Zhang Liwen, Opmeer Esther M, Ruhé Henricus G, Aleman André, van der Meer Lisette
Neuroimaging Center, Department of Neuroscience, University Medical Center, University of Groningen, Groningen, The Netherlands.
University Medical Center Groningen, Department of Psychiatry, University of Groningen, Program for Mood and Anxiety Disorders, Groningen, The Netherlands.
Neuroimage Clin. 2015 Apr 22;8:202-9. doi: 10.1016/j.nicl.2015.04.010. eCollection 2015.
Reflecting on the self and on others activates specific brain areas and contributes to metacognition and social cognition. The aim of the current study is to investigate brain activation during self- and other-reflection in patients with bipolar disorder (BD). In addition, we examined whether potential abnormal brain activation in BD patients could distinguish BD from patients with schizophrenia (SZ).
During functional magnetic resonance imaging (fMRI), 17 BD patients, 17 SZ patients and 21 healthy controls (HCs) performed a self-reflection task. The task consisted of sentences divided into three conditions: self-reflection, other-reflection and semantic control.
BD patients showed less activation in the posterior cingulate cortex (PCC) extending to the precuneus during other-reflection compared to HCs (p = 0.028 FWE corrected on cluster-level within the regions of interest). In SZ patients, the level of activation in this area was in between BD patients and HCs, with no significant differences between patients with SZ and BD. There were no group differences in brain activation during self-reflection. Moreover, there was a positive correlation between the PCC/precuneus activation during other-reflection and cognitive insight in SZ patients, but not in BD patients.
BD patients showed less activation in the PCC/precuneus during other-reflection. This may support an account of impaired integration of emotion and memory (evaluation of past and current other-related information) in BD patients. Correlation differences of the PCC/precuneus activation with the cognitive insight in patients with BD and SZ might reflect an important difference between these disorders, which may help to further explore potentially distinguishing markers.
对自我和他人进行反思会激活特定的脑区，并有助于元认知和社会认知。本研究的目的是调查双相情感障碍（BD）患者在自我反思和他人反思过程中的脑激活情况。此外，我们还研究了BD患者潜在的异常脑激活是否能将BD与精神分裂症（SZ）患者区分开来。
在功能磁共振成像（fMRI）过程中，17名BD患者、17名SZ患者和21名健康对照者（HCs）执行一项自我反思任务。该任务由分为三种条件的句子组成：自我反思、他人反思和语义控制。
与HCs相比，BD患者在他人反思过程中后扣带回皮层（PCC）延伸至楔前叶的激活较少（在感兴趣区域内，聚类水平上经FWE校正，p = 0.028）。在SZ患者中，该区域的激活水平介于BD患者和HCs之间，SZ患者与BD患者之间无显著差异。自我反思过程中的脑激活在各组之间没有差异。此外，SZ患者在他人反思过程中PCC/楔前叶的激活与认知洞察力呈正相关，而BD患者则不然。
BD患者在他人反思过程中PCC/楔前叶的激活较少。这可能支持了BD患者情感与记忆整合受损（对过去和当前与他人相关信息的评估）的观点。BD和SZ患者中PCC/楔前叶激活与认知洞察力的相关性差异可能反映了这两种疾病之间的重要差异，这可能有助于进一步探索潜在的鉴别标志物。
