IRCCS Santa Lucia Foundation, Laboratory of Clinical and Behavioural Neurology Via Ardeatina, 306. 00179 Rome, Italy.
Soc Cogn Affect Neurosci. 2013 Apr;8(4):418-23. doi: 10.1093/scan/nss016. Epub 2012 Jan 28.
Insight has been mostly studied from a clinical perspective. Recently, attention moved to cognitive insight or the ability to monitor and correct one's erroneous convictions. Here, we investigated the neuroanatomical correlates of cognitive insight. We administered the Beck cognitive insight scale to 45 outpatients with a schizophrenia diagnosis and 45 age- and gender-matched healthy control subjects who underwent a MRI investigation, including high-resolution volumetric and diffusion tensor imaging sequences. Gray and white matter volume, mean diffusivity and fractional anisotropy were used as dependent variables and were analyzed on a voxel-by-voxel basis with reference to the cognitive insight indexes. Self-reflectiveness was positively related to gray matter volume of the right ventro-lateral prefrontal cortex (VLPFC). No statistically significant results emerged from the DTI analyses, and no significant relationships were found for self-certainty and global cognitive insight. Reduced self-reflectiveness is related to a reduced volume of the VLPFC, an area involved in generating and maintaining in working memory different hypotheses about the self. This line of research focusing on the metacognitive features of insight in schizophrenia can provide relevant information to identify patients who are most vulnerable to lack of insight and develop effective cognitive therapeutic strategies.
洞察力主要从临床角度进行研究。最近，人们的注意力转向了认知洞察力，即监测和纠正错误信念的能力。在这里，我们研究了认知洞察力的神经解剖学相关性。我们对 45 名精神分裂症门诊患者和 45 名年龄和性别匹配的健康对照者进行了贝克认知洞察力量表的评估，这些对照者接受了 MRI 检查，包括高分辨率容积和弥散张量成像序列。将灰质和白质体积、平均弥散度和各向异性分数作为因变量，并参考认知洞察力指数进行了基于体素的分析。自我反省性与右侧腹外侧前额叶皮质（VLPFC）的灰质体积呈正相关。DTI 分析没有出现统计学上显著的结果，自我确信和整体认知洞察力也没有显著的相关性。自我反省性降低与 VLPFC 体积减小有关，VLPFC 是参与在工作记忆中生成和维持关于自我的不同假设的区域。这种专注于精神分裂症洞察力的元认知特征的研究可以提供相关信息，以识别最容易缺乏洞察力的患者，并制定有效的认知治疗策略。
