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Reality distortion is related to the structure of the salience network in schizophrenia

Published online by Cambridge University Press:  13 December 2010

L. Palaniyappan ,
P. Mallikarjun ,
V. Joseph ,
T. P. White  and
P. F. Liddle
L. Palaniyappan*
Affiliation:
Division of Psychiatry, University of Nottingham, A Floor, South Block, Queen's Medical Centre, Nottingham, UK
P. Mallikarjun
Affiliation:
Division of Psychiatry, University of Nottingham, A Floor, South Block, Queen's Medical Centre, Nottingham, UK
V. Joseph
Affiliation:
Division of Psychiatry, University of Nottingham, A Floor, South Block, Queen's Medical Centre, Nottingham, UK
T. P. White
Affiliation:
Division of Psychiatry, University of Nottingham, A Floor, South Block, Queen's Medical Centre, Nottingham, UK
P. F. Liddle
Affiliation:
Division of Psychiatry, University of Nottingham, A Floor, South Block, Queen's Medical Centre, Nottingham, UK
*
*Address for correspondence: L. Palaniyappan, Ph.D., Division of Psychiatry, A Floor, South Block, Queen's Medical Centre, Nottingham NG7 2UH, UK. (Email: [email protected])
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Abstract

Background

An intrinsic cerebral network comprising the anterior cingulate and anterior insula (the salience network) is considered to play an important role in salience detection in healthy volunteers. Aberrant salience has been proposed as an important mechanism in the production of psychotic symptoms such as delusions and hallucinations (reality distortion). We investigated whether structural deficits in the salience network are associated with the reality distortion seen in schizophrenia.

Method

A sample of 57 patients in a clinically stable state of schizophrenia and 41 controls were studied with high-resolution magnetic resonance imaging.

Results

Bilateral volume reduction was seen in the anterior cingulate and anterior insula in patients with schizophrenia. Reduced volume in the two left-sided regions of the salience network was significantly correlated with the severity of reality distortion.

Conclusions

These findings suggest that a deficit of grey matter in the salience network leads to an impaired attribution of salience to stimuli that is associated with delusions and hallucinations in schizophrenia.

Keywords

Cingulateinsulaneuroimagingreality distortionsalience network
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 8 , August 2011 , pp. 1701 - 1708
Copyright
Copyright © Cambridge University Press 2010

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