Abstract
Delusions of schizophrenia have been found to be associated with alterations of some brain regions in structure and task-induced activation. However, the relationship between spontaneously occurring symptoms and spontaneous brain activity remains unclear. In the current study, 14 schizophrenic patients with delusions and 14 healthy controls underwent a resting-state functional magnetic resonance imaging (RS-fMRI) scan. Patients with delusions of schizophrenia patients were rated with Positive and Negative Syndrome Scale (PANSS) and Characteristics of Delusional Rating Scale (CDRS). Regional homogeneity (ReHo) was calculated to measure the local synchronization of the spontaneous activity in a voxel-wise way. A two-sample t-test showed that ReHo of the right anterior cingulate gyrus and left medial superior frontal gyrus were higher in patients, and ReHo of the left superior occipital gyrus was lower, compared to healthy controls. Further, among patients, correlation analysis showed a significant difference between delusion scores of CRDS and ReHo of brain regions. ReHo of the left medial superior frontal gyrus was negatively correlated with patients’ CDRS scores but not with delusional PANSS scores. These results suggested that altered local synchronization of spontaneous brain activity may be related to the pathophysiology of delusion in schizophrenia.
Highlights
The correlation analysis (p < 0.05, AlphaSim corrected; see Fig 2a and 2b controlling for medication) showed that Characteristics of Delusional Rating Scale (CDRS) score was negatively correlated with the Regional homogeneity (ReHo) in the left medial superior frontal gyrus (SFG) (BA 9)
We found that ReHo in the right ACC, extending to left dorsal medial prefrontal cortex (dMPFC), was higher in schizophrenic patients compared to controls, while ReHo in the left superior occipital gyrus was lower in the schizophrenic patients group
The right ACC and left dMPFC were activated by a task designed to evoke sensations similar to delusions of reference in schizophrenia patients experiencing prominent referencing delusions [48]
Summary
“Delusion is a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof of evidence to the contrary” [American Psychiatric Association (APA), 1994]. Brain function research has been applied in the past to explore earlier brain changes, Many fMRI studies investigated brain activation in schizophrenic patients with delusions using cognitive tasks, such as a feedback task which was used to investigate the neural responses to feedback of (successful vs unsuccessful) monetary gain or avoidance of loss [14]. PET studies have shown the association between delusions and resting-state brain activity. Functional synchronization in certain brain regions [27] This method has already been used for investigation of functional modulations in the resting state for patients with schizophrenia [31, 32], Alzheimer’s disease (AD) [33], Parkinson’s disease (PD) [34], and other pathological states (see review by [35, 36]). We were interested in whether schizophrenic patients with delusions would show abnormal ReHo and, if so, whether the brain areas with abnormal ReHo were correlated with delusions
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