title: Neural primacy of the salience processing system in schizophrenia.
abstract: For effective information processing, two large-scale distributed neural networks appear to be critical: a multimodal executive system anchored on the dorsolateral prefrontal cortex (DLPFC) and a salience system anchored on the anterior insula. Aberrant interaction among distributed networks is a feature of psychiatric disorders such as schizophrenia. We used whole-brain Granger causal modeling using resting fMRI and observed a significant failure of both the feedforward and reciprocal influence between the insula and the DLPFC in schizophrenia. Further, a significant failure of directed influence from bilateral visual cortices to the insula was also seen in patients. These findings provide compelling evidence for a breakdown of the salience-execution loop in the clinical expression of psychosis. In addition, this offers a parsimonious explanation for the often-observed "frontal inefficiency," the failure to recruit prefrontal system when salient or novel information becomes available in patients with schizophrenia.
authors: Centre for Translational Neuroimaging in Mental Health, Division of Psychiatry, University of Nottingham, Nottingham NG7 2TU, UK. lena.palaniyappan@nottingham.ac.uk
authors: Lena
authors: L
authors: Palaniyappan
authors: Molly
authors: M
authors: Simmonite
authors: Thomas P
authors: TP
authors: White
authors: Elizabeth B
authors: EB
authors: Liddle
authors: Peter F
authors: PF
authors: Liddle
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D015233:Models, Statistical; D009415:Nerve Net / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology; D016571:Neural Networks, Computer; D009434:Neural Pathways / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology*; D010100:Oxygen; D011569:Psychiatric Status Rating Scales; D012146:Rest; D012559:Schizophrenia / Q000188:drug therapy / Q000473:pathology*; D013223:Statistics as Topic; D013997:Time Factors; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D010100:Oxygen
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