Format

Send to:

Choose Destination
See comment in PubMed Commons below
Schizophr Res. 2014 Jan;152(1):201-9. doi: 10.1016/j.schres.2013.11.026. Epub 2013 Dec 12.

Preservation and compensation: the functional neuroanatomy of insight and working memory in schizophrenia.

Author information

  • 1Department of Psychology, Institute of Psychiatry, King's College London, London, UK.
  • 2Department of Old Age Psychiatry, Institute of Psychiatry, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK.
  • 3School of Psychology, University of Birmingham, Birmingham, UK.
  • 4Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK.
  • 5Department of Psychology, Institute of Psychiatry, King's College London, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK.
  • 6Department of Psychology, Institute of Psychiatry, King's College London, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: veena.kumari@kcl.ac.uk.

Abstract

BACKGROUND:

Poor insight in schizophrenia has been theorised to reflect a cognitive deficit that is secondary to brain abnormalities, localized in the brain regions that are implicated in higher order cognitive functions, including working memory (WM). This study investigated WM-related neural substrates of preserved and poor insight in schizophrenia.

METHOD:

Forty stable schizophrenia outpatients, 20 with preserved and 20 with poor insight (usable data obtained from 18 preserved and 14 poor insight patients), and 20 healthy participants underwent functional magnetic resonance imaging (fMRI) during a parametric 'n-back' task. The three groups were preselected to match on age, education and predicted IQ, and the two patient groups to have distinct insight levels. Performance and fMRI data were analysed to determine how groups of patients with preserved and poor insight differed from each other, and from healthy participants.

RESULTS:

Poor insight patients showed lower performance accuracy, relative to healthy participants (p=0.01) and preserved insight patients (p=0.08); the two patient groups were comparable on symptoms and medication. Preserved insight patients, relative to poor insight patients, showed greater activity most consistently in the precuneus and cerebellum (both bilateral) during WM; they also showed greater activity than healthy participants in the inferior-superior frontal gyrus and cerebellum (bilateral). Group differences in brain activity did not co-vary significantly with performance accuracy.

CONCLUSIONS:

The precuneus and cerebellum function contribute to preserved insight in schizophrenia. Preserved insight as well as normal-range WM capacity in schizophrenia sub-groups may be achieved via compensatory neural activity in the frontal cortex and cerebellum.

Copyright © 2013 Elsevier B.V. All rights reserved.

KEYWORDS:

Cerebellum; Frontal cortex; Precuneus; Psychosis; Working memory capacity; fMRI

PMID:
24332795
[PubMed - indexed for MEDLINE]
PMCID:
PMC3906535
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for PubMed Central
    Loading ...
    Write to the Help Desk