title: Schizophrenia and autism as contrasting minds: neural evidence for the hypo-hyper-intentionality hypothesis.
abstract: Both schizophrenia (SCZ) and autism spectrum disorder (ASD) are characterized by mentalizing problems and associated neural dysfunction of the social brain. However, the deficits in mental state attribution are somehow opposed: Whereas patients with SCZ tend to over-attribute intentions to agents and physical events ("hyper-intentionality"), patients with autism treat people as devoid of intentions ("hypo-intentionality"). Here we aimed to investigate whether this hypo-hyper-intentionality hypothesis can be supported by neural evidence during a mentalizing task. Using functional magnetic resonance imaging (fMRI), we investigated the neural responses and functional connectivity during reading others intention. Scanning was performed in 23 individuals with ASD, 18 with paranoid SCZ and 23 gender and IQ matched control subjects. Both clinical groups showed reduced brain activation compared to controls for the contrast intentional vs physical information processing in left posterior superior temporal sulcus (pSTS) and ventral medial prefrontal cortex (vMPFC) for SCZ, and right pSTS in ASD. As predicted, these effects were caused in a group specific way: Relative increased activation for physical information processing in SCZ that was also correlated with positive PANNS score and relative decreased activation for intentional information processing in ASD. Additionally, we could demonstrate opposed connectivity patterns between the right pSTS and vMPFC in the clinical groups, ie, increased for SCZ, decreased for ASD. These findings represent opposed neural signatures in key regions of the social brain as predicted by the hyper-hypo-intentionality hypothesis.
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe-University, Frankfurt/M, Germany; angela.ciaramidaro@kgu.de.
authors.forename: Angela
authors.initials: A
authors.lastname: Ciaramidaro
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe-University, Frankfurt/M, Germany; Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden;
authors.forename: Sven
authors.initials: S
authors.lastname: Bölte
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe-University, Frankfurt/M, Germany;
authors.forename: Sabine
authors.initials: S
authors.lastname: Schlitt
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe-University, Frankfurt/M, Germany;
authors.forename: Daniela
authors.initials: D
authors.lastname: Hainz
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe-University, Frankfurt/M, Germany;
authors.forename: Fritz
authors.initials: F
authors.lastname: Poustka
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-University, Frankfurt/M, Germany; Psychiatric University Clinics, University of Basel, Basel, Switzerland;
authors.forename: Bernhard
authors.initials: B
authors.lastname: Weber
authors.affiliation: Center for Cognitive Science, University of Turin, Turin, Italy;
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Bara
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe-University, Frankfurt/M, Germany;
authors.forename: Christine
authors.initials: C
authors.lastname: Freitag
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: Henrik
authors.initials: H
authors.lastname: Walter
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology; D016022:Case-Control Studies; D002659:Child Development Disorders, Pervasive / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D033182:Intention; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000503:physiopathology*; D012559:Schizophrenia / Q000503:physiopathology; D012563:Schizophrenia, Paranoid / Q000503:physiopathology* / Q000523:psychology; D012938:Social Perception; D013702:Temporal Lobe / Q000503:physiopathology*; D056345:Theory of Mind / Q000502:physiology*; D055815:Young Adult
keywords: MPFC; autism; intention; mentalising; pSTS; schizophrenia