University Medical Center, Groningen, The Netherlands.
AD  - Department of Rehabilitation, Lentis, Zuidlaren, The Netherlands.
FAU - Pijnenborg, Gerdina H M
AU  - Pijnenborg GH
AD  - Department of Clinical Psychosis and Experimental Psychopathalogy, University of 
      Groningen, Grote Kruisstraat, The Netherlands.
AD  - Department of Psychotic Disorders, GGZ Drenthe, Assen, The Netherlands.
FAU - David, Anthony S
AU  - David AS
AD  - Department of Psychosis Studies, Institute of Psychiatry, King's College London, 
      Denmark, Hill, United Kingdom.
FAU - Aleman, Andre
AU  - Aleman A
AD  - Department of Neuroscience, University of Groningen, BCN Neuroimaging Center 
      (NIC), University Medical Center, Groningen, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20151015
PL  - United States
TA  - Hum Brain Mapp
JT  - Human brain mapping
JID - 9419065
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Models, Neurological
MH  - Nerve Net/*physiology
MH  - Neural Pathways/pathology/*physiology
MH  - Oxygen/blood
MH  - Prefrontal Cortex/blood supply/*pathology
MH  - Psychiatric Status Rating Scales
MH  - Schizophrenia/*pathology
MH  - *Schizophrenic Psychology
MH  - White Matter/blood supply/*pathology
MH  - Young Adult
PMC - PMC6869637
OTO - NOTNLM
OT  - anatomical connectivity
OT  - brain connectivity
OT  - diffusion tensor imaging (DTI)
OT  - dynamic causal modelling (DCM)
OT  - functional connectivity
OT  - insight into psychosis
OT  - schizophrenia
OT  - self-reflection
OT  - tract-based spatial statistics (TBSS)
EDAT- 2015/10/16 06:00
MHDA- 2016/10/08 06:00
PMCR- 2015/10/15
CRDT- 2015/10/16 06:00
PHST- 2015/04/30 00:00 [received]
PHST- 2015/08/11 00:00 [revised]
PHST- 2015/08/17 00:00 [accepted]
PHST- 2015/10/16 06:00 [entrez]
PHST- 2015/10/16 06:00 [pubmed]
PHST- 2016/10/08 06:00 [medline]
PHST- 2015/10/15 00:00 [pmc-release]
AID - HBM22955 [pii]
AID - 10.1002/hbm.22955 [doi]
PST - ppublish
SO  - Hum Brain Mapp. 2015 Dec;36(12):4859-68. doi: 10.1002/hbm.22955. Epub 2015 Oct 
      15.