self-evaluation in schizophrenia an fmri study with implications for the understanding of insight自我评价与影响精神分裂症fmri研究观点的理解.pdfVIP

Bedford et al. BMC Psychiatry 2012, 12:106 /1471-244X/12/106 RESEARCH ARTICLE Open Access Self-evaluation in schizophrenia: an fMRI study with implications for the understanding of insight 1 1 2 2 1* Nicholas J Bedford , Simon Surguladze , Vincent Giampietro , Michael J Brammer and Anthony S David Abstract Background: Lack of insight is a core feature of schizophrenia and is associated with structural brain abnormalities. The functional neuroanatomy of insight has only recently been investigated. When people evaluate their personality traits compared to those of another, activation is seen in central midline structures (CMS) of the brain. This study set out to compare cerebral activation in schizophrenia patients versus controls during a self-evaluation task which included positive and negative traits as well as mental and physical illness terms. Methods: Eleven schizophrenia patients and 8 healthy controls, matched for age were studied. Insight was assessed using the Schedule for the Assessment of Insight-expanded version (SAI-E). FMRI data were obtained with a 1.5 Tesla GE system and interactions between participant group, self versus other, significant at the cluster level, were recorded. Results: Significant hypoactivation in the medial superior frontal gyrus (dorsomedial prefrontal cortex) was observed in patients vs. controls during self-evaluation of all traits combined. A second cluster of hypoactivation in the posterior cingulate was also detected. When the response to individual traits was explored, underactivation in other frontal regions plus right inferior parietal lobule emerged and this tended to correlate, albeit weakly with lower insight scores.