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Journal ArticleDOI

Functional MRI of Verbal Self-monitoring in Schizophrenia: Performance and Illness-Specific Effects

TL;DR: It is concluded that hypoactivation of a neural network comprised of the thalamus and frontotemporal regions underlies impaired speech monitoring in schizophrenia.
Abstract: Previous small-sample studies have shown altered frontotemporal activity in schizophrenia patients with auditory hallucinations and impaired monitoring of self-generated speech. We examined a large cohort of patients with schizophrenia (n = 63) and a representative group of healthy controls (n = 20) to disentangle performance, illness, and symptom-related effects in functional magnetic resonance imaging-detected brain abnormalities during monitoring of self- and externally generated speech in schizophrenia. Our results revealed activation of the thalamus (medial geniculate nucleus, MGN) and frontotemporal regions with accurate monitoring across all participants. Less activation of the thalamus (MGN, pulvinar) and superior-middle temporal and inferior frontal gyri occurred in poorly performing patients (1 standard deviation below controls' mean; n = 36), relative to the combined group of controls and well-performing patients. In patients, (1) greater deactivation of the ventral striatum and hypothalamus to own voice, combined with nonsignificant activation of the same regions to others' voice, associated positively with negative symptoms (blunted affect, emotional withdrawal, poor rapport, passive social avoidance) regardless of performance and (2) exaggerated activation of the right superior-middle temporal gyrus during undistorted, relative to distorted, feedback associated with both positive symptoms (hallucinations, persecution) and poor performance. A further thalamic abnormality characterized schizophrenia patients regardless of performance and symptoms. We conclude that hypoactivation of a neural network comprised of the thalamus and frontotemporal regions underlies impaired speech monitoring in schizophrenia. Positive symptoms and poor monitoring share a common activation abnormality in the right superior temporal gyrus during processing of degraded speech. Altered striatal and hypothalamic modulation to own and others' voice characterizes emotionally withdrawn and socially avoidant patients.

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Journal ArticleDOI
TL;DR: This meta-analysis demonstrated that experiencing AVHs is associated with increased activity in fronto-temporal areas involved in speech generation and speech perception, but also within the medial temporal lobe, a structure notably involved in verbal memory.
Abstract: Objective:Auditory verbal hallucinations (AVHs) constitute severe, incapacitating symptoms of schizophrenia. Despite increasing interest in the functional exploration of AVHs, the available findings remain difficult to integrate because of their considerable variability. The authors' aim was to perform a robust quantitative review of existing functional data in order to elucidate consistent patterns observed during the emergence of AVHs and to orient new pathophysiological models of hallucinations. Method:Ten positron emission tomography or functional magnetic resonance imaging studies were selected for the meta-analysis after systematic review. A total of 68 patients with schizophrenia spectrum disorders experiencing AVHs during scanning were included. According to a random-effects activation likelihood estimation algorithm, stereotaxic coordinates of 129 foci, reported as significant in the source studies, were extracted and computed to estimate the brain locations most consistently associated with AVHs...

554 citations

Journal ArticleDOI
TL;DR: A pathway by which nature experience may improve mental well-being is revealed and it is suggested that accessible natural areas within urban contexts may be a critical resource for mental health in the authors' rapidly urbanizing world.
Abstract: Urbanization has many benefits, but it also is associated with increased levels of mental illness, including depression. It has been suggested that decreased nature experience may help to explain the link between urbanization and mental illness. This suggestion is supported by a growing body of correlational and experimental evidence, which raises a further question: what mechanism(s) link decreased nature experience to the development of mental illness? One such mechanism might be the impact of nature exposure on rumination, a maladaptive pattern of self-referential thought that is associated with heightened risk for depression and other mental illnesses. We show in healthy participants that a brief nature experience, a 90-min walk in a natural setting, decreases both self-reported rumination and neural activity in the subgenual prefrontal cortex (sgPFC), whereas a 90-min walk in an urban setting has no such effects on self-reported rumination or neural activity. In other studies, the sgPFC has been associated with a self-focused behavioral withdrawal linked to rumination in both depressed and healthy individuals. This study reveals a pathway by which nature experience may improve mental well-being and suggests that accessible natural areas within urban contexts may be a critical resource for mental health in our rapidly urbanizing world.

489 citations

Journal ArticleDOI
TL;DR: The 'resting state hypotheses' of AVH suggest that AVH may be traced back to abnormally elevated resting state activity in auditory cortex itself, abnormal modulation of the auditory cortex by anterior cortical midline regions as part of the default-mode network, and neural confusion between auditory cortical resting state changes and stimulus-induced activity.

173 citations


Cites background from "Functional MRI of Verbal Self-monit..."

  • ..., 2003, 2004), thalamus (Kumari et al., 2010), parahippocampal gyrus (Shergill et al....

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  • ..., 2003), left or right inferior frontal cortex (including Broca's regions on the left) (Kumari et al., 2010; Raij et al., 2009), the parietal cortex (including Wernicke's area) (Shergill et al....

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  • ...Patients with AVH showed reduced activity in various regions involved in the inner monitoring of speech like the middle temporal gyrus (MTG) (Kumari et al., 2010; McGuire et al., 1996; Shergill et al., 2003, 2004), thalamus (Kumari et al., 2010), parahippocampal gyrus (Shergill et al., 2003), left or right inferior frontal cortex (including Broca's regions on the left) (Kumari et al., 2010; Raij et al., 2009), the parietal cortex (including Wernicke's area) (Shergill et al., 2003) and the SMA (McGuire et al., 1996) during verbal imagery tasks where spoken sentences of other persons are imagined (or word generation tasks)....

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  • ...Patients with AVH showed reduced activity in various regions involved in the inner monitoring of speech like the middle temporal gyrus (MTG) (Kumari et al., 2010; McGuire et al., 1996; Shergill et al., 2003, 2004), thalamus (Kumari et al., 2010), parahippocampal gyrus (Shergill et al., 2003), left…...

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  • ...…inner monitoring of speech like the middle temporal gyrus (MTG) (Kumari et al., 2010; McGuire et al., 1996; Shergill et al., 2003, 2004), thalamus (Kumari et al., 2010), parahippocampal gyrus (Shergill et al., 2003), left or right inferior frontal cortex (including Broca's regions on the left)…...

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Journal ArticleDOI
TL;DR: The need for unified theoretical frameworks that account for the full range of hallucinatory experiences is discussed, with greater activity in auditory cortex during AVHs and in visual cortex during VHs supports models proposing over-stimulation of sensory cortices in the generation of these perceptual anomalies.

167 citations

Journal ArticleDOI
TL;DR: Thalamocortical connectivity to the LPFC is altered in schizophrenia with functional consequences on working memory processing in LPFC, and the correlation with BOLD activation was accentuated in patients as compared with controls in the ventral LPFC.

144 citations


Cites background from "Functional MRI of Verbal Self-monit..."

  • ...…(eg, Andrews et al, 2006; Byne et al, 2002; Byne et al, 2007; Harms et al, 2007; Hazlett et al, 1999; Kemether et al, 2003; Kessler et al, 2009; Kumari et al, 2010; Lehrer et al, 2005; Popken et al, 2000; Rose et al, 2006, but see, for example, Danos et al, 2005; Dorph-Petersen et al, 2004;…...

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References
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Journal ArticleDOI
TL;DR: An inventory of 20 items with a set of instructions and response- and computational-conventions is proposed and the results obtained from a young adult population numbering some 1100 individuals are reported.

33,268 citations

Journal ArticleDOI
TL;DR: Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
Abstract: The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.

18,358 citations


"Functional MRI of Verbal Self-monit..." refers background in this paper

  • ...Remaining 5 patients on both atypical and typical antipsychotics. at (df = 81) = 1.59, P > .10. bt (df = 81) = 2.84, P = .01. ct (df = 80) = 2.99, P = .004 (IQ not assessed in one patient, n reduced to 62). dPANSS = Positive and Negative Syndrome Scale.24 Words ‘‘self,’’ ‘‘other,’’ and ‘‘unsure’’ were displayed on the screen and were outlined in black after each participant’s response....

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  • ...PANSS = Positive and Negative Syndrome Scale.(24) fMRI of Verbal Self-monitoring in Schizophrenia...

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  • ...Note: PANSS = Positive and Negative Syndrome Scale.(24)...

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Journal ArticleDOI
TL;DR: It is suggested that both task-driven neuronal responses and behavior are reflections of this dynamic, ongoing, functional organization of the brain, featuring the presence of anticorrelated networks in the absence of overt task performance.
Abstract: During performance of attention-demanding cognitive tasks, certain regions of the brain routinely increase activity, whereas others routinely decrease activity. In this study, we investigate the extent to which this task-related dichotomy is represented intrinsically in the resting human brain through examination of spontaneous fluctuations in the functional MRI blood oxygen level-dependent signal. We identify two diametrically opposed, widely distributed brain networks on the basis of both spontaneous correlations within each network and anticorrelations between networks. One network consists of regions routinely exhibiting task-related activations and the other of regions routinely exhibiting task-related deactivations. This intrinsic organization, featuring the presence of anticorrelated networks in the absence of overt task performance, provides a critical context in which to understand brain function. We suggest that both task-driven neuronal responses and behavior are reflections of this dynamic, ongoing, functional organization of the brain.

7,741 citations


"Functional MRI of Verbal Self-monit..." refers background in this paper

  • ...As noted earlier, these areas were deactivated during active conditions and the observed difference between the poor and good performers in the medial prefrontal and the posterior temporal parietal cortices arose because of a lack of deactivation of these regions in the former group, perhaps reflecting the fact that this group activated task-relevant areas to a markedly reduced degree.(54)...

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Journal ArticleDOI
TL;DR: Analysis of regional activations across cognitive domains suggested that several brain regions, including the cerebellum, are engaged by a variety of cognitive challenges.
Abstract: Positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) have been extensively used to explore the functional neuroanatomy of cognitive functions. Here we review 275 PET and fMRI studies of attention (sustained, selective, Stroop, orientation, divided), perception (object, face, space/motion, smell), imagery (object, space/ motion), language (written/spoken word recognition, spoken/ no spoken response), working memory (verbal/numeric, object, spatial, problem solving), semantic memory retrieval (categorization, generation), episodic memory encoding (verbal, object, spatial), episodic memory retrieval (verbal, nonverbal, success, effort, mode, context), priming (perceptual, conceptual), and procedural memory (conditioning, motor, and nonmotor skill learning). To identify consistent activation patterns associated with these cognitive operations, data from 412 contrasts were summarized at the level of cortical Brodmann's areas, insula, thalamus, medial-temporal lobe (including hippocampus), basal ganglia, and cerebellum. For perception and imagery, activation patterns included primary and secondary regions in the dorsal and ventral pathways. For attention and working memory, activations were usually found in prefrontal and parietal regions. For language and semantic memory retrieval, typical regions included left prefrontal and temporal regions. For episodic memory encoding, consistently activated regions included left prefrontal and medial-temporal regions. For episodic memory retrieval, activation patterns included prefrontal, medial-temporal, and posterior midline regions. For priming, deactivations in prefrontal (conceptual) or extrastriate (perceptual) regions were consistently seen. For procedural memory, activations were found in motor as well as in non-motor brain areas. Analysis of regional activations across cognitive domains suggested that several brain regions, including the cerebellum, are engaged by a variety of cognitive challenges. These observations are discussed in relation to functional specialization as well as functional integration.

3,407 citations


"Functional MRI of Verbal Self-monit..." refers background in this paper

  • ...This may be associated with low discrimination between self-generated vs another person’s voices in poorly performing patients given the sensitivity of right TL to auditory distinctiveness.39 Reduced left IFG activity in poor performers may suggest a language-related deficit.38 Reduced IFG activation (in either hemisphere) could also be the cause or effect of reduced verbal WM.40 This in our task would mean loss of information after hearing the feedback, prior to being able to make a response about its origin....

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  • ...Reduced IFG activation (in either hemisphere) could also be the cause or effect of reduced verbal WM.(40) This in our task would mean loss of information after hearing the feedback, prior to being able to make a response about its origin....

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  • ...The left IFG (Broca’s area) activation was also expected given its role in speech and language,(37,38) while the right IFG activation may relate to the earlier noted WM requirement of our task.(40)...

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