Prasannakumar Akash, Korann Vittal, Jacob Arpitha, Bharath Rose Dawn, Kumar Vijay, Varambally Shivarama, Venkatasubramanian Ganesan, Rao Naren P
National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Asian J Psychiatr. 2022 Oct;76:103204. doi: 10.1016/j.ajp.2022.103204. Epub 2022 Jul 14.
Cognitive insight comprising self-reflection and self-certainty is an important determinant of functional outcomes in Schizophrenia. The neural correlates of cognitive insight in Schizophrenia are underexamined. The frontal pole (FP) is implicated in metacognitive function in healthy individuals, but its role is not well examined in Schizophrenia. We had earlier reported the relationship between Frontal pole volumes and cognitive insight in a small sample of only male patients. Hence, we studied this relationship in an independent sample of schizophrenia patients and healthy controls.
We examined 41 healthy volunteers (HV) and 57 patients with Schizophrenia (SCZ). We used a previously validated manual morphometric method to perform FP parcellation on images obtained from a 3 T scanner and calculated the volumes. Cognitive insight was measured using Beck's Cognitive insight scale (BCIS). To assess the relationship between FP volumes and BCIS scores, multiple linear regression analyses were performed.
In the overall sample, age, years of education, and intracranial volume were significant predictors of BCIS scores. Within the SCZ group, age and left FP volume were significant predictors of BCIS composite scores and age, ICV for BCIS-self certainty. There was no significant relationship between age and FP volumes in either SCZ or HV group.
The current study in an independent sample further supports the critical role of the frontal pole in cognitive insight, earlier reported by us. As cognitive insight has a vital role in functional outcome, our findings have potential clinical implications.
认知洞察力包括自我反思和自我确定性，是精神分裂症功能结局的重要决定因素。精神分裂症中认知洞察力的神经相关性研究不足。额极（FP）在健康个体的元认知功能中起作用，但其在精神分裂症中的作用尚未得到充分研究。我们之前仅在一小部分男性患者样本中报告了额极体积与认知洞察力之间的关系。因此，我们在精神分裂症患者和健康对照的独立样本中研究了这种关系。
我们检查了41名健康志愿者（HV）和57名精神分裂症患者（SCZ）。我们使用先前验证的手动形态测量方法对从3T扫描仪获得的图像进行额极分割并计算体积。使用贝克认知洞察力量表（BCIS）测量认知洞察力。为了评估额极体积与BCIS分数之间的关系，进行了多元线性回归分析。
在整个样本中，年龄、受教育年限和颅内体积是BCIS分数的重要预测因素。在SCZ组中，年龄和左额极体积是BCIS综合分数的重要预测因素，年龄、ICV是BCIS自我确定性的重要预测因素。在SCZ组或HV组中，年龄与额极体积之间均无显著关系。
我们在独立样本中的当前研究进一步支持了我们之前报道的额极在认知洞察力中的关键作用。由于认知洞察力在功能结局中起着至关重要的作用，我们的发现具有潜在的临床意义。
