title: Aberrant Salience Is Related to Dysfunctional Self-Referential Processing in Psychosis.
abstract: BACKGROUND
  A dysfunctional differentiation between self-relevant and irrelevant information may affect the perception of environmental stimuli as abnormally salient. The aberrant salience hypothesis assumes that positive symptoms arise from an attribution of salience to irrelevant stimuli accompanied by the feeling of self-relevance. Self-referential processing relies on the activation of cortical midline structures which was demonstrated to be impaired in psychosis. We investigated the neural correlates of self-referential processing, aberrant salience attribution, and the relationship between these 2 measures across the psychosis continuum.
  
  
  METHODS
  Twenty-nine schizophrenia patients, 24 healthy individuals with subclinical delusional ideation, and 50 healthy individuals participated in this study. Aberrant salience was assessed behaviorally in terms of reaction times to task irrelevant cues. Participants performed a self-reference task during fMRI in which they had to apply neutral trait words to them or to a public figure. The correlation between self-referential processing and aberrant salience attribution was tested.
  
  
  RESULTS
  Schizophrenia patients displayed increased aberrant salience attribution compared with healthy controls and individuals with subclinical delusional ideation, while the latter exhibited intermediate aberrant salience scores. In the self-reference task, schizophrenia patients showed reduced activation in the ventromedial prefrontal cortex (vmPFC), but individuals with subclinical delusional ideation did not differ from healthy controls. In schizophrenia patients, vmPFC activation correlated negatively with implicit aberrant salience attribution.
  
  
  CONCLUSIONS
  Higher aberrant salience attribution in schizophrenia patients is related to reduced vmPFC activation during self-referential judgments suggesting that aberrant relevance coding is reflected in decreased neural self-referential processing as well as in aberrant salience attribution.
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany; anne.pankow@charite.de.
authors.forename: Anne
authors.initials: A
authors.lastname: Pankow
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany;
authors.forename: Teresa
authors.initials: T
authors.lastname: Katthagen
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany;
authors.forename: Sarah
authors.initials: S
authors.lastname: Diner
authors.forename: Lorenz
authors.initials: L
authors.lastname: Deserno
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany;
authors.forename: Rebecca
authors.initials: R
authors.lastname: Boehme
authors.affiliation: Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
authors.forename: Nobert
authors.initials: N
authors.lastname: Kathmann
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany;
authors.forename: Tobias
authors.initials: T
authors.lastname: Gleich
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Faculty of Medicine, Universität Leipzig, Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Gaebler
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany;
authors.forename: Henrik
authors.initials: H
authors.lastname: Walter
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany;
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany; Max Planck Fellow Group 'Cognitive and Affective Control of Behavioral Adaption', Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany;
authors.forename: Florian
authors.initials: F
authors.lastname: Schlagenhauf
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention; D001921:Brain / Q000503:physiopathology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000503:physiopathology* / Q000523:psychology; D003702:Delusions / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007600:Judgment; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011618:Psychotic Disorders / Q000503:physiopathology / Q000523:psychology; D011930:Reaction Time; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012649:Self Concept; D055815:Young Adult
keywords: fMRI; psychosis; psychosis continuum; salience; self-referential processing; vmPFC