Neurobiology of insight deficits in schizophrenia: An fMRI study
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Prior research has shown insight deficits in schizophrenia to be associated with specific neuroimaging changes (primarily structural) especially in the prefrontal sub-regions. However, little is known about the functional correlates of impaired insight. Seventeen patients with schizophrenia (mean age 40.0±10.3; M/F=14/3) underwent fMRI on a Philips 3.0 T Achieva system while performing on a self-awareness task containing self- vs. other-directed sentence stimuli. SPM5 was used to process the imaging data. Preprocessing consisted of realignment, coregistration, and normalization, and smoothing. A regression analysis was used to examine the relationship between brain activation in response to self-directed versus other-directed sentence stimuli and average scores on behavioral measures of awareness of symptoms and attribution of symptoms to the illness from Scale to Assess Unawareness of Mental Disorders. Family Wise Error correction was employed in the fMRI analysis. Average scores on awareness of symptoms (1=aware; 5=unaware) were associated with activation of multiple brain regions, including prefrontal, parietal and limbic areas as well as basal ganglia. However, average scores on correct attribution of symptoms (1=attribute; 5=misattribute) were associated with relatively more localized activation of prefrontal cortex and basal ganglia. These findings suggest that unawareness and misattribution of symptoms may have different neurobiological basis in schizophrenia. While symptom unawareness may be a function of a more complex brain network, symptom misattribution may be mediated by specific brain regions.
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Poor insight may arise from abnormalities in brain function, as indicated by neuroimaging studies implicating various areas and networks.
“Consistent with this, studies employing both structural 99 and functional 100-105 neuroimaging have implicated a number of areas and networks in the development and maintenance of insight.”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [104]
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- Authors
- Shad, M. U., & Keshavan, M. S.
- Affiliations
- Oregon Health & Science University (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Shad, Mujeeb U.
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 165
- Issue
- 2-3
- Pages
- 220-226
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC4457549
- OpenAlex
- W2099070700
- Cited by
- 52
- References
- 71
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 5 · 2018: 6 · 2017: 6 · 2016: 7 · 2015: 3
- FWCI
- 5.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Binus University
- National Institutes of Health (5k23mh077924-05)
- National Institute of Mental Health (K23 MH077924-05, K23 MH077924)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- insight deficits, schizophrenia
- MeSH terms
- Adult, Awareness, Brain, Brain Mapping, Cognition Disorders, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Oxygen, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Statistics as Topic, Young Adult
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