Self-reflection and the brain: A theoretical review and meta-analysis of neuroimaging studies with implications for schizophrenia

Global neural self-disturbance in schizophrenia: A systematic fMRI review

There is a general consensus that schizophrenia (SZ) is characterized by major changes in the sense of self. Phenomenological studies suggest that these changes in the sense of self stem from a basic disturbance, hence the term 'basic self-disturbance'. While imaging studies demonstrate changes in various regions during self-focused tasks, the exact neural correlates of such basic self-disturbances remain unclear. If the self-disturbance is indeed basic and thereby underlies all other symptoms, one would expect it to be related to more global rather than local changes in the brain. Testing this hypothesis, we conducted a systematic review of fMRI studies on self in SZ. Our main findings are 1. Abnormal activity related to the self can be observed in a variety of different regions ranging from higher-order transmodal to lower-order unimodal regions, 2. These findings hold true across different tasks including self-reflection, self-referentiality, and self-agency, and 3. The global neural abnormalities related to the self in SZ correspond to all layers of the self, predominantly the mental and exteroceptive self. Such global neural disturbance of self converges well with the basic self-disturbance as described in phenomenology.

Brain regions supporting retrieval of words drawn at encoding: fMRI evidence for multimodal reactivation

Memory for words that are drawn or sketched by the participant, rather than written, during encoding is typically superior. While this drawing benefit has been reliably demonstrated in recent years, there has yet to be an investigation of its neural basis. Here, we asked participants to either create drawings, repeatedly write, or list physical characteristics depicting each target word during encoding. Participants then completed a recognition memory test for target words while undergoing functional magnetic resonance imaging (fMRI). Behavioural results showed memory was significantly higher for words drawn than written, replicating the typical drawing effect. Memory for words whose physical characteristics were listed at encoding was also higher than for those written repeatedly, but lower than for those drawn. Voxel-wise analyses of fMRI data revealed two distributed sets of brain regions more active for items drawn relative to written, the left angular gyrus (BA 39) and bilateral frontal (BA 10) regions, suggesting integration and self-referential processing during retrieval of drawn words. Brain-behaviour correlation analyses showed that the size of one's memory benefit for words drawn relative to written at encoding was positively correlated with activation in brain regions linked to visual representation and imagery (BA 17 and cuneus) and motor planning (premotor and supplementary motor areas; BA 6). This study suggests that drawing benefits memory by coactivating multiple sensory traces. Target words drawn during encoding are subsequently remembered by re-engaging visual, motoric, and semantic representations.

Behavioral evidence of impaired self-referential processing in patients with affective disorders and first-episode schizophrenia

Despite the critical role of self-disturbance in psychiatric diagnosis and treatment, its diverse behavioral manifestations remain poorly understood. This investigation aimed to elucidate unique patterns of self-referential processing in affective disorders and first-episode schizophrenia. A total of 156 participants (41 first-episode schizophrenia [SZ], 33 bipolar disorder [BD], 44 major depressive disorder [MDD], and 38 healthy controls [HC]) engaged in a self-referential effect (SRE) task, assessing trait adjectives for self-descriptiveness, applicability to mother, or others, followed by an unexpected recognition test. All groups displayed preferential self- and mother-referential processing with no significant differences in recognition scores. However, MDD patients showed significantly enhanced self-referential recognition scores and increased bias compared to HC, first-episode SZ, and BD. The present study provides empirical evidence for increased self-focus in MDD and demonstrates that first-episode SZ and BD patients maintain intact self-referential processing abilities. These findings refine our understanding of self-referential processing impairments across psychiatric conditions, suggesting that it could serve as a supplementary measure for assessing treatment response in first-episode SZ and potentially function as a discriminative diagnostic criterion between MDD and BD.

Default mode network shows distinct emotional and contextual responses yet common effects of retrieval demands across tasks

The default mode network (DMN) lies towards the heteromodal end of the principal gradient of intrinsic connectivity, maximally separated from the sensory-motor cortex. It supports memory-based cognition, including the capacity to retrieve conceptual and evaluative information from sensory inputs, and to generate meaningful states internally; however, the functional organisation of DMN that can support these distinct modes of retrieval remains unclear. We used fMRI to examine whether activation within subsystems of DMN differed as a function of retrieval demands, or the type of association to be retrieved, or both. In a picture association task, participants retrieved semantic associations that were either contextual or emotional in nature. Participants were asked to avoid generating episodic associations. In the generate phase, these associations were retrieved from a novel picture, while in the switch phase, participants retrieved a new association for the same image. Semantic context and emotion trials were associated with dissociable DMN subnetworks, indicating that a key dimension of DMN organisation relates to the type of association being accessed. The frontotemporal and medial temporal DMN showed a preference for emotional and semantic contextual associations, respectively. Relative to the generate phase, the switch phase recruited clusters closer to the heteromodal apex of the principal gradient-a cortical hierarchy separating unimodal and heteromodal regions. There were no differences in this effect between association types. Instead, memory switching was associated with a distinct subnetwork associated with controlled internal cognition. These findings delineate distinct patterns of DMN recruitment for different kinds of associations yet common responses across tasks that reflect retrieval demands.

Individual differences in the neural representation of cooperation and competition

Much evidence links the Big Five's agreeableness to a propensity for cooperation and aggressiveness to a propensity for competition. However, the neural basis for these associations is unknown. In this functional magnetic resonance imaging study, using multivariate pattern analysis of data recorded during a computer game in which participants were required to construct target patterns either in cooperation or in competition with another person, we sought to determine how individual differences in neural representations of cooperative and competitive behavior relate to individual differences in agreeableness and aggressiveness. During cooperation, agreeableness was positively correlated with the consistency of spatial patterns of neural activation in the left temporoparietal junction (TPJ) and showed positive correlations with inter-subject similarity in the dynamics of neural responses in the posterior default mode network hub and areas involved in the regulation of attention, movement planning, and visual perception. During competition, aggressiveness was positively correlated with the consistency of spatial patterns in the left and right TPJ and showed positive correlations with neural dynamics in visual processing and movement regulation areas. These results are consistent with the assumption that agreeable individuals are more involved in cooperative interactions with others, whereas aggression-prone individuals are more involved in competitive interactions.

A theory of the neural mechanisms underlying negative cognitive bias in major depression

The widely acknowledged cognitive theory of depression, developed by Aaron Beck, focused on biased information processing that emphasizes the negative aspects of affective and conceptual information. Current attempts to discover the neurological mechanism underlying such cognitive and affective bias have successfully identified various brain regions associated with severally biased functions such as emotion, attention, rumination, and inhibition control. However, the neurobiological mechanisms of how individuals in depression develop this selective processing toward negative is still under question. This paper introduces a neurological framework centered around the frontal-limbic circuit, specifically analyzing and synthesizing the activity and functional connectivity within the amygdala, hippocampus, and medial prefrontal cortex. Firstly, a possible explanation of how the positive feedback loop contributes to the persistent hyperactivity of the amygdala in depression at an automatic level is established. Building upon this, two hypotheses are presented: hypothesis 1 revolves around the bidirectional amygdalohippocampal projection facilitating the amplification of negative emotions and memories while concurrently contributing to the impediment of the retrieval of opposing information in the hippocampus attractor network. Hypothesis 2 highlights the involvement of the ventromedial prefrontal cortex in the establishment of a negative cognitive framework through the generalization of conceptual and emotional information in conjunction with the amygdala and hippocampus. The primary objective of this study is to improve and complement existing pathological models of depression, pushing the frontiers of current understanding in neuroscience of affective disorders, and eventually contributing to successful recovery from the debilitating affective disorders.

The state-trait sense of self inventory: A psychometric study of self-experience and its relation to psychosis-like manifestations

The sense of self is a fundamental construct in the study of the mind, yet its psychological nature remains elusive. We introduce a novel 25-item inventory to investigate selfhood both as an enduring trait and a temporary state. We hypothesized two foundational aspects of the self: identity (related to self-referencing and continuity over time) and agency (the perception of controlling own's actions and thoughts). Results from two population studies highlight a singular self-trait factor combining agency and identity. In contrast, self-state measures revealed a bifactorial structure with a high-order factor and three lower-order subfactors: state-identity, state-agency, and state-technology. These factors were predictive of psychosis-like experiences, schizotypal traits, and hopelessness. Mediation analysis demonstrated that the negative association between the sense of self and hopelessness is mediated by depressive manifestations. Our research provides a tool to shed new light on the complexity of the sense of self and its mental health implications.

Brain imaging studies of emotional well-being: a scoping review

This scoping review provides an overview of previous empirical studies that used brain imaging techniques to investigate the neural correlates of emotional well-being (EWB). We compiled evidence on this topic into one accessible and usable document as a foundation for future research into the relationship between EWB and the brain. PRISMA 2020 guidelines were followed. We located relevant articles by searching five electronic databases with 95 studies meeting our inclusion criteria. We explored EWB measures, brain imaging modalities, research designs, populations studied, and approaches that are currently in use to characterize and understand EWB across the literature. Of the key concepts related to EWB, the vast majority of studies investigated positive affect and life satisfaction, followed by sense of meaning, goal pursuit, and quality of life. The majority of studies used functional MRI, followed by EEG and event-related potential-based EEG to study the neural basis of EWB (predominantly experienced affect, affective perception, reward, and emotion regulation). It is notable that positive affect and life satisfaction have been studied significantly more often than the other three aspects of EWB (i.e., sense of meaning, goal pursuit, and quality of life). Our findings suggest that future studies should investigate EWB in more diverse samples, especially in children, individuals with clinical disorders, and individuals from various geographic locations. Future directions and theoretical implications are discussed, including the need for more longitudinal studies with ecologically valid measures that incorporate multi-level approaches allowing researchers to better investigate and evaluate the relationships among behavioral, environmental, and neural factors.

Systematic review registration

https://osf.io/t9cf6/.

Representational similarity analysis of self- versus other-processing: Effect of trait aggressiveness

In this study, using the self/other adjective judgment task, we aimed to explore how people perceive themselves in comparison to various other people, including friends, strangers, and those they dislike. Next, using representational similarity analysis, we sought to elucidate how these perceptual similarities and differences are represented in brain activity and how aggressiveness is related to these representations. Behavioral ratings show that, on average, people tend to consider themselves more like their friends than neutral strangers, and least like people they dislike. This pattern of similarity is positively correlated with neural representation in social and cognitive circuits of the brain and negatively correlated with neural representation in emotional centers that may represent emotional arousal associated with various social objects. Aggressiveness seems to predispose a person to a pattern of behavior that is the opposite of the average pattern, that is, a tendency to think of oneself as less like one's friends and more like one's enemies. This corresponds to an increase in the similarity of the behavioral representation with the representation in the emotional centers and a decrease in its similarity with the representation in the social and cognitive centers. This can be seen as evidence that in individuals prone to aggression, behavior in the social environment may depend to a greater extent on the representation of social objects in the emotional rather than social and cognitive brain circuits.

Hooked on a thought: Associations between rumination and neural responses to social rejection in adolescent girls

Rumination is a significant risk factor for psychopathology in adolescent girls and is associated with heightened and prolonged physiological arousal following social rejection. However, no study has examined how rumination relates to neural responses to social rejection in adolescent girls; thus, the current study aimed to address this gap. Adolescent girls (N = 116; ages 16.95-19.09) self-reported on their rumination tendency and completed a social evaluation fMRI task where they received fictitious feedback (acceptance, rejection) from peers they liked or disliked. Rejection-related neural activity and subgenual anterior cingulate cortex (sgACC) connectivity were regressed on rumination, controlling for rejection sensitivity and depressive symptoms. Rumination was associated with distinctive neural responses following rejection from liked peers including increased neural activity in the precuneus, inferior parietal gyrus, dorsolateral prefrontal cortex, and supplementary motor area (SMA) and reduced sgACC connectivity with multiple regions including medial prefrontal cortex, precuneus and ventrolateral prefrontal cortex. Greater precuneus and SMA activity mediated the effect of rumination on slower response time to report emotional state after receiving rejection from liked peers. These findings provide clues for distinctive cognitive processes (e.g., mentalizing, conflict processing, memory encoding) following the receipt of rejection in girls with high levels of rumination.

Looking into troubled waters: Childhood emotional maltreatment modulates neural responses to prolonged gazing into one's own, but not others', eyes

One of the most prevalent nonverbal, social phenomena known to automatically elicit self- and other-referential processes is eye contact. By its negative effects on the perception of social safety and views about the self and others, childhood emotional maltreatment (CEM) may fundamentally affect these processes. To investigate whether the socioaffective consequences of CEM may become visible in response to (prolonged) eye gaze, 79 adult participants (mean [M]age = 49.87, standard deviation [SD]age = 4.62) viewed videos with direct and averted gaze of an unfamiliar other and themselves while we recorded self-reported mood, eye movements using eye-tracking, and markers of neural activity using fMRI. Participants who reported higher levels of CEM exhibited increased activity in ventromedial prefrontal cortex to one's own, but not to others', direct gaze. Furthermore, in contrast to those who reported fewer of such experiences, they did not report a better mood in response to a direct gaze of self and others, despite equivalent amounts of time spent looking into their own and other peoples' eyes. The fact that CEM is associated with enhanced neural activation in a brain area that is crucially involved in self-referential processing (i.e., vmPFC) in response to one's own direct gaze is in line with the chronic negative impact of CEM on a person's self-views. Interventions that directly focus on targeting maladaptive self-views elicited during eye gaze to self may be clinically useful.

Neurophysiological error processing and addiction self-awareness correlates of reduced insight in cannabis use disorder

BACKGROUND AND AIMS

Cannabis use disorder (CUD) prevalence has increased, while perceived risks of cannabis use and CUD treatment need have decreased. Chronic cannabis use may also impair the neural and behavioral mechanisms of insight, further hampering treatment-seeking. This study aimed to measure whether CUD is characterized by reduced self-monitoring in drug-related contexts (objectively-assessed insight), subserved by functional neural abnormalities in error-processing and manifested clinically as decreased awareness of the need to change.

DESIGN

Case-control laboratory study was used.

SETTING

University setting was in Alabama, USA.

PARTICIPANTS

There were 42 CUD participants and 47 age-, sex-, and nicotine use-matched controls.

MEASUREMENTS

Participants completed a probabilistic choice task, adapted for the first time for CUD, in which they selected pleasant, unpleasant, neutral, and cannabis-related images according to their preference. Reduced versus accurate insight was operationalized as the correspondence between self-reported and actual most chosen image type. Neurophysiological error-processing during an inhibitory control task was recorded using electroencephalography. Participants with CUD completed measures of cannabis problem recognition and motivation to change.

FINDINGS

Compared with controls, the CUD group made significantly more cannabis selections on the choice task (mean difference [MD] = 8.11, 95% confidence interval [CI] [4.88 11.35], p < 0.001) and had significantly reduced insight into cannabis choice (odds ratio [OR] = 9.69, 95% CI [1.06 88.65], p = 0.04). CUD participants with reduced insight on the choice task had significantly decreased neurophysiological reactivity to errors on the inhibitory control task (error-related negativity) compared with CUD participants with accurate insight (MD = 2.64 μV, 95% CI [0.74 μV 4.54 μV], p = 0.008) and controls (MD = 4.05 μV, 95% CI [1.29 μV 6.80 μV], p = 0.005). Compared with CUD participants with accurate insight on the choice task, CUD participants with reduced insight reported significantly less agreement that they had a cannabis problem (MD = -5.06, 95% CI [-8.49-1.62], p = 0.003).

CONCLUSIONS

People with CUD who show reduced insight on a drug-related choice task may also have decreased early neural error-processing and less cannabis problem recognition.

Rich-club reorganization of white matter structural network in schizophrenia patients with auditory verbal hallucinations following 1 Hz rTMS treatment

The human brain comprises a large-scale structural network of regions and interregional pathways, including a selectively defined set of highly central and interconnected hub regions, often referred to as the "rich club", which may play a pivotal role in the integrative processes of the brain. A quintessential symptom of schizophrenia, auditory verbal hallucinations (AVH) have shown a decrease in severity following low-frequency repetitive transcranial magnetic stimulation (rTMS). However, the underlying mechanism of rTMS in treating AVH remains elusive. This study investigated the effect of low-frequency rTMS on the rich-club organization within the brain in patients diagnosed with schizophrenia who experience AVH using diffusion tensor imaging data. Through by constructing structural connectivity networks, we identified several critical rich hub nodes, which constituted a rich-club subnetwork, predominantly located in the prefrontal cortices. Notably, our findings revealed enhanced connection strength and density within the rich-club subnetwork following rTMS treatment. Furthermore, we found that the decreased connectivity within the subnetwork components, including the rich-club subnetwork, was notably enhanced in patients following rTMS treatment. In particular, the increased connectivity strength of the right median superior frontal gyrus, which functions as a critical local bridge, with the right postcentral gyrus exhibited a significant correlation with improvements in both positive symptoms and AVH. These findings provide valuable insights into the role of rTMS in inducing reorganizational changes within the rich-club structural network in schizophrenia and shed light on potential mechanisms through which rTMS may alleviate AVH.

Mental Pain Correlates with Mind Wandering, Self-Reflection, and Insight in Individuals with Psychotic Disorders: A Cross-Sectional Study

Understanding the cognitive processes that contribute to mental pain in individuals with psychotic disorders is important for refining therapeutic strategies and improving patient outcomes. This study investigated the potential relationship between mental pain, mind wandering, and self-reflection and insight in individuals diagnosed with psychotic disorders. We included individuals diagnosed with a 'schizophrenia spectrum disorder' according to DSM-5 criteria. Patients in the study were between 18 and 65 years old, clinically stable, and able to provide informed consent. A total of 34 participants, comprising 25 males and 9 females with an average age of 41.5 years (SD 11.5) were evaluated. The Psychache Scale (PAS), the Mind Wandering Deliberate and Spontaneous Scale (MWDS), and the Self-Reflection and Insight Scale (SRIS) were administered. Statistical analyses involved Spearman's rho correlations, controlled for potential confounders with partial correlations, and mediation and moderation analyses to understand the indirect effects of MWDS and SRIS on PAS and their potential interplay. Key findings revealed direct correlations between PAS and MWDS and inverse correlations between PAS and SRIS. The mediation effects on the relationship between the predictors and PAS ranged from 9.22% to 49.8%. The largest statistically significant mediation effect was observed with the SRIS-I subscale, suggesting that the self-reflection and insight component may play a role in the impact of mind wandering on mental pain. No evidence was found to suggest that any of the variables could function as relationship moderators for PAS. The results underscore the likely benefits of interventions aimed at reducing mind wandering and enhancing self-reflection in psychotic patients (e.g., metacognitive therapy, mindfulness). Further research will be essential to elucidate the underlying mechanisms.

Neural Representation of Collective Self-esteem in Resting-state Functional Connectivity and its Validation in Task-dependent Modality

INTRODUCTION

Collective self-esteem (CSE) is an important personality variable, defined as self-worth derived from membership in social groups. A study explored the neural basis of CSE using a task-based functional magnetic resonance imaging (fMRI) paradigm; however, task-independent neural basis of CSE remains to be explored, and whether the CSE neural basis of resting-state fMRI is consistent with that of task-based fMRI is unclear.

METHODS

We built support vector regression (SVR) models to predict CSE scores using topological metrics measured in the resting-state functional connectivity network (RSFC) as features. Then, to test the reliability of the SVR analysis, the activation pattern of the identified brain regions from SVR analysis was used as features to distinguish collective self-worth from other conditions by multivariate pattern classification in task-based fMRI dataset.

RESULTS

SVR analysis results showed that leverage centrality successfully decoded the individual differences in CSE. The ventromedial prefrontal cortex, anterior cingulate cortex, posterior cingulate gyrus, precuneus, orbitofrontal cortex, posterior insula, postcentral gyrus, inferior parietal lobule, temporoparietal junction, and inferior frontal gyrus, which are involved in self-referential processing, affective processing, and social cognition networks, participated in this prediction. Multivariate pattern classification analysis found that the activation pattern of the identified regions from the SVR analysis successfully distinguished collective self-worth from relational self-worth, personal self-worth and semantic control.

CONCLUSION

Our findings revealed CSE neural basis in the whole-brain RSFC network, and established the concordance between leverage centrality and the activation pattern (evoked during collective self-worth task) of the identified regions in terms of representing CSE.

Altered functional connectivity in anterior cingulate cortex subregions in treatment-resistant schizophrenia patients

BACKGROUND

The anterior cingulate cortex (ACC) plays a key role in motor control, attention, and cognitive control. It is well established that schizophrenia is associated with impaired functional connectivity (FC) of the ACC pathway. So far, however, there has been little discussion about the ACC subregions function in patients with treatment-resistant schizophrenia (TRS).

AIM

This study aims to characterize resting-state functional connectivity (rs-FC) profiles of ACC subregions in patients with TRS. The association between these FC and clinical symptoms, neurocognitive function, and grey matter volume (GMV) was studied as well.

METHODS

A total of 81 patients with schizophrenia (40 patients with TRS = 40, 41 patients with non-treatment-resistant schizophrenia (NTRS)) and 39 age- and gender-matched healthy controls (HC) were enrolled, and underwent structural magnetic resonance imaging (MRI), resting-state functional MRI (rs-fMRI), clinical evaluation. The ACC subregions, including subgenual ACC (sgACC), pregenual ACC (pgACC), and dorsal ACC (dACC), were selected as seed regions from the automated anatomical labelling atlas 3 (AAL3). The GMV of the ACC subregions were calculated and seed-based FC maps for all ACC subregions were generated and compared between the TRS and NTRS, HC group. Additionally, correlations between altered FC and clinical symptoms, GMV, and neurocognitive functions in the TRS patients were explored.

RESULT

Compared with HC, increased FC was observed in TRS and NTRS groups between bilateral sgACC and left cuneus, right cuneus, and left lingual gyrus, while decreased FC was found between bilateral dACC and thalamic. Additionally, compared with NTRS, the TRS group showed increased FC between bilateral dACC and right cuneus and decreased FC between bilateral dACC and thalamic. The TRS group showed decreased GMV in all ACC subregions than the HC group, and there is no significant difference between the TRS group and the NTRS group.

CONCLUSION

The findings in this study suggest that disrupted FC of subregional ACC has the potential as a marker for TRS. The dysconnectivity of bilateral dACC- right cuneus and bilateral dACC-thalamus, are likely to be the unique FC profiles of TRS. These findings further our understanding of the neurobiological impairments in TRS.

The neural signature of reality-monitoring: A meta-analysis of functional neuroimaging studies

Distinguishing imagination and thoughts from information we perceived from the environment, a process called reality-monitoring, is important in everyday situations. Although reality monitoring seems to overlap with the concept of self-monitoring, which allows one to distinguish self-generated actions or thoughts from those generated by others, the two concepts remain largely separate cognitive domains and their common brain substrates have received little attention. We investigated the brain regions involved in these two cognitive processes and explored the common brain regions they share. To do this, we conducted two separate coordinate-based meta-analyses of functional magnetic resonance imaging studies assessing the brain regions involved in reality- and self-monitoring. Few brain regions survived threshold-free cluster enhancement family-wise multiple comparison correction (p < .05), likely owing to the small number of studies identified. Using uncorrected statistical thresholds recommended by Signed Differential Mapping with Permutation of Subject Images, the meta-analysis of reality-monitoring studies (k = 9 studies including 172 healthy subjects) revealed clusters in the lobule VI of the cerebellum, the right anterior medial prefrontal cortex and anterior thalamic projections. The meta-analysis of self-monitoring studies (k = 12 studies including 192 healthy subjects) highlighted the involvement of a set of brain regions including the lobule VI of the left cerebellum and fronto-temporo-parietal regions. We showed with a conjunction analysis that the lobule VI of the cerebellum was consistently engaged in both reality- and self-monitoring. The current findings offer new insights into the common brain regions underlying reality-monitoring and self-monitoring, and suggest that the neural signature of the self that may occur during self-production should persist in memories.

Default egocentrism: an MVPA approach to overlap in own and others' socio-political attitudes

Understanding the socio-political attitudes of other people is a crucial skill, yet the neural mechanisms supporting this capacity remain understudied. This study used multivariate pattern analysis to examine patterns of activity in the default mode network (DMN) while participants assessed their own attitudes and the attitudes of other people. Classification analyses indicated that common patterns in DMN regions encode both own and others' support across a variety of contemporary socio-political issues. Moreover, cross-classification analyses demonstrated that a common coding of attitudes is implemented at a neural level. This shared informational content was associated with a greater perceived overlap between own attitude positions and those of others (i.e. attitudinal projection), such that higher cross-classification accuracy corresponded with greater attitudinal projection. This study thus identifies a possible neural basis for egocentric biases in the social perception of individual and group attitudes and provides additional evidence for self/other overlap in mentalizing.

The moderating effect of cognitive impairment on the relationship between inner speech and auditory verbal hallucinations among chronic patients with schizophrenia

BACKGROUND

Even though there is an increasing amount of evidence from behavioral and neuroimaging studies to suggest that pathological inner speech plays a role in the emergence of auditory verbal hallucinations (AVH), studies investigating the mechanisms underlying this relationship are rather scarce. Examining moderators might inform the development of new treatment options for AVH. We sought to extend the existing knowledge by testing the moderating role of cognitive impairment in the association between inner speech and hallucinations in a sample of Lebanese patients with schizophrenia.

METHODS

A cross-sectional study was conducted from May till August 2022, enrolling 189 chronic patients.

RESULTS

Moderation analysis revealed that, after controlling for delusions, the interaction of experiencing voices of other people in inner speech by cognitive performance was significantly associated with AVH. In people having low (Beta = 0.69; t = 5.048; p < .001) and moderate (Beta = 0.45; t = 4.096; p < .001) cognitive performance, the presence of voices of other people in inner speech was significantly associated with more hallucinations. This association was not significant in patients with high cognitive function (Beta = 0.21; t = 1.417; p = .158).

CONCLUSION

This preliminarily study suggests that interventions aiming at improving cognitive performance may also have a beneficial effect in reducing hallucinations in schizophrenia.

Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence

BACKGROUND

Substance use disorders (SUDs) affect ~ 35 million people globally and are associated with strong cravings, stress, and brain alterations. Mindfulness-based interventions (MBIs) can mitigate the adverse psychosocial outcomes of SUDs, but the underlying neurobiology is unclear. Emerging findings were systematically synthesised from fMRI studies about MBI-associated changes in brain function in SUDs and their associations with mindfulness, drug quantity, and craving.

METHODS

PsycINFO, Medline, CINAHL, PubMed, Scopus, and Web of Science were searched. Seven studies met inclusion criteria.

RESULTS

Group by time effects indicated that MBIs in SUDs (6 tobacco and 1 opioid) were associated with changes in the function of brain pathways implicated in mindfulness and addiction (e.g., anterior cingulate cortex and striatum), which correlated with greater mindfulness, lower craving and drug quantity.

CONCLUSIONS

The evidence for fMRI-related changes with MBI in SUD is currently limited. More fMRI studies are required to identify how MBIs mitigate and facilitate recovery from aberrant brain functioning in SUDs.

Early infant prefrontal gray matter volume is associated with concurrent and future infant emotionality

High levels of infant negative emotionality (NE) are associated with emotional and behavioral problems later in childhood. Identifying neural markers of high NE as well as low positive emotionality (PE) in infancy can provide neural markers to aid early identification of vulnerability, and inform interventions to help delay or even prevent psychiatric disorders before the manifestation of symptoms. Prefrontal cortical (PFC) subregions support the regulation of NE and PE, with each PFC subregion differentially specializing in distinct emotional regulation processes. Gray matter (GM) volume measures show good test-retest reliability, and thus have potential use as neural markers of NE and PE. Yet, while studies showed PFC GM structural abnormalities in adolescents and young adults with affective disorders, few studies examined how PFC subregional GM measures are associated with NE and PE in infancy. We aimed to identify relationships among GM in prefrontal cortical subregions at 3 months and caregiver report of infant NE and PE, covarying for infant age and gender and caregiver sociodemographic and clinical variables, in two independent samples at 3 months (Primary: n = 75; Replication sample: n = 40) and at 9 months (Primary: n = 44; Replication sample: n = 40). In the primary sample, greater 3-month medial superior frontal cortical volume was associated with higher infant 3-month NE (p < 0.05); greater 3-month ventrolateral prefrontal cortical volume predicted lower infant 9-month PE (p < 0.05), even after controlling for 3-month NE and PE. GM volume in other PFC subregions also predicted infant 3- and 9-month NE and PE, together with infant demographic factors, caregiver age, and/or caregiver affective instability and anxiety. These findings were replicated in the independent sample. To our knowledge, this is the first study to determine in primary and replication samples associations among infant PFC GM volumes and concurrent and prospective NE and PE, and identify promising, early markers of future psychopathology risk.

Me, Myself and My Insula: An Oasis in the Forefront of Self-Consciousness

The insula is a multiconnected brain region that centralizes a wide range of information, from the most internal bodily states, such as interoception, to high-order processes, such as knowledge about oneself. Therefore, the insula would be a core region involved in the self networks. Over the past decades, the question of the self has been extensively explored, highlighting differences in the descriptions of the various components but also similarities in the global structure of the self. Indeed, most of the researchers consider that the self comprises a phenomenological part and a conceptual part, in the present moment or extending over time. However, the anatomical substrates of the self, and more specifically the link between the insula and the self, remain unclear. We conducted a narrative review to better understand the relationship between the insula and the self and how anatomical and functional damages to the insular cortex can impact the self in various conditions. Our work revealed that the insula is involved in the most primitive levels of the present self and could consequently impact the self extended in time, namely autobiographical memory. Across different pathologies, we propose that insular damage could engender a global collapse of the self.

Behavioral and neuro-cognitive bases for emergence of norms and socially shared realities via dynamic interaction

In the digital era, new socially shared realities and norms emerge rapidly, whether they are beneficial or harmful to our societies. Although these are emerging properties from dynamic interaction, most research has centered on static situations where isolated individuals face extant norms. We investigated how perceptual norms emerge endogenously as shared realities through interaction, using behavioral and fMRI experiments coupled with computational modeling. Social interactions fostered convergence of perceptual responses among people, not only overtly but also at the covert psychophysical level that generates overt responses. Reciprocity played a critical role in increasing the stability (reliability) of the psychophysical function within each individual, modulated by neural activity in the mentalizing network during interaction. These results imply that bilateral influence promotes mutual cognitive anchoring of individual views, producing shared generative models at the collective level that enable endogenous agreement on totally new targets-one of the key functions of social norms.

Comparing gratitude and pride: evidence from brain and behavior

Gratitude and pride are both positive emotions. Yet gratitude motivates people to help others and build up relationships, whereas pride motivates people to pursue achievements and build on self-esteem. Although these social outcomes are crucial for humans to be evolutionarily adaptive, no study so far has systematically compared gratitude and pride to understand why and how they can motivate humans differently. In this review, we compared gratitude and pride from their etymologies, cognitive prerequisites, motivational functions, and brain regions involved. By integrating the evidence from brain and behavior, we suggest that gratitude and pride share a common reward basis, yet gratitude is more related to theory of mind, while pride is more related to self-referential processing. Moreover, we proposed a cognitive neuroscientific model to explain the dynamics in gratitude and pride under a reinforcement learning framework.

Beyond the veil of duality-topographic reorganization model of meditation

Meditation can exert a profound impact on our mental life, with proficient practitioners often reporting an experience free of boundaries between a separate self and the environment, suggesting an explicit experience of "nondual awareness." What are the neural correlates of such experiences and how do they relate to the idea of nondual awareness itself? In order to unravel the effects that meditation has on the brain's spatial topography, we review functional magnetic resonance imaging brain findings from studies specific to an array of meditation types and meditator experience levels. We also review findings from studies that directly probe the interaction between meditation and the experience of the self. The main results are (i) decreased posterior default mode network (DMN) activity, (ii) increased central executive network (CEN) activity, (iii) decreased connectivity within posterior DMN as well as between posterior and anterior DMN, (iv) increased connectivity within the anterior DMN and CEN, and (v) significantly impacted connectivity between the DMN and CEN (likely a nonlinear phenomenon). Together, these suggest a profound organizational shift of the brain's spatial topography in advanced meditators-we therefore propose a topographic reorganization model of meditation (TRoM). One core component of the TRoM is that the topographic reorganization of DMN and CEN is related to a decrease in the mental-self-processing along with a synchronization with the more nondual layers of self-processing, notably interoceptive and exteroceptive-self-processing. This reorganization of the functionality of both brain and self-processing can result in the explicit experience of nondual awareness. In conclusion, this review provides insight into the profound neural effects of advanced meditation and proposes a result-driven unifying model (TRoM) aimed at identifying the inextricably tied objective (neural) and subjective (experiential) effects of meditation.

A functional neuroimaging study of self-other processing alterations in atypical developmental trajectories of psychotic-like experiences

Self-disturbances constitute a hallmark of psychosis, but it remains unclear whether these alterations are present in at-risk populations, and therefore their role in the development of psychosis has yet to be confirmed. The present study addressed this question by measuring neural correlates of self-other processing in youth belonging to three developmental trajectories of psychotic experiences. Eighty-six youths were recruited from a longitudinal cohort of over 3800 adolescents based on their trajectories of Psychotic-Like Experiences from 12 to 16 years of age. Participants underwent neuroimaging at 17 years of age (mean). A functional neuroimaging task evaluating self- and other-related trait judgments was used to measure whole-brain activation and connectivity. Youth who showed an increasing trajectory displayed hypoactivation of the dorsomedial prefrontal cortex and hypoconnectivity with the cerebellum. By contrast, youth who showed a decreasing trajectory displayed decreased activation of the superior temporal gyrus, the inferior frontal gyrus, and the middle occipital gyrus. These findings suggest that the increasing trajectory is associated with alterations that might erode distinctions between self and other, influencing the emergence of symptoms such as hallucinations. The decreasing trajectory, in comparison, was associated with hypoactivations in areas influencing attention and basic information processing more generally. These alterations might affect the trajectories’ susceptibilities to positive vs. negative symptoms, respectively.

Interactions between the cortical midline structures and sensorimotor network track maladaptive self-beliefs in clinical high risk for psychosis

Individuals at clinical high risk for psychosis (CHR) report a maladaptive self-concept—with more negative and less positive self-beliefs—linked to clinical symptoms and functional impairment. Alterations have also been reported in brain networks associated with intrinsic (cortical midline structures, CMS) and extrinsic (sensorimotor network, SMN) self-processing. Theoretical accounts of multiple levels of self-experience in schizophrenia suggest that interactions between these networks would be relevant for self-beliefs. This study tested whether self-beliefs related to resting-state functional connectivity within and between the CMS and SMN. Participants were 56 individuals meeting CHR criteria and 59 matched healthy community participants (HC). Pearson correlations examined potential mediators and outcomes. The CHR group reported more negative and less positive self-beliefs. Greater resting-state functional connectivity between the posterior CMS (posterior cingulate cortex) and the SMN was associated with less positive self-beliefs in CHR, but more positive self-beliefs in HC. Attenuated negative symptoms and poorer social functioning were associated with CMS-SMN connectivity (trend level after FDR-correction) and self-beliefs. Reduced connectivity between the left and right PCC was associated with lower positive self-beliefs in CHR, although this effect was specific to very low levels of positive self-beliefs. Left-right PCC connectivity did not correlate with outcomes. Dynamic interactions between intrinsic and extrinsic self-processing supported positive self-beliefs in typically developing youth while undermining positive self-beliefs in CHR youth. Implications are discussed for basic self-fragmentation, narrative self-related metacognition, and global belief updating. Interventions for self-processing may be beneficial in the CHR syndrome.

Introspective self-narrative modulates the neuronal response during the emphatic process: an event-related potentials (ERPs) study

Empathy is the ability to perceive and understand others' emotional states generating a similar mental state in the self. Previous behavioural studies have shown that self-reflection can enhance the empathic process. The present event-related potentials' study aims to investigate whether self-reflection, elicited by an introspective self-narrative task, modulates the neuronal response to eye expressions and improves the accuracy of empathic process. The 29 participants included in the final sample were divided into two groups: an introspection group (IG) (n = 15), who received an introspective writing task, and a control group (CG) (n = 14), who completed a not-introspective writing task. For both groups, the electroencephalographic and behavioural responses to images depicting eye expressions taken from the "Reading the Mind in the Eyes" Theory of Mind test were recorded pre- (T0) and post- (T1) 7 days of writing. The main result showed that only the IG presented a different P300 amplitude in response to eye expressions at T1 compared to T0 on the left centre-frontal montage. No significant results on accuracy at T1 compared to T0 were found. These findings seem to suggest that the introspective writing task modulates attention and implicit evaluation of the socio-emotional stimuli. Results are discussed with reference to the hypothesis that such neuronal modulation is linked to an increase in the embodied simulation process underlying affective empathy.

Default mode network components and its relationship with anomalous self-experiences in schizophrenia: A rs-fMRI exploratory study

Anomalous self-experiences (ASEs) in schizophrenia have been under research for the last 20 years. However, no neuroimage studies have provided insight of the possible biological underpinning of ASEs. In this novel approach, the connectivity within the default mode network, calculated through a ROI-based analysis of functional magnetic resonance imaging data, was correlated to the ASEs scores assessed by the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE) in a sample of 22 schizophrenia patients. The Pearson's correlation coefficients between IPASE scores and intrahemispheric connectivity of the parahippocampal gyrus with the isthmus cingulate cortex in both hemispheres, and right parahippocampal gyrus with the right rostral anterior cingulate cortex were positive and significant suggesting a relation between hyperactive functional connectivity and anomalous self-experiences intensity. Prior literature reported these areas to have a role in self-processing and consciousness as well as being anatomically connected. Further research with larger sample size and comparison with controls are needed to confirm the relationship of this connectivity with anomalous self-experiences.

Loss of superiority illusion in bipolar depressive disorder: A combined functional and structural MRI study

Superiority illusion (SI) is a positive cognitive bias related to self, manifested as overestimated self-appraisal. Negative self-schema is a core feature of the cognitive model of depression, including bipolar depressive disorder (BDD). However, only little research has explored the impaired self-processing in BDD. The potential alteration of positive self-bias and the corresponding neural mechanism in BDD remains unclear. This study aimed to investigate the underlying neural mechanism of self-processing in BDD combining task-related functional magnetic resonance imaging and high-resolution T1 structural imaging. Forty-three BDD and forty-eight healthy controls were recruited and underwent a self-related task, where participants were required to evaluate how they compared with their average peers on a serial of positive and negative traits. We defined the ratio of neural activation and gray matter volume (GMV) in a region as the functional-structural coupling index to detect the changes of brain image in BDD. Furthermore, we used moderation analysis to explore the relationship among functional-structural coupling, behavioral scores and depression symptoms. BDD exhibited decreased task activation, GMV, and functional-structural coupling in bilateral anterior insula (AI) and inferior parietal lobule (IPL). The associations between functional-structural coupling in the right AI, IPL and negative trait self-rating scores were moderated by depressive symptom severity. The study revealed disturbed self-related processing and provided new evidences to neuropsychological dysfunction in BDD.

Self-awareness for financial decision making abilities is linked to right temporal cortical thickness in older adults

Everyday financial decision making and the awareness of the integrity of one's financial decision making abilities (or financial awareness) are both critical to study in older adults as they can help identify those at risk for making suboptimal financial decisions and prevent financial loss. In the current study, we examined the cognitive and cortical thickness correlates of financial decision making and financial awareness in 59 community-dwelling participants co-enrolled in a larger study (mean age=68.35 years (SD=5.5), mean education=15.91 (SD=2.36), 61% = women, 67% = White, 30% = Black participants). Data from standardized measures of financial decision making and cognition was investigated along with FreeSurfer (v. 5.3) derived thickness regions. Based on metacognitive frameworks, financial awareness was measured along with a well-validated measure of memory awareness. Results revealed that numeracy, executive functioning and vocabulary were associated with financial decision making, whereas in analysis adjusted for financial decision making, memory awareness relative to cognition was most strongly linked to financial awareness. No significant associations between thickness and financial decision making were found. However, both financial and memory awareness were associated with the same right-hemisphere temporal thickness regions underscoring the idea of a common substrate of awareness. Interestingly, our findings converge with the emerging work on financial exploitation in which the right sided temporal regions have been found to play a prominent role. Incorporating the contributing role of self-awareness in various models of financial exploitation will be an important consideration for future studies.

Brain Responses to Peer Feedback in Social Media Are Modulated by Valence in Late Adolescence

Previous studies have examined the neural correlates of receiving negative feedback from peers during virtual social interaction in young people. However, there is a lack of studies applying platforms adolescents use in daily life. In the present study, 92 late-adolescent participants performed a task that involved receiving positive and negative feedback to their opinions from peers in a Facebook-like platform, while brain activity was measured using functional magnetic resonance imaging (fMRI). Peer feedback was shown to activate clusters in the ventrolateral prefrontal cortex (VLPFC), medial prefrontal cortex (MPFC), superior temporal gyrus and sulcus (STG/STS), and occipital cortex (OC). Negative feedback was related to greater activity in the VLPFC, MPFC, and anterior insula than positive feedback, replicating previous findings on peer feedback and social rejection. Real-life habits of social media use did not correlate with brain responses to negative feedback.

Self-referential processing in individuals with nonsuicidal self-injury: An fMRI study

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Individuals with NSSI rated negative adjectives as more relevant.

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Altered self-referential processing in NSSI related to temporoparietal and subcortical areas.

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Brain activity in inferior parietal lobe related to ‘nonsuicidality’ in people with NSSI.

Nonsuicidal self-injury (NSSI) is associated with considerable deficits in managing negative self-directed internal experiences. The present study explores the neurophysiological correlates of self-referential processing in individuals with NSSI. A total of 26 individuals with NSSI (≥5 episodes of NSSI behavior in the past year, without suicide attempts) and 35 age-, sex-, education-, and intelligence quotient (IQ)-matched controls participated in this study. Participants underwent fMRI scanning as they performed a personal relevance rating task, which required them to evaluate the personal relevance of emotional words. As predicted, we found that individuals engaging in NSSI tended to rate negative adjectives as more relevant and positive adjectives as less relevant. An analysis of functional neuroimaging data showed that the NSSI group had increased activity relative to the control group in the inferior parietal lobe, inferior temporal gyrus, calcarine, insula, and thalamus in response to positive adjectives. The NSSI group also demonstrated greater activation in the calcarine and reduced activation in the inferior frontal gyrus in response to negative self-referential stimuli compared with the control group. In addition, increased right inferior parietal lobe activity during positive self-referential processing was correlated with reduced suicidal ideation in the NSSI group. Our study provides neural evidence for self-referential processing bias in individuals with NSSI and highlights the need for further research to clarify the pathophysiological features that are specific to NSSI.

Structural and Functional MRI Brain Changes in Patients with Schizophrenia Following Electroconvulsive Therapy: A Systematic Review

BACKGROUND

Schizophrenia (SZ) is a severe psychiatric disorder typically characterized by multidimensional psychotic syndromes. Electroconvulsive therapy (ECT) is a treatment option for medication-resistant patients with SZ or treating acute symptoms. Although the efficacy of ECT has been demonstrated in clinical use, its therapeutic mechanisms in the brain remain elusive.

OBJECTIVE

This study aimed to summarize brain changes on structural magnetic resonance imaging (sMRI) and functional MRI (fMRI) after ECT.

METHODS

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was carried out. The PubMed and Medline databases were systematically searched using the following medical subject headings (MeSH): (electroconvulsive therapy OR ECT) AND (schizophrenia) AND (MRI OR fMRI OR DTI OR DWI).

RESULTS

This review yielded 12 MRI studies, including 4 with sMRI, 5 with fMRI and 3 with multimodal MRI. Increases in volumes of the hippocampus and its adjacent regions (parahippocampal gyrus and amygdala), as well as the insula and frontotemporal regions, were noted after ECT. fMRI studies found ECT-induced changes in different brain regions/networks, including the hippocampus, amygdala, default model network, salience network and other regions/networks that are thought to highly correlate with the pathophysiologic characteristics of SZ. The results of the correlation between brain changes and symptom remissions are inconsistent.

CONCLUSION

Our review provides evidence supporting ECT-induced brain changes on sMRI and fMRI in SZ and explores the relationship between these changes and symptom remission.

Medial Prefrontal Activity During Self-Other Judgments is Modulated by Relationship Need Fulfillment

The medial prefrontal cortex (MPFC) plays an important role in representing semantic self-knowledge. Studies comparing semantic self-judgments with judgments of close others suggest that interpersonal closeness may influence the degree to which the MPFC differentiates self and other. We used optical neuroimaging to examine if support for competence, relatedness, and autonomy from relationship partners moderates MPFC activity during a personality judgement task. Participants (N = 109) were asked to judge the descriptive accuracy of trait adjectives for both themselves and a friend. Participants who reported lower need fulfillment with their friend showed elevated activity only in the self-judgment condition; in contrast, participants who reported higher need fulfillment with their friend showed similarly high levels of MPFC activity across the conditions. These results are consistent with the idea that the MPFC differentially represents others on the basis of the need fulfillment experienced within the relationship.

Resting-state fMRI in depressive and (hypo)manic mood states in bipolar disorders: A systematic review

OBJECTIVE

Abnormalities in spontaneous brain activity, measured with resting-state functional magnetic resonance imaging (rs-fMRI), may be key biomarkers for bipolar disorders. This systematic review compares rs-fMRI findings in people experiencing a bipolar depressive or (hypo)manic episode to bipolar euthymia and/or healthy participants.

METHODS

Medline, Web of Science and Embase were searched up until April 2021. Studies without control group, or including minors, neurological co-morbidities or mixed episodes, were excluded. Qualitative synthesis was used to report results and risk of bias was assessed using the National Heart, Lung and Blood Institute tool for case-control studies.

RESULTS

Seventy-one studies were included (3167 bipolar depressed/706 (hypo)manic). In bipolar depression, studies demonstrated default-mode (DMN) and frontoparietal network (FPN) dysfunction, altered baseline activity in the precuneus, insula, striatum, cingulate, frontal and temporal cortex, and disturbed regional homogeneity in parietal, temporal and pericentral areas. Functional connectivity was altered in thalamocortical circuits and between the cingulate cortex and precuneus. In (hypo)mania, studies reported altered functional connectivity in the amygdala, frontal and cingulate cortex. Finally, rs-fMRI disturbances in the insula and putamen correlate with depressive symptoms, cerebellar resting-state alterations could evolve with disease progression and altered amygdala connectivity might mediate lithium effects.

CONCLUSIONS

Our results suggest DMN and FPN dysfunction in bipolar depression, whereas local rs-fMRI alterations might differentiate mood states. Future studies should consider controlling rs-fMRI findings for potential clinical confounding factors such as medication. Considerable heterogeneity of methodology between studies limits conclusions. Standardised clinical reporting and consistent analysis approaches would increase coherence in this promising field.

Overlapping Functional Representations of Self- and Other-Related Thought are Separable Through Multivoxel Pattern Classification

Self-reflection and thinking about the thoughts and behaviors of others are important skills for humans to function in the social world. These two processes overlap in terms of the component processes involved, and share overlapping functional organizations within the human brain, in particular within the medial prefrontal cortex (MPFC). Several functional models have been proposed to explain these two processes, but none has directly explored the extent to which they are distinctly represented within different parts of the brain. This study used multivoxel pattern classification to quantify the separability of self- and other-related thought in the MPFC and expanded this question to the entire brain. Using a large-scale mega-analytic dataset, spanning three separate studies (n = 142), we find that self- and other-related thought can be reliably distinguished above chance within the MPFC, posterior cingulate cortex and temporal lobes. We highlight subcomponents of the ventral MPFC that are particularly important in representing self-related thought, and subcomponents of the orbitofrontal cortex robustly involved in representing other-related thought. Our findings indicate that representations of self- and other-related thought in the human brain are described best by a distributed pattern rather than stark localization or a purely ventral to dorsal linear gradient in the MPFC.

An Update on Clinical Insight, Cognitive Insight, and Introspective Accuracy in Schizophrenia-Spectrum Disorders: Symptoms, Cognition, and Treatment

INTRODUCTION

Poor insight, or unawareness of morbid changes in cognition, emotional states, or behavior, is commonly observed among people with schizophrenia. Poor insight represents a persistent barrier to wellness because it interferes with treatment and self-direction. Paradoxically, good insight may also be a barrier to health when awareness of these changes leads to depression or self-stigma.

AREAS COVERED

This paper builds upon this previous work by exploring these issues in schizophrenia separately as they have appeared in published research over the last three years in three different kinds of insight: clinical, cognition, and introspective accuracy. Specifically, studies are reviewed that address: the adverse effects of poor insight, the paradoxical effects of good insight, correlates with other forms of cognition, and emerging treatments.

EXPERT OPINION

The evidence continues to offer a nuanced picture of the complex effects of good insight in schizophrenia. Incremental improvements were also found in the development of novel integrative treatment approaches. This work also highlights the intricacy of the concept of insight, the need for further exploration of the effects of culture, and conceptual work that distinguishes the points of convergence and divergence of these forms of insight.

Investigating default mode network connectivity disruption in children of mothers with depression

BACKGROUND

Exposure to maternal major depressive disorder (MDD) bears long-term negative consequences for children's well-being; to date, no research has examined how exposure at different stages of development differentially affects brain functioning.

AIMS

Utilising a unique cohort followed from birth to preadolescence, we examined the effects of early versus later maternal MDD on default mode network (DMN) connectivity.

METHOD

Maternal depression was assessed at birth and ages 6 months, 9 months, 6 years and 10 years, to form three groups: children of mothers with consistent depression from birth to 6 years of age, which resolved by 10 years of age; children of mothers without depression; and children of mothers who were diagnosed with MDD in late childhood. In preadolescence, we used magnetoencephalography and focused on theta rhythms, which characterise the developing brain.

RESULTS

Maternal MDD was associated with disrupted DMN connectivity in an exposure-specific manner. Early maternal MDD decreased child connectivity, presenting a profile typical of early trauma or chronic adversity. In contrast, later maternal MDD was linked with tighter connectivity, a pattern characteristic of adult depression. Aberrant DMN connectivity was predicted by intrusive mothering in infancy and lower mother-child reciprocity and child empathy in late childhood, highlighting the role of deficient caregiving and compromised socio-emotional competencies in DMN dysfunction.

CONCLUSIONS

The findings pinpoint the distinct effects of early versus later maternal MDD on the DMN, a core network sustaining self-related processes. Results emphasise that research on the influence of early adversity on the developing brain should consider the developmental stage in which the adversity occured.

Neural mechanisms associated with semantic and basic self-oriented memory processes interact moderating self-esteem

Individuals constantly encounter feedback from others and process this feedback in various ways to maintain positive situational state self-esteem in relation to semantic-based or trait self-esteem. Individuals may utilize episodic or semantic-driven processes that modulate feedback in two different ways to maintain general self-esteem levels. To date, it is unclear how these processes work while individuals receive social feedback to modulate state self-esteem. Utilizing neural regions associated with semantic self-oriented and basic encoding processes (medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC), respectively), in addition to time-frequency and Granger causality analyses to assess mPFC and PCC interactions, this study examined how the encoding of social feedback modulated individuals' (N = 45) post-task state self-esteem in relation to their trait self-esteem. Findings highlight the dynamic interplay between mPFC and PCC that modulate state self-esteem in relation to trait self-esteem, to maintain high self-esteem in general in the moment and over time.

Impaired Self-Referential Cognitive Processing in Bipolar Disorder: A Functional Connectivity Analysis

Patients with bipolar disorder have deficits in self-referenced information. The brain functional connectivity during social cognitive processing in bipolar disorder is unclear. Electroencephalogram (EEG) was recorded in 23 patients with bipolar disorder and 19 healthy comparison subjects. We analyzed the time-frequency distribution of EEG power for each electrode associated with self, other, and font reflection conditions and used the phase lag index to characterize the functional connectivity between electrode pairs for 4 frequency bands. Then, the network properties were assessed by graph theoretic analysis. The results showed that bipolar disorder induced a weaker response power and phase lag index values over the whole brain in both self and other reflection conditions. Moreover, the characteristic path length was increased in patients during self-reflection processing, whereas the global efficiency and the node degree were decreased. In addition, when discriminating patients from normal controls, we found that the classification accuracy was high. These results suggest that patients have impeded integration of attention, memory, and other resources of the whole brain, resulting in a deficit of efficiency and ability in self-referential processing.

Self-prioritization is supported by interactions between large-scale brain networks

Resting-state functional magnetic resonance imaging (fMRI) has provided solid evidence that the default-mode network (DMN) is implicated in self-referential processing. The functional connectivity of the DMN has also been observed in tasks where self-referential processing leads to self-prioritization (SPE) in perception and decision-making. However, we are less certain about whether (i) SPE solely depends on the interplay within parts of the DMN or is driven by multiple brain networks; and (ii) whether SPE is associated with a unique component of interconnected networks or can be explained by related effects such as emotion prioritization. We addressed these questions by identifying and comparing topological clusters of networks involved in self-and emotion prioritization effects generated in an associative-matching task. Using network-based statistics, we found that SPE controlled by emotion is supported by a unique component of interacting networks, including the medial prefrontal part of the DMN (MPFC), Frontoparietal network (FPN) and insular Salience network (SN). This component emerged as a result of a focal effect confined to few connections, indicating that interaction between DMN, FPC and SN is critical to cognitive operations for the SPE. This result was validated on a separate data set. In contrast, prioritization of happy emotion was associated with a component formed by interactions between the rostral prefrontal part of SN, posterior parietal part of FPN and the MPFC, while sad emotion reveals a cluster of the DMN, Dorsal Attention Network (DAN) and Visual Medial Network (VMN). We discussed theoretical and methodological aspects of these findings within the more general domain of social cognition.

Stronger Mentalizing Network Connectivity in Expectant Fathers Predicts Postpartum Father-Infant Bonding and Parenting Behavior

Fathers play a critical role in parenting and in shaping child outcomes. However, the neurobiological underpinnings of successful adjustment to fatherhood have not been well-specified. Empathy and mentalizing abilities may characterize more effective fathering. These abilities may be supported by the functional connectivity (FC) of brain regions associated with social cognition and executive control. We used a seed-region-based approach to assess resting-state FC (rsFC) of the medial prefrontal cortex (mPFC) in 40 expectant fathers. We tested associations between mPFC whole-brain rsFC and fathers' self-report measures of empathy during pregnancy, as well as their ratings of father-infant bonding and fathering behaviors at six months postpartum. Stronger prenatal rsFC between the mPFC and precuneus, frontal pole, planum polare, and orbitofrontal cortex (OFC) was negatively associated with self-reported empathic concern and perspective-taking, whereas mPFC rsFC with the lateral occipital cortex (LOC) was positively associated with self-reported perspective-taking. Additionally, stronger prenatal connectivity between the mPFC rsFC and the superior parietal lobule and LOC regions predicted father reports of postpartum bonding with infants, and stronger prenatal mPFC rsFC with the LOC predicted more effective postpartum parenting. This study is the first to measure rsFC in expectant fathers as a predictor of subsequent adjustment to fathering.

Autobiographical memory unknown: Pervasive autobiographical memory loss encompassing personality trait knowledge in an individual with medial temporal lobe amnesia

Autobiographical memory consists of distinct memory types varying from highly abstract to episodic. Self trait knowledge, which is considered one of the more abstract types of autobiographical memory, is thought to rely on regions of the autobiographical memory neural network implicated in schema representation, including the ventromedial prefrontal cortex, and critically, not the medial temporal lobes. The current case study introduces an individual who experienced bilateral posterior cerebral artery strokes resulting in extensive medial temporal lobe damage with sparing of the ventromedial prefrontal cortex. Interestingly, in addition to severe retrograde and anterograde episodic and autobiographical fact amnesia, this individual's self trait knowledge was impaired for his current and pre-morbid personality traits. Yet, further assessment revealed that this individual had preserved conceptual knowledge for personality traits, could reliably and accurately rate another person's traits, and could access his own self-concept in a variety of ways. In addition to autobiographical memory loss, he demonstrated impairment on non-personal semantic memory tests, most notably on tests requiring retrieval of unique knowledge. This rare case of amnesia suggests a previously unreported role for the medial temporal lobes in self trait knowledge, which we propose reflects the critical role of this neural region in the storage and retrieval of personal semantics that are experience-near, meaning autobiographical facts grounded in spatiotemporal contexts.

Advancing the RDoC initiative through the assessment of caregiver social processes

The relationships infants and young children have with their caregivers are fundamental to their survival and well-being. Theorists and researchers across disciplines have attempted to describe and assess the variation in these relationships, leading to a general acceptance that caregiving is critical to understanding child functioning, including developmental psychopathology. At the same time, we lack consensus on how to assess these fundamental relationships. In the present paper, we first review research documenting the importance of the caregiver-child relationship in understanding environmental risk for psychopathology. Second, we propose that the National Institute of Mental Health's Research Domain Criteria (RDoC) initiative provides a useful framework for extending the study of children's risk for psychopathology by assessing their caregivers' social processes. Third, we describe the units of analysis for caregiver social processes, documenting how the specific subconstructs in the domain of social processes are relevant to the goal of enhancing knowledge of developmental psychopathology. Lastly, we highlight how past research can inform new directions in the study of caregiving and the parent-child relationship through this innovative extension of the RDoC initiative.

The nature of the self: Neural analyses and heritability estimates of self-evaluations in middle childhood

How neural correlates of self-concept are influenced by environmental versus genetic factors is currently not fully understood. We investigated heritability estimates of behavioral and neural correlates of self-concept in middle childhood since this phase is an important time window for taking on new social roles in academic and social contexts. To do so, a validated self-concept fMRI task was applied in a twin sample of 345 participants aged between 7 and 9 years. In the self-concept condition, participants were asked to indicate whether academic and social traits applied to them whereas the control condition required trait categorization. The self-processing activation analyses (n = 234) revealed stronger medial prefrontal cortex (mPFC) activation for self than for control conditions. This effect was more pronounced for social-self than academic self-traits, whereas stronger dorsolateral prefrontal cortex (DLPFC) activation was observed for academic versus social self-evaluations. Behavioral genetic modeling (166 complete twin pairs) revealed that 25-52% of the variation in academic self-evaluations was explained by genetic factors, whereas 16-49% of the variation in social self-evaluations was explained by shared environmental factors. Neural genetic modeling (91 complete twin pairs) for variation in mPFC and anterior prefrontal cortex (PFC) activation for academic self-evaluations confirmed genetic and unique environmental influences, whereas anterior PFC activation for social self-evaluations was additionally influenced by shared environmental influences. This indicates that environmental context possibly has a larger impact on the behavioral and neural correlates of social self-concept at a young age. This is the first study demonstrating in a young twin sample that self-concept depends on both genetic and environmental factors, depending on the specific domain.

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

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.

The roles of the LpSTS and DLPFC in self-prioritization: A transcranial magnetic stimulation study

The Self‐Attention Network (SAN) has been proposed to describe the underlying neural mechanism of the self‐prioritization effect, yet the roles of the key nodes in the SAN—the left posterior superior temporal sulcus (LpSTS) and the dorsolateral prefrontal cortex (DLPFC)—still need to be clarified. One hundred and nine participants were randomly assigned into the LpSTS group, the DLPFC group, or the sham group. We used the transcranial magnetic stimulation (TMS) technique to selectively disrupt the functions of the corresponding targeted region, and observed its impacts on self‐prioritization effect based on the difference between the performance of the self‐matching task before and after the targeted stimulation. We analyzed both model‐free performance measures and HDDM‐based performance measures for the self‐matching task. The results showed that the inhibition of LpSTS could lead to reduced performance in processing self‐related stimuli, which establishes a causal role for the LpSTS in self‐related processing and provide direct evidence to support the SAN framework. However, the results of the DLPFC group from HDDM analysis were distinct from the results based on response efficiency. Our investigation further the understanding of the differentiated roles of key nodes in the SAN in supporting the self‐salience in information processing.

Aberrant default mode connectivity in adolescents with early-onset psychosis: A resting state fMRI study

Abnormal default mode network (DMN) connectivity has been found in schizophrenia and other psychotic disorders. However, there are limited studies on early onset psychosis (EOP), and their results show lack of agreement. Here, we investigated within-network DMN connectivity in EOP compared to healthy controls (HC), and its relationship to clinical characteristics. A sample of 68 adolescent patients with EOP (mean age 16.53 ± 1.12 [SD] years, females 66%) and 95 HC (mean age 16.24 ± 1.50 [SD], females 60%) from two Scandinavian cohorts underwent resting state functional magnetic resonance imaging (rsfMRI). A group independent component analysis (ICA) was performed to identify the DMN across all participants. Dual regression was used to estimate spatial maps reflecting each participant's DMN network, which were compared between EOP and HC using voxel-wise general linear models and permutation-based analyses. Subgroup analyses were performed within the patient group, to explore associations between diagnostic subcategories and current use of psychotropic medication in relation to connectivity strength. The analysis revealed significantly reduced DMN connectivity in EOP compared to HC in the posterior cingulate cortex, precuneus, fusiform cortex, putamen, pallidum, amygdala, and insula. The subgroup analysis in the EOP group showed strongest deviations for affective psychosis, followed by other psychotic disorders and schizophrenia. There was no association between DMN connectivity strength and the current use of psychotropic medication. In conclusion, the findings demonstrate weaker DMN connectivity in adolescent patients with EOP compared to healthy peers, and differential effects across diagnostic subcategories, which may inform our understanding of underlying disease mechanisms in EOP.

Resting-State Functional Brain Connectivity for Human Mentalizing: Biobehavioral Mechanisms of Theory of Mind in Multiple Sclerosis

Although neural hubs of mentalizing are acknowledged, the brain mechanisms underlying mentalizing deficit, characterizing different neurological conditions, are still a matter of debate. To investigate the neural underpinning of Theory of Mind (ToM) deficit in Multiple Sclerosis (MS), a region of interest (ROI)-based resting-state fMRI study was proposed. 37 MS patients (23 females, mean age=54.08±11.37 years, median Expanded Disability Status Scale=6.00) underwent an MRI and a neuro-psychosocial examination, and were compared with 20 sex-age-education matched healthy subjects. A neuroanatomical ToM model was constructed deriving 11 bilateral ROI, then between and within-functional connectivity (FC) were assessed to test for group differences. Correlation with psychosocial scores was also investigated. Lower ToM performance was registered for MS both in cognitive and affective ToM, significantly associated with processing speed. A disconnection between limbic-paralimbic network and prefrontal execution loops was observed. A trend of aberrant intrinsic connectivity in MS within the anterior cingulate cortex (ACC) was also reported. Finally, a correlation between cognitive ToM and intrinsic FC was detected in ACC and dorsal striatum, belonging to the limbic-paralimbic network, likely explaining the behavioral deficit in MS. The results suggest that aberrant intrinsic and extrinsic connectivity constitutes a crucial neural mechanism underlying ToM deficit in MS.