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Insight does not come at random: Individual gray matter networks relate to clinical and cognitive insight in schizophrenia
Progress in Neuro-Psychopharmacology and Biological Psychiatry ( IF 5.6 ) Pub Date : 2021-01-23 , DOI: 10.1016/j.pnpbp.2021.110251
Daouia I Larabi 1 , Jan-Bernard C Marsman 2 , André Aleman 3 , Betty M Tijms 4 , Esther M Opmeer 5 , Gerdina H M Pijnenborg 6 , Lisette van der Meer 7 , Marie-José van Tol 2 , Branislava Ćurčić-Blake 2
Affiliation  

Background

Impaired clinical and cognitive insight are prevalent in schizophrenia and relate to poorer outcome. Good insight has been suggested to depend on social cognitive and metacognitive abilities requiring global integration of brain signals. Impaired insight has been related to numerous focal gray matter (GM) abnormalities distributed across the brain suggesting dysconnectivity at the global level. In this study, we test whether global integration deficiencies reflected in gray matter network connectivity underlie individual variations in insight.

Methods

We used graph theory to examine whether individual GM-network metrics relate to insight in patients with a psychotic disorder (n = 114). Clinical insight was measured with the Schedule for the Assessment of Insight–Expanded and item G12 of the Positive and Negative Syndrome Scale, and cognitive insight with the Beck Cognitive Insight Scale. Individual GM-similarity networks were created from GM-segmentations of T1-weighted MRI-scans. Graph metrics were calculated using the Brain Connectivity Toolbox.

Results

Networks of schizophrenia patients with poorer clinical insight showed less segregation (i.e. clustering coefficient) into specialized subnetworks at the global level. Schizophrenia patients with poorer cognitive insight showed both less segregation and higher connectedness (i.e. lower path length) of their brain networks, making their network topology more “random”.

Conclusions

Our findings suggest less segregated processing of information in patients with poorer cognitive and clinical insight, in addition to higher connectedness in patients with poorer cognitive insight. The ability to take a critical perspective on one's symptoms (clinical insight) or views (cognitive insight) might depend especially on segregated specialized processing within distinct subnetworks.



中文翻译:

洞察力并非随机而来:个体灰质网络与精神分裂症的临床和认知洞察力有关

背景

临床和认知洞察力受损在精神分裂症中普遍存在,并且与较差的结果有关。有人提出,良好的洞察力取决于需要全球整合大脑信号的社会认知和元认知能力。洞察力受损与分布在大脑中的大量局灶性灰质 (GM) 异常有关,这表明在全球范围内存在连接障碍。在这项研究中,我们测试了灰质网络连接中反映的全球整合缺陷是否是个体洞察力差异的基础。

方法

我们使用图论来检查个体 GM 网络指标是否与精神病患者的洞察力有关(n  = 114)。临床洞察力是用扩展洞察力评估表和正负综合征量表的 G12 项来衡量的,而认知洞察力是用贝克认知洞察力量表来衡量的。单个 GM 相似性网络是从 T1 加权 MRI 扫描的 GM 分割创建的。图表指标是使用大脑连接工具箱计算的。

结果

临床洞察力较差的精神分裂症患者网络在全球范围内表现出较少的分离(即聚类系数)到专门的子网络中。认知洞察力较差的精神分裂症患者的大脑网络表现出较少的分离性和较高的连通性(即较短的路径长度),这使得他们的网络拓扑结构更加“随机”。

结论

我们的研究结果表明,认知和临床洞察力较差的患者对信息的分离处理较少,而认知洞察力较差的患者的联系性较高。对一个人的症状(临床洞察力)或观点(认知洞察力)采取批判性观点的能力可能尤其取决于不同子网络中的隔离专门处理。

更新日期:2021-02-10
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