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Cortical thinning in relation to impaired insight into illness in patients with treatment resistant schizophrenia.
Kim, Julia; Song, Jianmeng; Kambari, Yasaman; Plitman, Eric; Shah, Parita; Iwata, Yusuke; Caravaggio, Fernando; Brown, Eric E; Nakajima, Shinichiro; Chakravarty, M Mallar; De Luca, Vincenzo; Remington, Gary; Graff-Guerrero, Ariel; Gerretsen, Philip.
Afiliação
  • Kim J; Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
  • Song J; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Kambari Y; Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
  • Plitman E; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Shah P; Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
  • Iwata Y; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Caravaggio F; Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
  • Brown EE; Department of Psychiatry, McGill University, Montreal, QC, Canada.
  • Nakajima S; Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
  • Chakravarty MM; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • De Luca V; University of Yamanashi, Faculty of Medicine, Department of Neuropsychiatry, Yamanashi, Japan.
  • Remington G; Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
  • Graff-Guerrero A; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
  • Gerretsen P; Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
Schizophrenia (Heidelb) ; 9(1): 27, 2023 Apr 29.
Article em En | MEDLINE | ID: mdl-37120642
ABSTRACT
Impaired insight into illness is a common element of schizophrenia that contributes to treatment nonadherence and negative clinical outcomes. Previous studies suggest that impaired insight may arise from brain abnormalities. However, interpretations of these findings are limited due to small sample sizes and inclusion of patients with a narrow range of illness severity and insight deficits. In a large sample of patients with schizophrenia, the majority of which were designated as treatment-resistant, we investigated the associations between impaired insight and cortical thickness and subcortical volumes. A total of 94 adult participants with a schizophrenia spectrum disorder were included. Fifty-six patients (60%) had treatment-resistant schizophrenia. The core domains of insight were assessed with the VAGUS insight into psychosis scale. We obtained 3T MRI T1-weighted images, which were analysed using CIVET and MAGeT-Brain. Whole-brain vertex-wise analyses revealed impaired insight, as measured by VAGUS average scores, was related to cortical thinning in left frontotemporoparietal regions. The same analysis in treatment-resistant patients showed thinning in the same regions, even after controlling for age, sex, illness severity, and chlorpromazine antipsychotic dose equivalents. No association was found in non-treatment-resistant patients. Region-of-interest analyses revealed impaired general illness awareness was associated with cortical thinning in the left supramarginal gyrus when controlling for covariates. Reduced right and left thalamic volumes were associated with VAGUS symptom attribution and awareness of negative consequences subscale scores, respectively, but not after correction for multiple testing. Our results suggest impaired insight into illness is related to cortical thinning in left frontotemporoparietal regions in patients with schizophrenia, particularly those with treatment resistance where insight deficits may be more chronic.

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article