Association between cognitive insight and prefrontal function during a cognitive task in schizophrenia: A multichannel near-infrared spectroscopy study

Insight has been studied mostly from a clinical perspective. Recently, the focus of this research field shifted to cognitive insight or the ability to monitor and correct the erroneous convictions of individuals. In this study, we investigated the relationship between cognitive insight and prefrontal function during a cognitive task in 30 patients with clinically stable schizophrenia and 30 age- and gender-matched healthy controls. We measured the changes in hemoglobin concentration in the prefrontal and temporal cortical regions during a verbal fluency task (VFT) by using 52-channel near-infrared spectroscopy (NIRS). Cognitive insight was measured using the Beck Cognitive Insight Scale (BCIS). Regional hemodynamic changes were significantly smaller in the schizophrenia group than in the control group in prefrontal and temporal regions, and significant positive relationship was observed between the score of the BCIS self-reflectiveness subscale and right ventrolateral prefrontal and right temporal functions during the VFT. These results suggest that the right ventrolateral prefrontal and temporal cortical regions are associated with cognitive insight in clinically stable patients with schizophrenia and that NIRS is an efficient medical tool for monitoring these characteristics.

[1]  Oshin Vartanian,et al.  Task constraints modulate activation in right ventral lateral prefrontal cortex , 2005, NeuroImage.

[2]  Jonas Persson,et al.  Common prefrontal activations during working memory, episodic memory, and semantic memory , 2003, Neuropsychologia.

[3]  Archana K. Singh,et al.  Exploring the false discovery rate in multichannel NIRS , 2006, NeuroImage.

[4]  M. Tamura,et al.  Interpretation of near-infrared spectroscopy signals: a study with a newly developed perfused rat brain model. , 2001, Journal of applied physiology.

[5]  A. David,et al.  Insight: its relationship with cognitive function, brain volume and symptoms in schizophrenia , 2002, Psychological Medicine.

[6]  B. Turetsky,et al.  Reduced dorsal and orbital prefrontal gray matter volumes in schizophrenia. , 2000, Archives of general psychiatry.

[7]  Matcheri S Keshavan,et al.  Insight and prefrontal cortex in first-episode Schizophrenia , 2004, NeuroImage.

[8]  Insight and psychosis , 1999 .

[9]  Kiyoto Kasai,et al.  Association between severe dorsolateral prefrontal dysfunction during random number generation and earlier onset in schizophrenia , 2011, Clinical Neurophysiology.

[10]  Jae Hoon Lee,et al.  Near-Infrared Light Propagation in an , 2005 .

[11]  C. Frith,et al.  Development and neurophysiology of mentalizing. , 2003, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[12]  Insight in psychosis and neuropsychological function , 2006, British Journal of Psychiatry.

[13]  S. Kay,et al.  The positive and negative syndrome scale (PANSS) for schizophrenia. , 1987, Schizophrenia bulletin.

[14]  A. Villringer,et al.  Decrease in parietal cerebral hemoglobin oxygenation during performance of a verbal fluency task in patients with Alzheimer's disease monitored by means of near-infrared spectroscopy (NIRS) — correlation with simultaneous rCBF-PET measurements , 1997, Brain Research.

[15]  N. Makris,et al.  Cortical abnormalities in schizophrenia identified by structural magnetic resonance imaging. , 1999, Archives of general psychiatry.

[16]  G. Bond,et al.  Self-Appraisal of Illness Questionnaire (SAIQ): relationship to researcher-rated insight and neuropsychological function in schizophrenia , 2000, Schizophrenia Research.

[17]  David A. Boas,et al.  A Quantitative Comparison of Simultaneous BOLD fMRI and NIRS Recordings during Functional Brain Activation , 2002, NeuroImage.

[18]  Masako Okamoto,et al.  Virtual spatial registration of stand-alone fNIRS data to MNI space , 2007, NeuroImage.

[19]  J. Gorman,et al.  Assessment of insight in psychosis. , 1993, The American journal of psychiatry.

[20]  S. Raffard,et al.  La conscience des troubles (insight) dans la schizophrénie : une revue critique: Partie II : modèles explicatifs et hypothèses psychopathologiques , 2008 .

[21]  Oshin Vartanian,et al.  Dissociating the roles of right ventral lateral and dorsal lateral prefrontal cortex in generation and maintenance of hypotheses in set-shift problems. , 2005, Cerebral cortex.

[22]  J. Alvarez,et al.  Executive Function and the Frontal Lobes: A Meta-Analytic Review , 2006, Neuropsychology Review.

[23]  Hiroyuki Okada,et al.  Cerebral hemodynamics evaluation by near-infrared time-resolved spectroscopy: Correlation with simultaneous positron emission tomography measurements , 2006, NeuroImage.

[24]  Paul M. Grant,et al.  Assessment of cognitive insight: a qualitative review. , 2012, Schizophrenia bulletin.

[25]  Cheryl L. Grady,et al.  Common and Unique Neural Activations in Autobiographical, Episodic, and Semantic Retrieval , 2007, Journal of Cognitive Neuroscience.

[26]  D. Kingdon,et al.  Effectiveness of a brief cognitive-behavioural therapy intervention in the treatment of schizophrenia. , 2002, The British journal of psychiatry : the journal of mental science.

[27]  Masako Okamoto,et al.  Automated cortical projection of head-surface locations for transcranial functional brain mapping , 2005, NeuroImage.

[28]  J. Fuster.  Prefrontal Cortex , 2018 .

[29]  A. Aleman,et al.  REFLEX, a social-cognitive group treatment to improve insight in schizophrenia: study protocol of a multi-center RCT , 2011, BMC psychiatry.

[30]  D. Boas,et al.  Non-invasive neuroimaging using near-infrared light , 2002, Biological Psychiatry.

[31]  須藤 友博.  Multichannel near-infrared spectroscopy in depression and schizophrenia : Cognitive brain activation study , 2004 .

[32]  Masato Fukuda,et al.  Reduced frontopolar activation during verbal fluency task in schizophrenia: A multi-channel near-infrared spectroscopy study , 2008, Schizophrenia Research.

[33]  T. Shallice,et al.  The cognitive and neuroanatomical correlates of multitasking , 2000, Neuropsychologia.

[34]  O. Andreassen,et al.  Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study , 2007, BMC psychiatry.

[35]  Atsushi Maki,et al.  Noninvasive near‐infrared topography of human brain activity using intensity modulation spectroscopy , 1996 .

[36]  Teruhiko Higuchi,et al.  Frontal and right temporal activations correlate negatively with depression severity during verbal fluency task: a multi-channel near-infrared spectroscopy study. , 2012, Journal of psychiatric research.

[37]  Kazunori Matsumoto,et al.  Psychometric properties of the Japanese version of the Beck Cognitive Insight Scale: Relation of cognitive insight to clinical insight , 2009, Psychiatry and clinical neurosciences.

[38]  Carlo Caltagirone,et al.  The neuroanatomical correlates of cognitive insight in schizophrenia. , 2013, Social cognitive and affective neuroscience.

[39]  Stephan Heckers,et al.  Schizophrenia and cognitive function , 2000, Current Opinion in Neurobiology.

[40]  Harald Schrader,et al.  Magnetic resonance imaging after most common form of concussion , 2009, BMC Medical Imaging.

[41]  J. Strauss,et al.  Flexible System for the Diagnosis of Schizophrenia: Report from the WHO International Pilot Study of Schizophrenia , 1973, Science.

[42]  K. Dobson,et al.  Insight in schizophrenia: a meta-analysis , 2003, Schizophrenia Research.

[43]  J. McEvoy,et al.  Common sense, insight, and neuropsychological test performance in schizophrenia patients. , 1996, Schizophrenia bulletin.

[44]  Insight and Psychosis , 1990, British Journal of Psychiatry.

[45]  R. C. Oldfield.  The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[46]  Peter Fransson,et al.  Sustained and Transient Neural Modulations in Prefrontal Cortex Related to Declarative Long-Term Memory, Working Memory, and Attention , 2007, Cortex.

[47]  A. Villringer,et al.  Assessment of local brain activation. A simultaneous PET and near-infrared spectroscopy study. , 1997, Advances in experimental medicine and biology.

[48]  G. Dimaggio,et al.  Metacognition in schizophrenia: Correlates and stability of deficits in theory of mind and self-reflectivity , 2011, Psychiatry Research.

[49]  C. Caltagirone,et al.  Neuropsychological correlates of cognitive insight in schizophrenia , 2010, Psychiatry Research.

[50]  A. Beck,et al.  A new instrument for measuring insight: the Beck Cognitive Insight Scale , 2004, Schizophrenia Research.

[51]  R Kikinis,et al.  Prefrontal gray matter volume reduction in first episode schizophrenia. , 2001, Cerebral cortex.

[52]  P. Lysaker,et al.  Cognitive insight and psychotic disorder: The impact of active delusions , 2007, Schizophrenia Research.

[53]  N. Andreasen,et al.  Theory of mind and schizophrenia: a positron emission tomography study of medication-free patients. , 2008, Schizophrenia bulletin.

[54]  E. Gratton,et al.  Investigation of human brain hemodynamics by simultaneous near-infrared spectroscopy and functional magnetic resonance imaging. , 2001, Medical physics.

[55]  Ken Inoue,et al.  Relationship between the prefrontal function during a cognitive task and the severity of the symptoms in patients with panic disorder: A multi-channel NIRS study , 2009, Psychiatry Research: Neuroimaging.

[56]  Huijuan Zhao,et al.  Maps of optical differential pathlength factor of human adult forehead, somatosensory motor and occipital regions at multi-wavelengths in NIR. , 2002, Physics in medicine and biology.

[57]  M. Bell,et al.  Neurocognitive function and insight in schizophrenia: support for an association with impairments in executive function but not with impairments in global function , 1998, Acta psychiatrica Scandinavica.

[58]  Sid Gilman,et al.  Handbook of physiology. Section 1: The nervous system, vol II. Motor control, parts 1 and 2. Section editors: John M. Brookhart and Vernon B. Mountcastle volume editor: Vernon B. Brooks Bethesda, MD, American Physiological Society, 1981 1480 pp, illustrated , 1983 .

[59]  K. Zakzanis,et al.  Further parameters of insight and neuropsychological deficit in schizophrenia and other chronic mental disease. , 1998, The Journal of nervous and mental disease.

[60]  D. Delpy,et al.  Near-infrared light propagation in an adult head model. II. Effect of superficial tissue thickness on the sensitivity of the near-infrared spectroscopy signal. , 2003, Applied optics.

[61]  Masako Okamoto,et al.  Three-dimensional probabilistic anatomical cranio-cerebral correlation via the international 10–20 system oriented for transcranial functional brain mapping , 2004, NeuroImage.