Delineating insight-processing-related functional activations in the precuneus in first-episode psychosis patients

Loading...
Thumbnail Image
Journal Title
Journal ISSN
Volume Title
A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Date
2021-11-30
Major/Subject
Mcode
Degree programme
Language
en
Pages
8
Series
Psychiatry Research - Neuroimaging, Volume 317
Abstract
Poor insight is a central characteristic of psychotic disorders, and it has been suggested to result from a general dysfunction in self-reflection. However, brain processing of clinical insight and more general self-reflection has not been directly compared. We compared tasks on (1) self-reflection on psychosis-related mental functioning (clinical insight, in patients only), (2) self-reflection on mental functioning unrelated to psychosis (general metacognition), and (3) semantic control during blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging with 19 first-episode psychosis patients and 24 control participants. Arterial-spin-labeling (ASL) images were collected at rest. Clinical insight was evaluated with the Schedule for the Assessment of Insight. In patients, posterosuperior precuneus showed stronger activation during the insight task than during the semantic control task, while anteroinferior precuneus and posterior cingulate cortex (PCC) showed stronger activation during the insight task than during the general metacognition task. No significant group differences in brain activation emerged during the general metacognition task. Although the BOLD measures did not correlate with clinical insight measures, ASL-measured cerebral blood flow (CBF) values did correlate when extracted from the task-selective precuneus/PCC areas: higher CBF correlated with higher clinical insight scores. These results suggest that regions in the posteromedial cortex are selective for clinical insight.
Description
Funding Information: We want to thank all the participants, and Eva Rikandi, Marita Kattelus, Tuula Mononen, Laura Hietapakka, and Sanna Leppänen for their help with the collection of the data. This work was supported by the Sigrid Jusélius Foundation (J.S.), the Finnish Cultural Foundation (T.M. and J.S.), the Jalmari and Rauha Ahokas Foundation (T.M.), the Doctoral Program Brain and Mind of the University of Helsinki (T.M.), the Paulo Foundation (T.M.), the Finnish Association of Psychiatric Research (T.M.), the Academy of Finland (grants # 278171 and # 323035 to J.S. and # 315861 to T.T.R.), the Finnish Medical Foundation (T.T.R.), State funding for university-level health research ( Hospital District of Helsinki and Uusimaa # TYH2013332 , # TYH2014228 , # TYH2017128 to T.K.), and the European Union's Seventh Framework Programme for project METSY (# 602478 to J.S.). Publisher Copyright: © 2021
Keywords
Arterial spin labeling, First-episode psychosis, Functional magnetic resonance imaging, Insight, Posterior cingulate cortex, Precuneus, Schizophrenia
Other note
Citation
Mäntylä , T , Kieseppä , T , Suvisaari , J & Raij , T T 2021 , ' Delineating insight-processing-related functional activations in the precuneus in first-episode psychosis patients ' , Psychiatry Research - Neuroimaging , vol. 317 , 111347 . https://doi.org/10.1016/j.pscychresns.2021.111347