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Asian J Psychiatr. 2011 Dec;4(4):248-54. doi: 10.1016/j.ajp.2011.09.002. Epub 2011 Nov 21.
Self-awareness (SA) is a cognitive ability to differentiate between self and non-self cues and is pivotal to understand the behavior of other human beings. For this reason, there has been a significant interest to investigate the neurobiology of SA in human subjects. So far the majority of such research has been conducted in healthy subjects but a significant relationship between impaired SA and poor psychosocial outcome in schizophrenia has stimulated neuroimaging research in this patient population. The results from small number of neuroimaging studies in schizophrenia suggest that impaired SA may be mediated by a dysfunction of cortical midline structures. This paper is an attempt to review emerging functional magnetic resonance imaging (fMRI) data in schizophrenia and to propose a hypothetical model of deficits in SA in schizophrenia that can be tested in future research. The model is refined from the available literature and proposes that self-referential activity appears to reflect a shift from activation of anterior to posterior cortical midline structures in schizophrenia subjects, which may be related to lack of functional connectivity between different cortical midline regions.
自我意识（SA）是一种区分自我和非自我线索的认知能力，对于理解他人的行为至关重要。出于这个原因，人们对人类的自我意识的神经生物学进行了大量的研究。到目前为止，大多数此类研究都是在健康受试者中进行的，但自我意识受损与精神分裂症患者的不良社会心理结局之间存在显著关联，这激发了对该患者群体的神经影像学研究。少数精神分裂症神经影像学研究的结果表明，自我意识受损可能是由皮质中线结构功能障碍介导的。本文试图综述精神分裂症中涌现的功能磁共振成像（fMRI）数据，并提出一个精神分裂症中自我意识缺陷的假设模型，以便在未来的研究中进行检验。该模型是从现有文献中提炼出来的，提出自我参照活动似乎反映了精神分裂症患者从前皮质中线结构向后皮质中线结构的激活转变，这可能与不同皮质中线区域之间缺乏功能连接有关。
