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Association between prefrontal N-acetylaspartate and insight in psychotic disorders.
- Source :
-
Schizophrenia research [Schizophr Res] 2017 Jan; Vol. 179, pp. 112-118. Date of Electronic Publication: 2016 Sep 19. - Publication Year :
- 2017
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Abstract
- Insight is impaired in most patients with psychosis and has been associated with poorer prognosis. The exact neural basis of impaired insight is still unknown, but it may involve disrupted prefrontal neural connectivity. Numerous studies have indeed found white matter (WM) abnormalities in psychosis. The association between prefrontal WM abnormalities and insight has not been studied yet by means of proton magnetic resonance spectroscopy ( <superscript>1</superscript> H-MRS). <superscript>1</superscript> H-MRS can be used to measure N-acetylaspartate (NAA), which is considered to be a marker of neuronal integrity. We measured insight with the Birchwood Insight Scale (BIS) as well as item G12 of the Positive and Negative Syndrome Scale (PANSS) in 88 patients with psychosis. Prefrontal WM concentrations of NAA and ratios of NAA to creatine (Cr) were assessed with <superscript>1</superscript> H-MRS. Nonparametric partial correlational analyses were conducted between NAA concentrations and insight controlling for illness duration, standardized antipsychotic dose, symptom scores, voxel grey matter content and voxel cerebrospinal fluid content. We found a significant correlation between reduced NAA/Cr ratios and poorer insight as measured with the BIS, which remained significant after additional correction for full width at half maximum, signal/noise and age. This is the first study reporting a relationship between lower prefrontal concentrations of a marker of neuronal integrity and impaired insight, providing further evidence that prefrontal pathology may play an important role in impaired insight in psychosis. This may be explained by the involvement of the prefrontal cortex in several executive and metacognitive functions, such as cognitive flexibility and perspective taking.<br /> (Copyright © 2016 Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Aspartic Acid metabolism
Executive Function physiology
Female
Humans
Male
Metacognition physiology
Prefrontal Cortex diagnostic imaging
Proton Magnetic Resonance Spectroscopy
Psychotic Disorders diagnostic imaging
Young Adult
Aspartic Acid analogs & derivatives
Awareness physiology
Comprehension physiology
Prefrontal Cortex metabolism
Psychotic Disorders metabolism
Psychotic Disorders physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1573-2509
- Volume :
- 179
- Database :
- MEDLINE
- Journal :
- Schizophrenia research
- Publication Type :
- Academic Journal
- Accession number :
- 27658999
- Full Text :
- https://doi.org/10.1016/j.schres.2016.09.018