ABSTRACT
Deficits in working memory (WM) are a consistent neurocognitive marker for schizophrenia. Previous studies have suggested that WM is the product of coordinated activity in distributed functionally connected brain regions. Independent component analysis (ICA) is a data-driven approach that can identify temporally coherent networks that underlie fMRI activity. We applied ICA to an fMRI dataset for 115 patients with chronic schizophrenia and 130 healthy controls by performing the Sternberg Item Recognition Paradigm. Here, we describe the first results using ICA to identify differences in the function of WM networks in schizophrenia compared to controls. ICA revealed six networks that showed significant differences between patients with schizophrenia and healthy controls. Four of these networks were negatively task-correlated and showed deactivation across the posterior cingulate, precuneus, medial prefrontal cortex, anterior cingulate, inferior parietal lobules, and parahippocampus. These networks comprise brain regions known as the default-mode network (DMN), a well-characterized set of regions shown to be active during internal modes of cognition and implicated in schizophrenia. Two networks were positively task-correlated, with one network engaging WM regions such as bilateral DLPFC and inferior parietal lobules while the other network engaged primarily the cerebellum. Our results suggest that DLPFC dysfunction in schizophrenia might be lateralized to the left and intrinsically tied to other regions such as the inferior parietal lobule and cingulate gyrus. Furthermore, we found that DMN dysfunction in schizophrenia exists across multiple subnetworks of the DMN and that these subnetworks are individually relevant to the pathophysiology of schizophrenia. In summary, this large multisite study identified multiple temporally coherent networks, which are aberrant in schizophrenia versus healthy controls and suggests that both task-correlated and task-anticorrelated networks may serve as potential biomarkers.
Subject(s)
Brain/physiopathology , Memory Disorders/etiology , Memory, Short-Term/physiology , Models, Neurological , Prefrontal Cortex/physiopathology , Schizophrenia/complications , Acoustic Stimulation/methods , Adult , Analysis of Variance , Brain/blood supply , Brain Mapping , Discriminant Analysis , Female , Functional Laterality , Humans , Image Processing, Computer-Assisted/methods , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neural Pathways/blood supply , Neural Pathways/physiopathology , Neuropsychological Tests , Oxygen/blood , Prefrontal Cortex/blood supply , Principal Component Analysis , Psychiatric Status Rating Scales , Reaction Time/physiology , Young AdultABSTRACT
This paper defines a symptom construct termed psychological pain and reviews clinical and neuroimaging evidence relevant to it. The psychological pain associated with severe depression is often perceived as worse than any physical pain that the individual has experienced and could be a critical component of suicidality that could be systematically assessed in potentially suicidal patients. Converging evidence from brain imaging studies suggests overlapping patterns of brain activation induced by both psychological pain and by physical pain. Future research on the role of psychological pain and its interaction with nociceptive pathways may provide novel clues to the understanding and treatment of depression and other psychiatric illnesses.