Altered functional connectivity during self- and close other-reflection in patients with bipolar disorder with past psychosis and patients with schizophrenia.
Disturbances in implicit self-processing have been reported both in psychotic patients with bipolar disorder (BD) and schizophrenia. It remains unclear whether these two psychotic disorders show disturbed functional connectivity during explicit self-reflection, which is associated with social functioning and illness symptoms. Therefore, we investigated functional connectivity during explicit self-reflection in BD with past psychosis and schizophrenia. Twenty-three BD-patients, 17 schizophrenia-patients and 21 health controls (HC) performed a self-reflection task, including the conditions self-reflection, close other-reflection and semantic control. Functional connectivity was investigated with generalized psycho-physiological interaction (gPPI). During self-reflection compared to semantic, BD-patients had decreased connectivity between several cortical-midline structures (CMS) nodes (i.e., anterior cingulate cortex, ventromedial prefrontal cortex), the insula and the head of the caudate while HC showed increased connectivities. Schizophrenia-patients, during close other-reflection compared to semantic, demonstrated reduced ventral-anterior insula-precuneus/posterior cingulate cortex (PCC) functional connectivity, whereas this was increased in HC. There were no differences between BD and schizophrenia during self- and close other-reflection. We propose that decreased functional connectivity between the CMS nodes/insula and head of the caudate in BD-patients may imply a reduced involvement of the motivational system during self-reflection; and the reduced functional connectivity between the ventral-anterior insula and precuneus/PCC during close other-reflection in schizophrenia-patients may subserve difficulties in information integration of autobiographical memory and emotional awareness in relation to close others. These distinctive impaired patterns of functional connectivity in BD and schizophrenia (compared to HC) deserve further investigation to determine their robustness and associations with differences in clinical presentation.
University of Groningen, University Medical Center Groningen, Department of Neuroscience, NeuroImaging Center, Section Cognitive Neuropsychiatry, Groningen, The Netherlands. Electronic address: wenwenleer@gmail.com.
Liwen
L
Zhang
University of Groningen, University Medical Center Groningen, Department of Neuroscience, NeuroImaging Center, Section Cognitive Neuropsychiatry, Groningen, The Netherlands; Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands; University of Groningen, Rob Giel Research Center, Groningen, The Netherlands.
Lisette
L
Vander Meer
University of Groningen, University Medical Center Groningen, Department of Neuroscience, NeuroImaging Center, Section Cognitive Neuropsychiatry, Groningen, The Netherlands.
Esther M
EM
Opmeer
University of Groningen, University Medical Center Groningen, Department of Neuroscience, NeuroImaging Center, Section Cognitive Neuropsychiatry, Groningen, The Netherlands.
Jan-Bernard C
JC
Marsman
University of Groningen, University Medical Center Groningen, Program for Mood and Anxiety Disorders, Department of Psychiatry, Groningen, The Netherlands.
Henricus G
HG
Ruhé
University of Groningen, University Medical Center Groningen, Department of Neuroscience, NeuroImaging Center, Section Cognitive Neuropsychiatry, Groningen, The Netherlands; University of Groningen, Department of Psychology, Groningen, The Netherlands.
André
A
Aleman
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007600:Judgment / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012649:Self Concept; D012660:Semantics
D011619:Psychotropic Drugs
Bipolar disorder; Close other-reflection; Functional connectivity; Generalized psycho-physiological interaction; Schizophrenia; Self-reflection