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The frontal pole and cognitive insight in schizophrenia

机译：精神分裂症的额极和认知洞察力

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摘要

Absence of insight owing to impaired self-reflection and lack of touch with reality is a hallmark of schizophrenia. Functional imaging studies in healthy individuals have implicated the frontal pole (FP), sub-division of the prefrontal cortex in self-reflective processes. Despite the significance of self-referential processing in the pathogenesis of schizophrenia, the relationship between FP volume and cognitive insight in this disorder is under explored. We examined the relationship between cognitive insight and volume of FP using precise manual morphometry of high resolution magnetic resonance images in 19 schizophrenia patients (SCZ) and 21 healthy volunteers (HV). The manual morphometry technique was replicated from a previous study based on a cytoarchitectonically and functionally valid definition of FP and cognitive insight was measured using Beck's cognitive insight scale. Left frontal pole volume was a significant predictor of self-reflection sub-score of Beck's cognitive insight scale (beta=0.68; t = 2.86; p = 0.01). A significant inverse relationship between age and bilateral FP volumes was noted in HV (left FP r=-0.45; p = 0.04; right FP r=-0.57; p = 0.008) but not in SCZ (p>0.05). Our findings provide anatomical substrates to devise intervention strategies targeting cognitive insight, thereby improving treatment adherence and functional outcomes.
机译：由于自我反省受损和缺乏对现实的接触而缺乏洞察力是精神分裂症的一个标志。对健康人的功能成像研究表明，额叶极（FP）是前额叶皮层在自我反射过程中的亚区。尽管自我参照加工在精神分裂症的发病机制中具有重要意义，但在这种疾病中，FP量与认知洞察力之间的关系尚不清楚。我们对19名精神分裂症患者（SCZ）和21名健康志愿者（HV）的高分辨率磁共振图像进行了精确的手动形态测量，研究了认知洞察力和FP体积之间的关系。手动形态测量技术是从之前的一项基于FP的细胞结构和功能有效定义的研究中复制出来的，认知洞察是使用贝克的认知洞察量表测量的。左额极容积是贝克认知洞察力量表自我反思子分数的一个显著预测因子（β=0.68；t=2.86；p=0.01）。在HV（左侧FP r=-0.45；p=0.04；右侧FP r=-0.57；p=0.008）中，年龄和双侧FP体积之间存在显著的负相关，但在SCZ中则没有（p>0.05）。我们的发现为制定针对认知洞察力的干预策略提供了解剖学基础，从而提高治疗依从性和功能结果。

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