Background
Schizophrenia/schizoaffective disorder involves reality distortion (RD), which impairs
the ability to process socioemotional information. Because this psychological capacity
maps to the medial prefrontal cortex (MPFC) and schizophrenia involves abnormal MPFC
function, we tested the hypothesis that treated schizophrenic/schizoaffective patients
with persistent RD (RD+) would exhibit greater MPFC dysfunction than patients without
significant RD (RD−). The amygdala interacts with MPFC, also carries out socioemotional
processing, and has been implicated in schizophrenia; thus, we also tested the hypothesis
that patients would exhibit aberrant amygdala activity.
Methods
Eleven RD+ patients, 12 RD− patients, and 15 healthy control subjects (HC) viewed
emotionally salient pictures with neutral, aversive, and positive content during the
acquisition of blood oxygenation level-dependent (BOLD) sensitive functional magnetic
resonance imaging.
Results
All groups had similar behavioral responses to the pictures. The RD+ subjects had
greater BOLD responses (compared with the RD− and HC groups) to the aversive pictures
in the anterior MPFC. Both patient groups showed reduced activation in MPFC and the
left amygdala (compared with HC) for neutral pictures (compared with blank condition),
although this effect could be explained by medication.
Conclusions
Reality distortion is associated with hyperactivity of the MPFC in schizophrenic/schizoaffective
patients whose symptoms persist in spite of antipsychotic treatment.
Key Words
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Article info
Publication history
Published online: April 19, 2007
Accepted:
November 29,
2006
Received in revised form:
November 28,
2006
Received:
March 23,
2006
Identification
Copyright
© 2007 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
