title: An anterior-to-posterior shift in midline cortical activity in schizophrenia during self-reflection.
abstract: BACKGROUND
  Deficits in social cognition, including impairments in self-awareness, contribute to the overall functional disability associated with schizophrenia. Studies in healthy subjects have shown that social cognitive functions, including self-reflection, rely on the medial prefrontal cortex (mPFC) and posterior cingulate gyrus, and these regions exhibit highly correlated activity during "resting" states. In this study, we tested the hypothesis that patients with schizophrenia show dysfunction of this network during self-reflection and that this abnormal activity is associated with changes in the strength of resting-state correlations between these regions.
  
  
  METHODS
  Activation during self-reflection and control tasks was measured with functional magnetic resonance imaging in 19 patients with schizophrenia and 20 demographically matched control subjects. In addition, the resting-state functional connectivity of midline cortical areas showing abnormal self-reflection-related activation in schizophrenia was measured.
  
  
  RESULTS
  Compared with control subjects, the schizophrenia patients demonstrated lower activation of the right ventral mPFC and greater activation of the mid/posterior cingulate gyri bilaterally during self-reflection, relative to a control task. A similar pattern was seen during overall social reflection. In addition, functional connectivity between the portion of the left mid/posterior cingulate gyrus showing abnormally elevated activity during self-reflection in schizophrenia, and the dorsal anterior cingulate gyrus was lower in the schizophrenia patients compared with control subjects.
  
  
  CONCLUSIONS
  Schizophrenia is associated with an anterior-to-posterior shift in introspection-related activation, as well as changes in functional connectivity, of the midline cortex. These findings provide support for the hypothesis that aberrant midline cortical function contributes to social cognitive impairment in schizophrenia.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA. dholt@partners.org
authors.forename: Daphne J
authors.initials: DJ
authors.lastname: Holt
authors.forename: Brittany S
authors.initials: BS
authors.lastname: Cassidy
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Andrews-Hanna
authors.forename: Su Mei
authors.initials: SM
authors.lastname: Lee
authors.forename: Garth
authors.initials: G
authors.lastname: Coombs
authors.forename: Donald C
authors.initials: DC
authors.lastname: Goff
authors.forename: John D
authors.initials: JD
authors.lastname: Gabrieli
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Moran
mesh_terms: D000339:Affect / Q000502:physiology; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004532:Ego; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008606:Mental Processes / Q000502:physiology; D009434:Neural Pathways / Q000502:physiology; D010100:Oxygen / Q000097:blood; D010775:Photic Stimulation; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology; D011930:Reaction Time / Q000502:physiology; D011932:Reading; D012559:Schizophrenia / Q000473:pathology / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012649:Self Concept; D012938:Social Perception
chemical_list: D010100:Oxygen