title: Deficit in a neural correlate of reality monitoring in schizophrenia patients.
abstract: Patients who suffer from the devastating psychiatric illness schizophrenia are plagued by hallucinations, bizarre behavior, and delusional ideas, such as believing that they are controlled by malevolent outside forces. A fundamental human cognitive operation that may contribute to these hallmark symptoms is the ability to maintain accurate and coherent self-referential processing over time, such as occurs during reality monitoring (distinguishing self-generated from externally perceived information). However, the neural bases for a disturbance in this operation in schizophrenia have not been fully explored. Using functional magnetic resonance imaging, we asked clinically stable schizophrenia patients to remember whether or not they had generated a target word during an earlier sentence completion task. We found that, during accurate performance of this self-referential source memory task, the schizophrenia subjects manifest a deficit in rostral medial prefrontal cortex (mPFC) activity--a brain region critically implicated in both the instantiation and the retrieval of self-referential information in healthy subjects. Impairment in rostral mPFC function likely plays a key role in the profound subjective disturbances that characterize schizophrenia and that are the aspect of the disorder most troubling to patients and to society at large.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA 94121, USA. Sophia.vinogradov@ucsf.edu
authors.forename: Sophia
authors.initials: S
authors.lastname: Vinogradov
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Luks
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Schulman
authors.forename: Gregory V
authors.initials: GV
authors.lastname: Simpson
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011936:Reality Testing; D021641:Recognition, Psychology / Q000502:physiology; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012649:Self Concept