Triple Network Model Research Articles

Bridging disparate symptoms of schizophrenia: a triple network dysfunction theory.

Schizophrenia is a complex neuropsychiatric disorder with variable symptomatology, traditionally divided into positive and negative symptoms, and cognitive deficits. However, the etiology of this disorder has yet to be fully understood. Recent findings suggest that alteration of the basic sense of self-awareness may be an essential distortion of schizophrenia spectrum disorders. In addition, extensive research of social and mentalizing abilities has stressed the role of distortion of social skills in schizophrenia.This article aims to propose and support a concept of a triple brain network model of the dysfunctional switching between default mode and central executive network (CEN) related to the aberrant activity of the salience network. This model could represent a unitary mechanism of a wide array of symptom domains present in schizophrenia including the deficit of self (self-awareness and self-representation) and theory of mind (ToM) dysfunctions along with the traditional positive, negative and cognitive domains. We review previous studies which document the dysfunctions of self and ToM in schizophrenia together with neuroimaging data that support the triple brain network model as a common neuronal substrate of this dysfunction.

Resting state functional hyperconnectivity within a triple network model in paranoid schizophrenia

BackgroundThree large-scale intrinsic connectivity brain networks, the salience network (SN), the central executive network (CEN), and the default mode network (DMN), have fundamental roles in higher cognitive processes. In particular, SN activity is crucial in the process of salience mapping—ie, allocating attentional resources to external and internal stimuli and attributing salience to the stimuli. Recent functional neuroimaging studies suggest that the core psychopathological changes in schizophrenia could arise from aberrant connectivity (dysconnectivity) within large scale networks in the brain. However, studies have yielded inconsistent results and have largely been unsuccessful at mapping these abnormalities to core psychopathology. The triple network model of aberrant saliency mapping suggests that the dysconnectivity underlying the psychopathology could lie within these three core brain networks. We hypothesised that intrinsic connectivity within these brain networks is altered in schizophrenia when compared with healthy adults. MethodsWe assessed 37 medicated patients with paranoid schizophrenia (Diagnostic and Statistical Manual of Mental Disorders IV-295.3) and 37 age-matched and sex-matched controls from the Center for Biomedical Research Excellence dataset. We did a group-level independent component analysis on resting-state functional MRI to extract 30 group-level spatial intrinsic connectivity (IC) maps (FSL, FMRIB Software Library). From the group-level IC maps, we identified maps corresponding to the SN, DMN, and CEN. Then, we estimated a version of the group-level spatial map for each individual using the dual regression method and established between-group differences using permutation tests. Using a sparse logistic regression method, we also assessed whether IC maps could predict group membership (patient vs healthy controls) and, with a similar method, whether the IC maps could predict psychotic symptomatology (the positive and negative syndrome scale [PANSS]). FindingsThe schizophrenia group showed stronger functional connectivity within the left CEN, SN, and DMN than did controls. When we used leave-one-out cross-validation, the SN map best discriminated patients from controls with 82·4% accuracy, 94·6 % sensitivity, and 70% specificity. In addition, the SN maps predicted the severity of positive symptoms score on the PANSS (r2=0·95, p<0·0001), particularly delusions (r2=0·38, p=0·003). DMN hyperconnectivity predicted negative symptoms score (r2=0·98, p=0·0005). InterpretationThe SN, CEN, and DMN in paranoid schizophrenia are characterised by significant hyperconnectivity. SN hyperconnectivity predicted positive symptoms, especially delusions. This hyperconnectivity seems to be a prominent feature of paranoid schizophrenia and could represent the pathophysiological change underlying the psychopathology. The cross-sectional nature of our data means that causal associations are speculative. Nonetheless, our results suggest that hyperconnectivity within the SN could be a potential biomarker of schizophrenia. FundingJim Gatherall Travelling Fellowship awarded to RK to attend Stanford Cognitive and Systems Neuroscience laboratory.

Shifted intrinsic connectivity of central executive and salience network in borderline personality disorder

This case study describes 1 year of the psychoanalytic psychotherapy using clinical data, a standardized instrument of the psychotherapeutic process (Psychotherapy process Q-Set, PQS), and functional neuroimaging (fMRI). A female dysthymic patient with narcissistic traits was assessed at monthly intervals (12 sessions). In the fMRI scans, which took place immediately after therapy hours, the patient looked at pictures of attachment-relevant scenes (from the Adult Attachment Projective Picture System, AAP) divided into two groups: those accompanied by a neutral description, and those accompanied by a description tailored to core conflicts of the patient as assessed in the AAP. Clinically, this patient presented defense mechanisms that influenced the relationship with the therapist and that was characterized by fluctuations of mood that lasted whole days, following a pattern that remained stable during the year of the study. The two modes of functioning associated with the mood shifts strongly affected the interaction with the therapist, whose quality varied accordingly (“easy” and “difficult” hours). The PQS analysis showed the association of “easy” hours with the topic of the involvement in significant relationships and of “difficult hours” with self-distancing, a defensive maneuver common in narcissistic personality structures. In the fMRI data, the modes of functioning visible in the therapy hours were significantly associated with modulation of the signal elicited by personalized attachment-related scenes in the posterior cingulate (p = 0.017 cluster-level, whole-volume corrected). This region has been associated in previous studies to self-distancing from negatively valenced pictures presented during the scan. The present study may provide evidence of the possible involvement of this brain area in spontaneously enacted self-distancing defensive strategies, which may be of relevance in resistant reactions in the course of a psychoanalytic psychotherapy.

Shifted intrinsic connectivity of central executive and salience network in borderline personality disorder

Borderline personality disorder (BPD) is characterized by “stable instability” of emotions and behavior and their regulation. This emotional and behavioral instability corresponds with a neurocognitive triple network model of psychopathology, which suggests that aberrant emotional saliency and cognitive control is associated with aberrant interaction across three intrinsic connectivity networks [i.e., the salience network (SN), default mode network (DMN), and central executive network (CEN)]. The objective of the current study was to investigate whether and how such triple network intrinsic functional connectivity (iFC) is changed in patients with BPD. We acquired resting-state functional magnetic resonance imaging (rs-fMRI) data from 14 patients with BPD and 16 healthy controls. High-model order independent component analysis was used to extract spatiotemporal patterns of ongoing, coherent blood-oxygen-level-dependent signal fluctuations from rs-fMRI data. Main outcome measures were iFC within networks (intra-iFC) and between networks (i.e., network time course correlation inter-iFC). Aberrant intra-iFC was found in patients’ DMN, SN, and CEN, consistent with previous findings. While patients’ inter-iFC of the CEN was decreased, inter-iFC of the SN was increased. In particular, a balance index reflecting the relationship of CEN- and SN-inter-iFC across networks was strongly shifted from CEN to SN connectivity in patients. Results provide first preliminary evidence for aberrant triple network iFC in BPD. Our data suggest a shift of inter-network iFC from networks involved in cognitive control to those of emotion-related activity in BPD, potentially reflecting the persistent instability of emotion regulation in patients.

THE METABOLIC RATE IN EMOTIONAL MOODS INDUCED BY SUGGESTION IN HYPNOSIS

Back to table of contents Previous article Next article ARTICLENo AccessTHE METABOLIC RATE IN EMOTIONAL MOODS INDUCED BY SUGGESTION IN HYPNOSISJ. C. Whitehorn, Helge Lundholm, and G. E. GardnerJ. C. WhitehornSearch for more papers by this author, Helge LundholmSearch for more papers by this author, and G. E. GardnerSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.86.4.661AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byTinnitus and the Triple Network Model: A PerspectiveClinical and Experimental Otorhinolaryngology, Vol. 15, No. 3Pain and the Triple Network Model7 March 2022 | Frontiers in Neurology, Vol. 13Life stress and background anxiety are not associated with resting metabolic rate in healthy adultsApplied Physiology, Nutrition, and Metabolism, Vol. 45, No. 8American Journal of Clinical Hypnosis, Vol. 5, No. 4The Journal of the American Dental Association, Vol. 49, No. 6The American Journal of Medicine, Vol. 5, No. 6The Journal of General Psychology, Vol. 16, No. 1The Psychiatric Quarterly, Vol. 9, No. 4The Journal of General Psychology, Vol. 13, No. 1Journal of Mental Science, Vol. 81, No. 334 Volume 86Issue 4 January 1930Pages 661-666 Metrics PDF download History Published online 1 April 2006 Published in print 1 January 1930