Elsevier

Biological Psychiatry

Volume 69, Issue 5, 1 March 2011, Pages 415-423
Biological Psychiatry

Archival Report
An Anterior-to-Posterior Shift in Midline Cortical Activity in Schizophrenia During Self-Reflection

https://doi.org/10.1016/j.biopsych.2010.10.003Get rights and content

Background

Deficits in social cognition, including impairments in self-awareness, contribute to the overall functional disability associated with schizophrenia. Studies in healthy subjects have shown that social cognitive functions, including self-reflection, rely on the medial prefrontal cortex (mPFC) and posterior cingulate gyrus, and these regions exhibit highly correlated activity during “resting” states. In this study, we tested the hypothesis that patients with schizophrenia show dysfunction of this network during self-reflection and that this abnormal activity is associated with changes in the strength of resting-state correlations between these regions.

Methods

Activation during self-reflection and control tasks was measured with functional magnetic resonance imaging in 19 patients with schizophrenia and 20 demographically matched control subjects. In addition, the resting-state functional connectivity of midline cortical areas showing abnormal self-reflection-related activation in schizophrenia was measured.

Results

Compared with control subjects, the schizophrenia patients demonstrated lower activation of the right ventral mPFC and greater activation of the mid/posterior cingulate gyri bilaterally during self-reflection, relative to a control task. A similar pattern was seen during overall social reflection. In addition, functional connectivity between the portion of the left mid/posterior cingulate gyrus showing abnormally elevated activity during self-reflection in schizophrenia, and the dorsal anterior cingulate gyrus was lower in the schizophrenia patients compared with control subjects.

Conclusions

Schizophrenia is associated with an anterior-to-posterior shift in introspection-related activation, as well as changes in functional connectivity, of the midline cortex. These findings provide support for the hypothesis that aberrant midline cortical function contributes to social cognitive impairment in schizophrenia.

Section snippets

Participants

Nineteen patients with DSM-IV–diagnosed schizophrenia and 20 healthy control subjects were enrolled in the study. Patients with clinically stable schizophrenia, diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) (22), were recruited and characterized by the MGH Schizophrenia Clinical and Research Program recruitment team. Healthy control subjects were recruited via advertisement. All subjects were right-handed and native speakers of English. The healthy control

Behavior

There were no significant differences between the two groups in response times for the SR (t = .88, df = 33, p = .39) or AL (t = 1.74, df = 33, p = .09) tasks, or in the percentages of trials rated as self-descriptive during the SR blocks (t = .111, df = 33, p = .91), or rated as desirable during the AL blocks (t = .54, df = 33, p = .59). See Table 2 for means and additional behavioral results.

Anatomic ROI analysis (SR or AL vs. a low-level baseline)

In this analysis, a significant Region by Task by Group interaction (F = 3.31; df = 2; p = .04), with

Discussion

In this study, patients with schizophrenia showed abnormally elevated activation of the right and left m/pCC during self-reflection, compared to a low-level baseline and to responses during a nonintrospective task. Also, in a cortical surface-based analysis, the schizophrenia patients showed abnormally reduced responses during self-reflection, compared with a nonintrospective task, within the right ventral mPFC. Lastly, this abnormal pattern of task-dependent activation in schizophrenia was

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