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

Human Brain Mapping

Volumn 35, Issue 9, 2014, Pages 4729-4740

  Spalletta, Gianfranco ^a   Piras, Fabrizio ^a   Piras, Federica ^a   Caltagirone, Carlo ^a,b   Orfei, Maria Donata ^a  

^a IRCCS FONDAZIONE SANTA LUCIA   (Italy)

^b UNIVERSITY OF ROME TOR VERGATA   (Italy)

Author keywords

Awareness; Cognition; Prefrontal cortex; Psychosis; Self monitoring; White matter

Indexed keywords

ADULT; ATTENTION; BRAIN; COMPLICATION; DEPRESSION; EXECUTIVE FUNCTION; FEMALE; GRAY MATTER; HUMAN; IMPULSIVENESS; MALE; MENTAL FUNCTION; NEUROPSYCHOLOGICAL TEST; NUCLEAR MAGNETIC RESONANCE IMAGING; ORGAN SIZE; PATHOLOGY; PREFRONTAL CORTEX; PSYCHOLOGIC TEST; PSYCHOLOGICAL RATING SCALE; PSYCHOLOGY; SCHIZOPHRENIA; SELF CONCEPT; WHITE MATTER;

ADULT; ATTENTION; BRAIN; DEPRESSION; EXECUTIVE FUNCTION; FEMALE; GRAY MATTER; HUMANS; IMPULSIVE BEHAVIOR; MAGNETIC RESONANCE IMAGING; MALE; MENTAL PROCESSES; NEUROPSYCHOLOGICAL TESTS; ORGAN SIZE; PREFRONTAL CORTEX; PSYCHIATRIC STATUS RATING SCALES; PSYCHOLOGICAL TESTS; SCHIZOPHRENIA; SCHIZOPHRENIC PSYCHOLOGY; SELF CONCEPT; WHITE MATTER;

EID: 84904462091     PISSN: 10659471     EISSN: 10970193     Source Type: Journal    
DOI: 10.1002/hbm.22507     Document Type: Article

References (101)

1. Abdul-Rahman MF, Qiu A, Sim K (2011): Regionally specific white matter disruptions of fornix and cingulum in schizophrenia. PLoS One 6:e18652.
2. Aleman A, Agrawal N, Morgan KD, David AS (2006): Insight in psychosis and neuropsychological function: Meta-analysis. Br J Psychiatry 189:204-212.
3. Amador X, Strauss D (1993): Poor insight in schizophrenia. Psychiatric Q 64:305-318.
4. Amador XF, Gorman JM (1998): Psychopathologic domains and insight in schizophrenia. Psychiatr Clin Northern Am 21:27-42.
5. APA (2000): Diagnostic and Statistical Manual of Mental Disorder, DSM-IV-TR. Washington: APA.
6. Ashburner J (2007): A fast diffeomorphic image registration algorithm. Neuroimage 38:95-113.
7. Ashburner J, Friston KJ (2005): Unified segmentation. Neuroimage 26:839-851.
8. Austin MP, Mitchell P, Goodwin GM (2001): Cognitive deficits in depression: Possible implications for functional neuropathology. Br J Psychiatry 178:200-206.
9. Badre D, Hoffman J, Cooney JW, D'Esposito M (2009): Hierarchical cognitive control deficits following damage to the human frontal lobe. Nat Neurosci 12:515-522.
10. Badre D, Wagner AD (2004): Selection, integration, and conflict monito̊ assessing the nature and generality of prefrontal cognitive control mechanisms. Neuron 41:473-487.
11. Badre D, Wagner AD (2005): Frontal lobe mechanisms that resolve proactive interference. Cereb Cortex 15:2003-2012.
12. Badre D, Wagner AD (2006): Computational and neurobiological mechanisms underlying cognitive flexibility. Proc Natl Acad Sci USA 103:7186-7191.
13. Badre D, Wagner AD (2007): Left ventrolateral prefrontal cortex and the cognitive control of memory. Neuropsychologia 45:2883-2901.
14. Barrett EA, Sundet K, Faerden A, Agartz I, Bratlien U, Romm KL, Mork E, Rossberg JI, Steen NE, Andreassen OA, et al. (2010): Suicidality in first episode psychosis is associated with insight and negative beliefs about psychosis. Schizophr Res 123:257-262.
15. Bassitt DP, Neto MR, de Castro CC, Busatto GF (2007): Insight and regional brain volumes in schizophrenia. Eur Arch Psychiatry Clin Neurosci 257:58-62.
16. Beck AT, Baruch E, Balter JM, Steer RA, Warman DM (2004): A new instrument for measuring insight: The Beck Cognitive Insight Scale. Schizophr Res 68:319-329.
17. Bergouignan L, Chupin M, Czechowska Y, Kinkingnehun S, Lemogne C, Le Bastard G, Lepage M, Garnero L, Colliot O, Fossati P (2009): Can voxel based morphometry, manual segmentation and automated segmentation equally detect hippocampal volume differences in acute depression? Neuroimage 45:29-37.
18. Bora E, Erkan A, Kayahan B, Veznedaroglu B (2007): Cognitive insight and acute psychosis in schizophrenia. Psychiatry Clin Neurosci 61:634-639.
19. Boyer L, Aghababian V, Richieri R, Loundou A, Padovani R, Simeoni MC, Auquier P, Lancon C (2012): Insight into illness, neurocognition and quality of life in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 36:271-276.
20. Buchy L, Czechowska Y, Chochol C, Malla A, Joober R, Pruessner J, Lepage M (2010): Toward a model of cognitive insight in first-episode psychosis: Verbal memory and hippocampal structure. Schizophr Bull 36:1040-1049.
21. Buchy L, Luck D, Czechowska Y, Malla A, Joober R, Lepage M (2012): Diffusion tensor imaging tractography of the fornix and belief confidence in first-episode psychosis. Schizophr Res 137:80-84.
22. Buchy L, Malla A, Joober R, Lepage M (2009): Delusions are associated with low self-reflectiveness in first-episode psychosis. Schizophr Res 112:187-191.
23. Bunge SA, Ochsner KN, Desmond JE, Glover GH, Gabrieli JD (2001): Prefrontal regions involved in keeping information in and out of mind. Brain 124:2074-2086.
24. Burianova H, Grady CL (2007): Common and unique neural activations in autobiographical, episodic, and semantic retrieval. J Cogn Neurosci 19:1520-1534.
25. Carlesimo GA, Caltagirone C, Gainotti G (1996): The Mental Deterioration Battery: Normative data, diagnostic reliability and qualitative analyses of cognitive impairment. The Group for the Standardization of the Mental Deterioration Battery. Eur Neurol 36:378-384.
26. Clark KA, Nuechterlein KH, Asarnow RF, Hamilton LS, Phillips OR, Hageman NS, Woods RP, Alger JR, Toga AW, Narr KL (2011): Mean diffusivity and fractional anisotropy as indicators of disease and genetic liability to schizophrenia. J Psychiatr Res 45:980-988.
27. Clark L, Chamberlain SR, Sahakian BJ (2009): Neurocognitive mechanisms in depression: Implications for treatment. Annu Rev Neurosci 32:57-74.
28. Cooke M, Peters E, Fannon D, Anilkumar AP, Aasen I, Kuipers E, Kumari V (2007): Insight, distress and coping styles in schizophrenia. Schizophr Res 94:12-22.
29. Cooke MA, Fannon D, Kuipers E, Peters E, Williams SC, Kumari V (2008): Neurological basis of poor insight in psychosis: A voxel-based MRI study. Schizophr Res 103:40-51.
30. Critchley H, Seth A (2012): Will studies of macaque insula reveal the neural mechanisms of self-awareness? Neuron 74:423-426.
31. Critchley HD, Wiens S, Rotshtein P, Ohman A, Dolan RJ (2004): Neural systems supporting interoceptive awareness. Nat Neurosci 7:189-195.
32. Crumlish N, Whitty P, Kamali M, Clarke M, Browne S, McTigue O, Lane A, Kinsella A, Larkin C, O'Callaghan E (2005): Early insight predicts depression and attempted suicide after 4 years in first-episode schizophrenia and schizophreniform disorder. Acta Psychiatr Scand 112:449-455.
33. David AS (1990): Insight and psychosis. Br J Psychiatry 156:798-808.
34. David AS, Bedford N, Wiffen B, Gilleen J (2012): Failures of metacognition and lack of insight in neuropsychiatric disorders. Philos Trans R Soc Lond B Biol Sci 367:1379-1390.
35. Ehrsson HH, Spence C, Passingham RE (2004): That's my hand! Activity in premotor cortex reflects feeling of ownership of a limb. Science 305:875-877.
36. Erickson M, Jaafari N, Lysaker P (2011): Insight and negative symptoms as predictors of functioning in a work setting in patients with schizophrenia. Psychiatry Res 189:161-165.
37. First M, Spitzer R, Gibbon M, Williams J (2002): Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.
38. Flashman LA, McAllister TW, Johnson SC, Rick JH, Green RL, Saykin AJ (2001): Specific frontal lobe subregions correlated with unawareness of illness in schizophrenia: A preliminary study. J Neuropsychiatry Clin Neurosci 13:255-257.
39. Flavell J (1979): Metacognition and cognitive monitoring: A new area of cognitive-developmental enquiry. Am Psychol 34:906-911.
40. Folstein MF, Folstein SE, McHugh PR (1975): "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189-198.
41. Ghahremani DG, Lee B, Robertson CL, Tabibnia G, Morgan AT, De Shetler N, Brown AK, Monterosso JR, Aron AR, Mandelkern MA, Poldrack RA, London ED (2012): Striatal dopamine D2/D3 receptors mediate response inhibition and related activity in frontostriatal neural circuitry in humans. J Neurosci 32:7316-7324.
42. Gilbert AR, Moore GJ, Keshavan MS, Paulson LA, Narula V, Mac Master FP, Stewart CM, Rosenberg DR (2000): Decrease in thalamic volumes of pediatric patients with obsessive-compulsive disorder who are taking paroxetine. Arch Gen Psychiatry 57:449-456.
43. Glantz LA, Lewis DA (2000): Decreased dendritic spine density on prefrontal cortical pyramidal neurons in schizophrenia. Arch Gen Psychiatry 57:65-73.
44. Ha TH, Youn T, Ha KS, Rho KS, Lee JM, Kim IY, Kim SI, Kwon JS (2004): Gray matter abnormalities in paranoid schizophrenia and their clinical correlations. Psychiatry Res 132:251-260.
45. Hasson-Ohayon I, Kravetz S, Roe D, David AS, Weiser M (2006): Insight into psychosis and quality of life. Compr Psychiatry 47:265-269.
46. Hazlett HC, Poe MD, Gerig G, Smith RG, Piven J (2006): Cortical gray and white brain tissue volume in adolescents and adults with autism. Biol Psychiatry 59:1-6.
47. Hazlett HC, Poe MD, Gerig G, Styner M, Chappell C, Smith RG, Vachet C, Piven J (2011): Early brain overgrowth in autism associated with an increase in cortical surface area before age 2 years. Arch Gen Psychiatry 68:467-476.
48. Heaton RK, Chelune GJ, Talley JL, Kay CG, Curtiss G (1993): Wisconsin Card Sorting Test. Manual Odessa, FL: Psychological Assessment Resources.
49. Iosifescu DV (2012): The relation between mood, cognition and psychosocial functioning in psychiatric disorders. Eur Neuropsychopharmacol 22 Suppl 3:S499-S504.
50. Jaspers K (1963): General Psychopatology. Hamilton JHaM, translator. Manchester: Manchester University Press.
51. Johnson SC, Baxter LC, Wilder LS, Pipe JG, Heiserman JE, Prigatano GP (2002): Neural correlates of self-reflection. Brain 125:1808-1814.
52. Karow A, Pajonk FG (2006): Insight and quality of life in schizophrenia: Recent findings and treatment implications. Curr Opin Psychiatry 19:637-641.
53. Kay SR, Fiszbein A, Opler LA (1987): The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261-276.
54. Kjaer TW, Nowak M, Lou HC (2002): Reflective self-awareness and conscious states: PET evidence for a common midline parietofrontal core. Neuroimage 17:1080-1086.
55. Koren D, Seidman LJ, Poyurovsky M, Goldsmith M, Viksman P, Zichel S, Klein E (2004): The neuropsychological basis of insight in first-episode schizophrenia: A pilot metacognitive study. Schizophr Res 70:195-202.
56. Koriat A, Goldsmith M (1996): Monitoring and control processes in the strategic regulation of memory accuracy. Psychol Rev 103:490-517.
57. Kostopoulos P, Albanese MC, Petrides M (2007): Ventrolateral prefrontal cortex and tactile memory disambiguation in the human brain. Proc Natl Acad Sci USA 104:10223-10228.
58. Kostopoulos P, Petrides M (2008): Left mid-ventrolateral prefrontal cortex: Underlying principles of function. Eur J Neurosci 27:1037-1049.
59. Kurtz MM, Tolman A (2011): Neurocognition, insight into illness and subjective quality-of-life in schizophrenia: What is their relationship? Schizophr Res 127:157-162.
60. Laroi F, Fannemel M, Ronneberg U, Flekkoy K, Opjordsmoen S, Dullerud R, Haakonsen M (2000): Unawareness of illness in chronic schizophrenia and its relationship to structural brain measures and neuropsychological tests. Psychiatry Res 100:49-58.
61. Liemburg EJ, van der Meer L, Swart M, Curcic-Blake B, Bruggeman R, Knegtering H, Aleman A (2012): Reduced connectivity in the self-processing network of schizophrenia patients with poor insight. PLoS One 7:e42707.
62. Lucas JA, Ivnik RJ, Smith GE, Bohac DL, Tangalos EG, Graff-Radford NR, Petersen RC (1998): Mayo's older Americans normative studies: Category fluency norms J Clin Exp Neuropsychol 20:194-200.
63. Majer M, Ising M, Kunzel H, Binder EB, Holsboer F, Modell S, Zihl J (2004): Impaired divided attention predicts delayed response and risk to relapse in subjects with depressive disorders. Psychol Med 34:1453-1463.
64. Marková IS, Berrios GE (1992): The assessment of insight in clinical psychiatry: A new scale. Acta Psychiatr Scand 86:159-164.
65. Marková IS, Roberts KH, Gallagher C, Boos H, McKenna PJ, Berrios GE (2003): Assessment of insight in psychosis: A re-standardization of a new scale. Psychiatry Res 119:81-88.
66. McClintock SM, Husain MM, Greer TL, Cullum CM (2010): Association between depression severity and neurocognitive function in major depressive disorder: A review and synthesis. Neuropsychology 24:9-34.
67. Measso G, Caverzeran F, Zappalá G, Lebowitz BD, Crook TH, Pirozzolo FJ, Amaducci L, Masari D, Grigoletto F (1993): The mini-mental state examination: Normative study of an Italian random sample. Dev Neuropsychol 9:77-85.
68. Miller EK, Cohen JD (2001): An integrative theory of prefrontal cortex function. Annu Rev Neurosci 24:167-202.
69. Modinos G, Ormel J, Aleman A (2009): Activation of anterior insula during self-reflection. PLoS One 4:e4618.
70. Mohamed S, Rosenheck R, McEvoy J, Swartz M, Stroup S, Lieberman JA (2009): Cross-sectional and longitudinal relationships between insight and attitudes toward medication and clinical outcomes in chronic schizophrenia. Schizophr Bull 35:336-346.
71. Moraschi M, Hagberg GE, Di Paola M, Spalletta G, Maraviglia B, Giove F (2010): Smoothing that does not blur: Effects of the anisotropic approach for evaluating diffusion tensor imaging data in the clinic. J Magn Reson Imaging 31:690-697.
72. Morgan KD, Dazzan P, Morgan C, Lappin J, Hutchinson G, Suckling J, Fearon P, Jones PB, Leff J, Murray RM, et al. (2010): Insight, grey matter and cognitive function in first-onset psychosis. Br J Psychiatry 197:141-148.
73. Mori S, Wakana S, van Zijl P, Nagae-Poetscher L (2005): MRI Atlas of the Human White Matter. Amsterdam, The Netherlands: Elsevier.
74. Murphy FC, Michael A, Sahakian BJ (2012): Emotion modulates cognitive flexibility in patients with major depression. Psychol Med 42:1373-1382.
75. Ochsner KN, Beer JS, Robertson ER, Cooper JC, Gabrieli JD, Kihsltrom JF, D'Esposito M (2005): The neural correlates of direct and reflected self-knowledge. Neuroimage 28:797-814.
76. Orfei MD, Caltagirone C, Spalletta G (2007): I disturbi della consapevolezza nelle malattie neuropsichiatriche. Milano: Springer-Verlag Italia.
77. Orfei MD, Piras F, Macci E, Caltagirone C, Spalletta G (2013): The neuroanatomical correlates of cognitive insight in schizophrenia. Soc Cogn Affect Neurosci 8:418-423.
78. Orfei MD, Robinson RG, Bria P, Caltagirone C, Spalletta G (2008): Unawareness of illness in neuropsychiatric disorders: Phenomenological certainty versus etiopathogenic vagueness. Neuroscientist 14:203-222.
79. Orfei MD, Spoletini I, Banfi G, Caltagirone C, Spalletta G (2010): Neuropsychological correlates of cognitive insight in schizophrenia. Psychiatry Res 178:51-56.
80. Palaniyappan L, Mallikarjun P, Joseph V, Liddle PF (2011): Appreciating symptoms and deficits in schizophrenia: Right posterior insula and poor insight. Prog Neuropsychopharmacol Biol Psychiatry 35:523-527.
81. Perez-Iglesias R, Tordesillas-Gutierrez D, McGuire PK, Barker GJ, Roiz-Santianez R, Mata I, de Lucas EM, Rodriguez-Sanchez JM, Ayesa-Arriola R, Vazquez-Barquero JL, et al. (2010): White matter integrity and cognitive impairment in first-episode psychosis. Am J Psychiatry 167:451-458.
82. Petrides M (2005): Lateral prefrontal cortex: Architectonic and functional organization. Philos Trans R Soc Lond B Biol Sci 360:781-795.
83. Rossell SL, Coakes J, Shapleske J, Woodruff PW, David AS (2003): Insight: Its relationship with cognitive function, brain volume and symptoms in schizophrenia. Psychol Med 33:111-119.
84. Rushworth MF, Behrens TE, Rudebeck PH, Walton ME (2007): Contrasting roles for cingulate and orbitofrontal cortex in decisions and social behaviour. Trends Cogn Sci 11:168-176.
85. Sapara A, Cooke M, Fannon D, Francis A, Buchanan RW, Anilkumar AP, Barkataki I, Aasen I, Kuipers E, Kumari V (2007): Prefrontal cortex and insight in schizophrenia: A volumetric MRI study. Schizophr Res 89:22-34.
86. Sasson E, Doniger GM, Pasternak O, Tarrasch R, Assaf Y (2012): Structural correlates of cognitive domains in normal aging with diffusion tensor imaging. Brain Struct Funct 217:503-515.
87. Schmitz TW, Johnson SC (2006): Self-appraisal decisions evoke dissociated dorsal-ventral aMPFC networks. Neuroimage 30:1050-1058.
88. Schmitz TW, Kawahara-Baccus TN, Johnson SC (2004): Metacognitive evaluation, self-relevance, and the right prefrontal cortex. Neuroimage 22:941-947.
89. Selemon LD, Rajkowska G, Goldman-Rakic PS (1998): Elevated neuronal density in prefrontal area 46 in brains from schizophrenic patients: Application of a three-dimensional, stereologic counting method. J Comp Neurol 392:402-412.
90. Shad MU, Muddasani S, Prasad K, Sweeney JA, Keshavan MS (2004): Insight and prefrontal cortex in first-episode schizophrenia. Neuroimage 22:1315-1320.
91. Shad MU, Tamminga CA, Cullum M, Haas GL, Keshavan MS (2006): Insight and frontal cortical function in schizophrenia: A review. Schizophr Res 86:54-70.
92. Simpson GM, Angus JWS (1970): A rating scale for extrapyramidal side effects. Acta Psychiatr Scand 212 (Suppl.):11-19.
93. Stern ER, Gonzalez R, Welsh RC, Taylor SF (2010): Updating beliefs for a decision: Neural correlates of uncertainty and underconfidence. J Neurosci 30:8032-8041.
94. Sui J, Chechlacz M, Humphreys GW (2012): Dividing the self: Distinct neural substrates of task-based and automatic self-prioritization after brain damage. Cognition 122:150-162.
95. Thompson WK, Hallmayer J, O'Hara R (2011): Design considerations for characterizing psychiatric trajectories across the lifespan: Application to effects of APOE-epsilon4 on cerebral cortical thickness in Alzheimer's disease. Am J Psychiatry 168:894-903.
96. Trivedi JK, Dhyani M, Goel D, Sharma S, Singh AP, Sinha PK, Tandon R (2008): Neurocognitive dysfunction in patients with obsessive compulsive disorder. Afr J Psychiatry (Johannesbg) 11:204-209.
97. Tzourio-Mazoyer N, Landeau B, Papathanassiou D, Crivello F, Etard O, Delcroix N, Mazoyer B, Joliot M (2002): Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 15:273-289.
98. van Schouwenburg MR, O'Shea J, Mars RB, Rushworth MF, Cools R (2012): Controlling human striatal cognitive function via the frontal cortex. J Neurosci 32:5631-5637.
99. Vartanian O, Goel V (2005): Task constraints modulate activation in right ventral lateral prefrontal cortex. Neuroimage 27:927-933.
100. Wiest-Daessle N, Prima S, Coupe P, Morrissey SP, Barillot C (2008): Rician noise removal by non-Local Means filtering for low signal-to-noise ratio MRI: Applications to DT-MRI. Med Image Comput Comput Assist Interv 11:171-179.
101. Woods SW (2003): Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 64:663-667.