Abstract
Neuroimaging studies have revealed how intrinsic dysconnectivity among cortical regions of the mentalizing network (MENT) and the mirror neuron system (MNS) could explain the theory of mind (ToM) deficit in schizophrenia patients. However, despite the concurrent involvement of the cerebellum with the cortex in social cognition, the dysfunction in intrinsic interplay between the cerebellar nodes of MENT/MNS and the cortex in schizophrenia patients remains unknown. Thus, we aimed to investigate whether resting-state cerebello–cortical dysconnectivity exists in first-episode psychosis (FEP) patients in relationship with their ToM deficit. A total of 37 FEP patients and 80 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Using a priori-defined cerebellar seeds that functionally connect to the MENT (right crus II) and MNS (right crus I), we compared cerebello–cortical functional connectivities (FCs) in FEP patients and HCs. Correlations between cerebello–parietal connectivities and ToM performance were investigated in FEP patients. FEP patients showed hyperconnectivity between the right crus II and anterior cingulate gyrus and between the right crus I and supplementary motor area, bilateral postcentral gyrus, and right central/parietal operculum (CO/PO). Hypoconnectivity was found between the right crus II and left supramarginal gyrus (SMG) in FEP patients. FCs between the right crus II and left SMG and between the right crus I and right CO/PO were significantly correlated with ToM scores in FEP patients. In accordance with the “cognitive dysmetria” hypothesis, our results highlight the importance of cerbello-cortical dysconnectivities in understanding social cognitive deficits in schizophrenia patients.
Highlights
Patients with schizophrenia are consistently reported to have a deficit in theory of mind (ToM), the ability to represent the mental lives of others[1]
No significant differences in sociodemographic characteristics were observed between groups, except intelligence quotient (IQ), as the patients with first-episode psychosis (FEP) scored significantly lower than healthy controls (HCs) (t116 = −5.413, p < 0.001)
Univariate statistics controlling for IQ revealed significant group differences in ToM task scores; FEP patients performed significantly worse than HCs in the false belief task (F1,113 = 8.604, p = 0.004)
Summary
Patients with schizophrenia are consistently reported to have a deficit in theory of mind (ToM), the ability to represent the mental lives of others[1]. One theory that may explain this deficit is “cognitive dysmetria”, which views the diverse symptoms of schizophrenia as arising from a disrupted cortico-cerebellar-thalamic-cortical circuit (CCTCC), the error detection function of the cerebellum[2,3]. Rs-fMRI scans revealed dysconnectivity among the cerebral nodes of the MENT and MNS in patients with schizophrenia and patients with first-episode psychosis (FEP) and how these disrupted connectivities could explain patients’ symptom severity[15] and impaired ToM task performance[16]. The intrinsic connections that the cerebellar nodes of the MNT/MENT make with the cortex in schizophrenia patients and their relationship with their ToM deficits must first be understood
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