Medial frontal hyperactivity in reality distortion.
BACKGROUND
Schizophrenia/schizoaffective disorder involves reality distortion (RD), which impairs the ability to process socioemotional information. Because this psychological capacity maps to the medial prefrontal cortex (MPFC) and schizophrenia involves abnormal MPFC function, we tested the hypothesis that treated schizophrenic/schizoaffective patients with persistent RD (RD+) would exhibit greater MPFC dysfunction than patients without significant RD (RD-). The amygdala interacts with MPFC, also carries out socioemotional processing, and has been implicated in schizophrenia; thus, we also tested the hypothesis that patients would exhibit aberrant amygdala activity.


METHODS
Eleven RD+ patients, 12 RD- patients, and 15 healthy control subjects (HC) viewed emotionally salient pictures with neutral, aversive, and positive content during the acquisition of blood oxygenation level-dependent (BOLD) sensitive functional magnetic resonance imaging.


RESULTS
All groups had similar behavioral responses to the pictures. The RD+ subjects had greater BOLD responses (compared with the RD- and HC groups) to the aversive pictures in the anterior MPFC. Both patient groups showed reduced activation in MPFC and the left amygdala (compared with HC) for neutral pictures (compared with blank condition), although this effect could be explained by medication.


CONCLUSIONS
Reality distortion is associated with hyperactivity of the MPFC in schizophrenic/schizoaffective patients whose symptoms persist in spite of antipsychotic treatment.
Taylor
Stephan F
SF
Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan 48109-5765, USA. sftaylor@umich.edu
Welsh
Robert C
RC
Chen
Ashley C
AC
Velander
Alan J
AJ
Liberzon
Israel
I
D000328:Adult; D000679:Amygdala / Q000187:drug effects / Q000503:physiopathology; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001931:Brain Mapping; D004292:Dominance, Cerebral / Q000502:physiology; D004644:Emotions / Q000187:drug effects / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology; D010364:Pattern Recognition, Visual / Q000187:drug effects / Q000502:physiology; D010469:Perceptual Distortion / Q000187:drug effects / Q000502:physiology*; D011936:Reality Testing; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012938:Social Perception
D014150:Antipsychotic Agents