M90. Associations of Cortical Thickness With Awareness of Illness in Enduring Schizophrenia
Notice bibliographique
Résumé
Background: The relationship between poor insight and less favorable outcomes in schizophrenia has led to research efforts to understand its neurobiological basis. Thus far, research on the neural correlates of insight has been restricted by small sample sizes and a focus on regions of interest related to neuropsychological theories of insight. Moreover, few studies have assessed the neural correlates of specific insight dimensions in enduring schizophrenia and instead have relied on single-item measures of insight. Therefore, the purpose of this study was to examine the association of cortical thickness with the insight dimension of awareness of illness, in a large sample of enduring schizophrenia patients, using a whole-brain approach. We hypothesized that compared to patients with intact insight, patients with impaired insight would have thinner cortex in a network of brain structures associated with self-reflectiveness and metacognition in the temporal, and medial frontal regions. Methods: We used a categorical approach to insight and classified a group of 110 enduring schizophrenia patients in 2 groups according to their summed scores on 3 items of the Scale to Assess Insight (Expanded), which assess awareness of illness. Forty-one patients were classified as having impaired insight into illness (score of 0–5), and 69 patients as intact insight (score >6). T1-weighted structural images were acquired on a 3T MRI scanner for the 2 patient subgroups, and for 69 healthy control subjects matched to patients for age and sex. MR images were processed using CIVET (version 2.0) and quality controlled pre- and post-processing. Whole-brain, vertex-wise linear models were applied to evaluate cortical thickness differences between the 2 patient subgroups and controls. All analyses were controlled for age and sex. Results: There was no significant difference in cortical thickness in either hemisphere between the 2 patient subgroups. However, the impaired insight group displayed significantly thinner cortex within the right insula, temporal gyri, and anterior cingulate cortex compared to healthy controls (P < .05, FDR corrected). There was no significant cortical thickness difference between the intact insight group and healthy controls. Conclusion: These results do not replicate previous findings obtained with smaller samples using single-item measures of insight into illness, and instead suggest that insight into illness may not have a clear neuroanatomical basis at the level of the cortex. Poor awareness of illness may instead be a latent symptom, emerging as a result of a combination of schizophrenia-related deficits, that cannot be captured at the level of the brain. Accordingly, the cortical thinning observed in individuals with impaired insight, but not those with intact insight, compared to controls, may suggest that individuals with impaired insight represent a subset of patients with more severe pathology.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».