Voegler Rolf, Becker Michael P I, Nitsch Alexander, Miltner Wolfgang H R, Straube Thomas
From the Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany (Voegler, Becker, Straube); and the Department of Biological and Clinical Psychology, Friedrich Schiller University, Jena, Germany (Nitsch, Miltner).
J Psychiatry Neurosci. 2016 Mar;41(2):E3-12. doi: 10.1503/jpn.150092.
Neuroimaging methods have pointed to deficits in the interaction of large-scale brain networks in patients with schizophrenia. Abnormal connectivity of the right anterior insula (AI), a central hub of the salience network, is frequently reported and may underlie patients' deficits in adaptive salience processing and cognitive control. While most previous studies used resting state approaches, we examined right AI interactions in a task-based fMRI study.
Patients with schizophrenia and healthy controls performed an adaptive version of the Eriksen Flanker task that was specifically designed to ensure a comparable number of errors between groups.
We included 27 patients with schizophrenia and 27 healthy controls in our study. The between-groups comparison replicated the classic finding of reduced activation in the midcingulate cortex (MCC) in patients with schizophrenia during the commission of errors while controlling for confounding factors, such as task performance and error frequency, which have been neglected in many previous studies. Subsequent psychophysiological interaction analysis revealed aberrant functional connectivity (FC) between the right AI and regions in the inferior frontal gyrus and temporoparietal junction. Additionally, FC between the MCC and the dorsolateral prefrontal cortex was reduced.
As we examined a sample of medicated patients, effects of antipsychotic medication may have influenced our results.
Overall, it appears that schizophrenia is associated with impairment of networks associated with detection of errors, refocusing of attention, superordinate guiding of cognitive control and their respective coordination.
神经影像学方法已指出精神分裂症患者大脑大规模网络交互存在缺陷。右前脑岛（AI）作为突显网络的核心枢纽，其连接异常屡有报道，可能是患者适应性突显处理和认知控制缺陷的基础。尽管先前大多数研究采用静息态方法，但我们在一项基于任务的功能磁共振成像（fMRI）研究中检测了右AI的交互作用。
精神分裂症患者和健康对照者执行了Eriksen侧翼任务的适应性版本，该版本经过专门设计，以确保两组之间的错误数量可比。
我们的研究纳入了27例精神分裂症患者和27名健康对照者。在控制诸如任务表现和错误频率等先前许多研究中被忽视的混杂因素的情况下，组间比较重现了精神分裂症患者在犯错时扣带中部皮质（MCC）激活降低这一经典发现。随后的心理生理交互作用分析显示，右AI与额下回和颞顶联合区的区域之间存在异常功能连接（FC）。此外，MCC与背外侧前额叶皮质之间的FC降低。
由于我们研究的是用药患者样本，抗精神病药物的作用可能影响了我们的结果。
总体而言，精神分裂症似乎与与错误检测、注意力重新聚焦、认知控制的上级指导及其各自协调相关的网络受损有关。
