Diffusion tensor imaging tractography of the fornix and belief confidence in first-episode psychosis

Buchy, Lisa; Luck, David; Czechowska, Yvonne; Malla, Ashok; Joober, Ridha; Lepage, Martín

doi:10.1016/j.schres.2012.02.015

Cited by 22 publications

(12 citation statements)

References 34 publications

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“…Likely, decreased FA of anterior thalamus radiation was reported in a previous DTI study in patients suffering from MDD (Lai and Wu, 2014). Fornix in turn strongly predicts psychosis and apathy (Buchy et al, 2012;Hollocks et al, 2015). This finding may support the different nature of depression in PD compared to that in non-PD patients.…”

Section: Discussionsupporting

confidence: 74%

Comparison of structural connectivity in Parkinson's disease with depressive symptoms versus non-depressed: a diffusion MRI connectometry study

Ansari

Moradi

Sherbaf

et al. 2018

Int. Psychogeriatr.

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Section: Discussionsupporting

confidence: 74%

Comparison of structural connectivity in Parkinson's disease with depressive symptoms versus non-depressed: a diffusion MRI connectometry study

Ansari

Moradi

Sherbaf

et al. 2018

Int. Psychogeriatr.

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“…The results of the few studies that have explored the functional neural correlates of self-evaluation in schizophrenia using an fMRI task design are inconclusive (Murphy et al, 2010; Holt et al, 2011; Bedford et al, 2012), but suggest that the default mode network, cortical midline structures, and other regions implicated in self-awareness, including the insula and inferior parietal lobes, may play an influential role (Raij et al, 2012; van der Meer et al, 2013). Intriguingly, self-certainty, a subdimension of the Beck Cognitive Insight Scale (Beck et al, 2004) representing mental inflexibility, is linked with lower performance on verbal memory and executive function tasks (Lepage et al, 2008; Cooke et al, 2010; Orfei et al, 2010) and with structural changes in related brain regions, specifically greater FA values in the right fornix and volumetric reductions in the hippocampus (Buchy et al, 2010, 2012). …”

Section: Introductionmentioning

confidence: 99%

Impaired insight into illness and cognitive insight in schizophrenia spectrum disorders: Resting state functional connectivity

Gerretsen¹,

Menon

Mamo³

et al. 2014

Schizophrenia Research

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Background Impaired insight into illness (clinical insight) in schizophrenia has negative effects on treatment adherence and clinical outcomes. Schizophrenia is described as a disorder of disrupted brain connectivity. In line with this concept, resting state networks (RSNs) appear differentially affected in persons with schizophrenia. Therefore, impaired clinical, or the related construct of cognitive insight (which posits that impaired clinical insight is a function of metacognitive deficits), may reflect alterations in RSN functional connectivity (fc). Based on our previous research, which showed that impaired insight into illness was associated with increased left hemisphere volume relative to right, we hypothesized that impaired clinical insight would be associated with increased connectivity in the DMN with specific left hemisphere brain regions. Methods Resting state MRI scans were acquired for participants with schizophrenia or schizoaffective disorder (n = 20). Seed-to-voxel and ROI-to-ROI fc analyses were performed using the CONN-fMRI fc toolbox v13 for established RSNs. Clinical and cognitive insight were measured with the Schedule for the Assessment of Insight—Expanded Version and Beck Cognitive Insight Scale, respectively, and included as the regressors in fc analyses. Results As hypothesized, impaired clinical insight was associated with increased connectivity in the default mode network (DMN) with the left angular gyrus, and also in the self-referential network (SRN) with the left insula. Cognitive insight was associated with increased connectivity in the dorsal attention network (DAN) with the right inferior frontal cortex (IFC) and left anterior cingulate cortex (ACC). Conclusion Increased connectivity in DMN and SRN with the left angular gyrus and insula, respectively, may represent neural correlates of impaired clinical insight in schizophrenia spectrum disorders, and is consistent with the literature attributing impaired insight to left hemisphere dominance. Increased connectivity in the DAN with the IFC and ACC in relation to cognitive insight may facilitate enhanced mental flexibility in this sample.

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“…Given these considerations, in the present article from now on we will refer to this specific dimension of self-awareness as metacognitive insight. Such studies highlighted the involvement of the ventrolateral prefrontal area (Orfei et al, 2013), the hippocampus (Buchy et al, 2010), and the fornix (Buchy et al, 2012). In fact, while clinical insight does not imply necessarily any actual significant change in patients' underlying belief system nor in one's own behavior (Bora et al, 2007;Jaspers, 1963), metacognitive insight best reflects one's actual judgments about the self.…”

Section: Introductionmentioning

confidence: 99%

“…While several studies have described the neural correlates of clinical insight, reporting an involvement of prefrontal areas (Cooke et al, 2008;Flashman et al, 2001;Laroi et al, 2000;Morgan et al, 2010;Sapara et al, 2007;Shad et al, 2004Shad et al, , 2006, temporal areas (Cooke et al, 2008;Ha et al, 2004;Palaniyappan et al, 2011), or even no structural alterations accompanying poor clinical insight (Bassitt et al, 2007;Buchy et al, 2009;Rossell et al, 2003), only few studies investigated the neural correlates of cognitive insight. Such studies highlighted the involvement of the ventrolateral prefrontal area (Orfei et al, 2013), the hippocampus (Buchy et al, 2010), and the fornix (Buchy et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

The structural neuroanatomy of metacognitive insight in schizophrenia and its psychopathological and neuropsychological correlates

Spalletta

Piras

et al. 2014

Human Brain Mapping

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Lack of insight into illness is a multidimensional phenomenon that has relevant implications on clinical course and therapy compliance. Here, we focused on metacognitive insight in schizophrenia, that is, the ability to monitor one's changes in state of mind and sensations, with the aim of investigating its neuroanatomical, psychopathological, and neuropsychological correlates. Fifty-seven consecutive patients with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) diagnosis of schizophrenia were administered the Insight Scale, and comprehensive psychopathological and neuropsychological batteries. They underwent a high-resolution T1-weighted magnetic resonance imaging investigation. Gray matter (GM) and white matter (WM) volumes were analyzed on a voxel-by-voxel basis using Statistical Parametric Mapping 8. Reduced metacognitive insight was related to reduced GM volumes in the left ventrolateral prefrontal cortex, right dorsolateral prefrontal cortex and insula, and bilateral premotor area and putamen. Further, it was related to reduced WM volumes of the right superior longitudinal fasciculum, left corona radiata, left forceps minor, and bilateral cingulum. Increased metacognitive insight was related to increased depression severity and attentional control impairment, while the latter was related to increased GM volumes in brain areas linked to metacognitive insight. Results of this study suggest that prefrontal GM and WM bundles, all implied in cognitive control and self-reflection, may be the neuroanatomical correlates of metacognitive insight in schizophrenia. Further, higher metacognitive insight is hypothesized to be a risk factor for depression which may subsequently impair attention. This line of research may provide the basis for the development of cognitive interventions aimed at improving self-monitoring and compliance to treatment.

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Diffusion tensor imaging tractography of the fornix and belief confidence in first-episode psychosis

Cited by 22 publications

References 34 publications

Comparison of structural connectivity in Parkinson's disease with depressive symptoms versus non-depressed: a diffusion MRI connectometry study

Comparison of structural connectivity in Parkinson's disease with depressive symptoms versus non-depressed: a diffusion MRI connectometry study

Impaired insight into illness and cognitive insight in schizophrenia spectrum disorders: Resting state functional connectivity

The structural neuroanatomy of metacognitive insight in schizophrenia and its psychopathological and neuropsychological correlates

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