Delineating insight-processing-related functional activations in the precuneus in first-episode psychosis patients

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Mäntylä , T , Kieseppä , T , Suvisaari , J & Raij , T T 2021 , ' Delineating insight-processing-related functional activations in the precuneus in first-episode psychosis patients ' , Psychiatry Research. Neuroimaging , vol. 317 , 111347 . https://doi.org/10.1016/j.pscychresns.2021.111347

Title: Delineating insight-processing-related functional activations in the precuneus in first-episode psychosis patients
Author: Mäntylä, Teemu; Kieseppä, Tuula; Suvisaari, Jaana; Raij, Tuukka T.
Contributor: University of Helsinki, Medicum
University of Helsinki, HUS Psychiatry
University of Helsinki, National Institute for Health and Welfare (THL)
University of Helsinki, Clinicum
Date: 2021-11-30
Language: eng
Number of pages: 8
Belongs to series: Psychiatry Research. Neuroimaging
ISSN: 0925-4927
URI: http://hdl.handle.net/10138/335705
Abstract: Poor insight is a central characteristic of psychotic disorders, and it has been suggested to result from a general dysfunction in self-reflection. However, brain processing of clinical insight and more general self-reflection has not been directly compared. We compared tasks on (1) self-reflection on psychosis-related mental functioning (clinical insight, in patients only), (2) self-reflection on mental functioning unrelated to psychosis (general metacognition), and (3) semantic control during blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging with 19 first-episode psychosis patients and 24 control participants. Arterial-spin-labeling (ASL) images were collected at rest. Clinical insight was evaluated with the Schedule for the Assessment of Insight. In patients, posterosuperior precuneus showed stronger activation during the insight task than during the semantic control task, while anteroinferior precuneus and posterior cingulate cortex (PCC) showed stronger activation during the insight task than during the general metacognition task. No significant group differences in brain activation emerged during the general metacognition task. Although the BOLD measures did not correlate with clinical insight measures, ASL-measured cerebral blood flow (CBF) values did correlate when extracted from the task-selective precuneus/PCC areas: higher CBF correlated with higher clinical insight scores. These results suggest that regions in the posteromedial cortex are selective for clinical insight.
Subject: Insight
Precuneus
Posterior cingulate cortex
Functional magnetic resonance imaging
Arterial spin labeling
Schizophrenia
First-episode psychosis
SCHIZOPHRENIA SPECTRUM DISORDERS
CORTICAL MIDLINE STRUCTURES
SELF-REFLECTION
POOR INSIGHT
BRAIN
METAANALYSIS
ILLNESS
SCALE
CONNECTIVITY
OPTIMIZATION
3124 Neurology and psychiatry
515 Psychology
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