title: Cognitive insight is associated with cortical thickness in first-episode psychosis.
abstract: Compared to non-clinical subjects, people with psychosis show poor cognitive insight as reflected in low Self-Reflectiveness and high Self-Certainty. Neuroimaging studies have reported that 1) low Self-Reflectiveness is associated with volumetric reductions in ventrolateral prefrontal cortex (VLPFC), 2) higher Self-Certainty is associated with volumetric reductions in hippocampus, and 3) higher Self-Certainty is associated with fractional anisotropy in the fornix, in people with psychosis. The aims of the current study were to expand on this research by 1) performing an exploratory whole-brain cortical thickness analysis of the neural correlates of cognitive insight, to reveal whether regions outside the VLPFC are important for cognitive insight, and 2) to evaluate associations between cognitive insight and subfields of the hippocampus, which are distinct, interacting, and have different functions. We also aimed to replicate previous research documenting associations between cognitive insight and 3) total hippocampal volumes and 4) fornix fractional anisotropy. Fifteen people with a first-episode psychosis completed the Beck Cognitive Insight Scale and provided magnetic resonance and diffusion tensor imaging scans. Cortical thickness and hippocampal volumes were analyzed in FreeSurfer, and fornixfractional anisotropy was analyzed in Diffusion Toolkit/TrackVis. Higher Self-Reflectiveness and lower Self-Certainty significantly associated with thickness and thinness in VLPFC, respectively, as well as thickness and thinness in widespread frontal, parietal and temporal cortices. No associations emerged between Self-Reflectiveness or Self-Certainty and hippocampal total or sub-field volumes, or fornix fractional anisotropy. Results suggest that the neural correlates of cognitive insight involve a network of frontal, temporal and parietal brain regions.
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Buchy
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada.
authors.forename: Mariapaola
authors.initials: M
authors.lastname: Barbato
authors.affiliation: Department of Psychiatry, University of Calgary, Alberta, Canada; Strategic Clinical Network for Addictions and Mental Health, Alberta Health Services, Alberta, Canada; Department of Pediatrics, University of Calgary, Alberta, Canada.
authors.forename: Frank P
authors.initials: FP
authors.lastname: MacMaster
authors.affiliation: Department of Radiology and Pediatrics, University of Calgary, Alberta, Canada.
authors.forename: Signe
authors.initials: S
authors.lastname: Bray
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada.
authors.forename: Darren
authors.initials: D
authors.lastname: Clark
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Deighton
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada. Electronic address: jmadding@ucalgary.ca.
authors.forename: Jean
authors.initials: J
authors.lastname: Addington
mesh_terms: D000208:Acute Disease; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000473:pathology; D003071:Cognition; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000523:psychology*; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D012565:Schizophrenic Psychology; D012649:Self Concept; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Cognitive bias; Diffusion tensor imaging; Magnetic resonance imaging; Schizophrenia; Self-certainty; Self-reflectiveness