Reality distortion is related to the structure of the salience network in schizophrenia

Palaniyappan, Lena; Mallikarjun, Pavan; Joseph, Verghese; White, Thomas P.; Liddle, Peter F.

doi:10.1017/s0033291710002205

Cited by 93 publications

(53 citation statements)

References 47 publications

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“…This network deficit is also reported in some patients with autism spectrum disorder [52], which may be consistent with the shared genetic and biological risks between autistic spectrum disorder and some cases of schizophrenia [53]. The pathological role of the insula in abnormal fixation of belief has also been implicated in delusion [54,55].…”

Section: Pathological Roles Of the Insula In Psychiatric And Neurologsupporting

confidence: 73%

The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology

Namkung¹,

Kim²,

Sawa³

2018

Trends in Neurosciences

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Supported by recent human neuroimaging studies, the insula is re-emerging as an important brain area not only in the physiological understanding of the brain, but also in pathological contexts in clinical research. Here, we briefly introduce the anatomical and histological features of the human insula. We then summarize the physiological functions of the insula and underscore its pathological roles in psychiatric and neurological disorders that have long been underestimated. We finally propose possible strategies through which the role of the insula may be further understood for both basic and clinical neuroscience.

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Section: Pathological Roles Of the Insula In Psychiatric And Neurologsupporting

confidence: 73%

The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology

Namkung¹,

Kim²,

Sawa³

2018

Trends in Neurosciences

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“…In accordance with this, deficits in grey matter volumes in the insula and ACC have also been negatively associated with delusion and hallucinations in psychotic patients. 37 However, grey matter losses in the ACC and insula have been detected across different psychiatric diagnoses and may not be speci c to psychosis. 38 Within the framework of proximal salience, de cient insular detection of external salient events, such as those of rewarding cues, might lead to a faulty allocation of salience to internally generated thoughts and impede the attention to relevant external information.…”

Section: Discussionmentioning

confidence: 99%

Dysfunctional insular connectivity during reward prediction in patients with first-episode psychosis

Schmidt

Palaniyappan

Smieskova

et al. 2016

jpn

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IntroductionOur brain is constantly exposed to a wide variety of stimuli, which compete for limited cognitive resources. External stimu li are processed depending on their salience so as to ignore predictable, state and task-irrelevant events while enhancing resource allocation in order to process unexpected or state-and task-relevant events. Efficient prediction of salient stimuli, such as those of rewards, is thus essential for adapting ongoing behaviour. This process requires the ability to learn that a neutral stimulus becomes emotionally endowed owing to its association with primary reinforcement. 1 Behavioural and fMRI studies have demonstrated impairments in patients with psychosis when anticipating reward.2 Relative to controls, behavioural evidence indicated that patients with rst-episode psychosis (FEP) exhibited less reactivity to reward-predicting cues.3 Functional MRI studies during reward prediction have reported reduced activity in diverse brain regions, including the ventral striatum (VS), 4,5 anterior cingulate cortex (ACC), midbrain, thalamus and cerebellum, of unmedicated patients with FEP compared with controls. 5 It has further been shown that VS activation during reward prediction was negatively related to positive psychotic symptoms in patients with FEP. 4,5 Reward processing is critically mediated by dopamine, 6,7 and the VS response to reward-predicting cues is likely triggered by dopamine activity. 8,9 A previous fMRI study in patients with chronic schizophrenia showed that the VS response during reward prediction was reduced only in patients treated with typical antipsychotics, whereas no difference was observed between healthy controls and patients treated with atypical medication. 10 In line with this nding in patients with chronic schizophrenia, the reduced baseline VS activation during reward prediction seen in patients with FEP relative to healthy controls has been reported to be normalized after 6 weeks of monotherapy with atypical antipsychotics.11 The largest improvement in positive symptoms was seen in patients with the highest VS signal increase.11 Although not speci cally during reward processing, a recent resting-state fMRI study in patients Background: Increasing evidence indicates that psychosis is associated with abnormal reward processing. Imaging studies in patients with first-episode psychosis (FEP) have revealed reduced activity in diverse brain regions, including the ventral striatum, insula and anterior cingulate cortex (ACC), during reward prediction. However, whether these reductions in local brain activity are due to altered connectivity has rarely been explored. Methods: We applied dynamic causal modelling and Bayesian model selection to fMRI data during the Salience Attribution Task to investigate whether patients with FEP showed abnormal modulation of connectivity between the ventral striatum, insula and ACC induced by rewarding cues and whether these changes were related to positive psychotic symptoms and atypical antipsychotic medication. Results: The model...

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“…18 However, most of these investigations evaluated patients with schizophrenia. 26,[31][32][33] The issue of whether morphological changes in the insula were specific to patients with schizophrenia remained a controversial one. 34 However, recent studies have shown a considerable degree of overlap in the regional patterns of brain abnormalities observed across psychotic disorders.…”

Section: Discussionmentioning

confidence: 99%

“…8 Functional and structural neuroimaging studies have found abnormalities in networks which encompass the limbic/paralimbic emotional salience areas and the dorsal neocortical executive control systems to be associated with delusion in both affective disorders and schizophrenia. [8][9][10] However, no studies as yet have evaluated neural morphological abnormalities in patients with BD who experience hallucinations.…”

Section: Introductionmentioning

confidence: 99%

Neural correlates of hallucinations in bipolar disorder

Neves

Duarte

Albuquerque

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: Approximately one-half of all patients affected by bipolar disorder present with psychotic features on at least one occasion. Several studies have found that alterations in the activity of mesolimbic and prefrontal regions are related to aberrant salience in psychotic patients. The aim of the present study was to investigate the structural correlates of a history of hallucinations in a sample of euthymic patients with bipolar I disorder (BD-I). Methods: The sample consisted of 21 euthymic patients with BD-I and no comorbid axis I DSM-IV-TR disorders. Voxel based morphometry (VBM) was used to compare patients with and without a lifetime history of hallucinations. Preprocessing was performed using the Diffeomorphic Anatomical Registration through Exponentiated Lie Algebra (DARTEL) algorithm for VBM in SPM8. Images were processed using optimized VBM. Results: The main finding of the present study was a reduction in gray matter volume in the right posterior insular cortex of patients with BD-I and a lifetime history of hallucinations, as compared to subjects with the same diagnosis but no history of hallucinations. Conclusions: This finding supports the presence of abnormalities in the salience network in BD patients with a lifetime history of hallucinations. These alterations may be associated with an aberrant assignment of salience to the elements of one's own experience, which could result in psychotic symptoms.

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Reality distortion is related to the structure of the salience network in schizophrenia

Abstract: These findings suggest that a deficit of grey matter in the salience network leads to an impaired attribution of salience to stimuli that is associated with delusions and hallucinations in schizophrenia.

Cited by 93 publications

References 47 publications

The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology

The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology

Dysfunctional insular connectivity during reward prediction in patients with first-episode psychosis

Neural correlates of hallucinations in bipolar disorder

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