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. 2015 Dec 30;234(3):285-91.
doi: 10.1016/j.pscychresns.2015.11.001. Epub 2015 Nov 6.

Schizophrenia symptom and functional correlates of anterior cingulate cortex activation to emotion stimuli: An fMRI investigation

Brady D Nelson  1 , Olivia A Bjorkquist  2 , Emily K Olsen  2 , Ellen S Herbener  3
Affiliations

Schizophrenia symptom and functional correlates of anterior cingulate cortex activation to emotion stimuli: An fMRI investigation

Brady D Nelson et al. Psychiatry Res. .

Abstract

Schizophrenia is a chronic mental illness characterized by distinct positive and negative symptoms and functional impairment. The anterior cingulate cortex (ACC) is a region of the brain's limbic system that is hypoactive during emotion processing in schizophrenia. Recent evidence suggests the hypoactive ACC in schizophrenia is due to negative (and not positive) symptoms. However, this finding has not been replicated and the functional significance of this relationship remains unclear. The present study examined the association between positive and negative symptoms, ACC activation to emotional images, and functional outcome in schizophrenia. Specifically, 16 schizophrenia/schizoaffective disorder (SZ/SZAF) and 15 control (CON) participants underwent an fMRI scan while completing an emotional picture-rating task. SZ/SZAF participants also completed clinician-rated measures of positive and negative symptoms and functional abilities. SZ/SZAF participants with high negative symptoms had reduced ACC activation to pleasant images relative to those with low negative symptoms and CON, who did not differ. Furthermore, amongst all SZ/SZAF participants poorer social functioning was associated with decreased ACC activation to pleasant images. Finally, ACC activation partially mediated the relationship between negative symptoms and social dysfunction. These results provide evidence of the functional significance of the relationship between negative symptoms and ACC dysfunction in schizophrenia.

Keywords: Anterior cingulate; Emotion; Fmri; Functioning; Negative symptoms; Schizophrenia.

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Figures

Figure 1
Figure 1
ROI template for the ACC ACC = anterior cingulate cortex; ROI = region of interest.
Figure 2
Figure 2
Scatterplots depicting the relationship between peak ACC activation to pleasant images and PANSS negative symptoms (top) and QLS interpersonal relationships (bottom) in SZ/SZAF participants. ACC = anterior cingulate cortex; PANSS = Positive and Negative Syndrome Scale; QLS = Quality of Life Scale; SZ/SZAF = schizophrenia/schizoaffective disorder.
Figure 3
Figure 3
Diagnostic group differences between controls and SZ/SZAF participants with low vs. high negative symptoms in peak ACC activation to pleasant images. SZ/SZAF participants with high (n = 7) vs. low (n = 7) negative symptoms were determined using a median split (median = 19) on the PANSS negative symptoms. Error bars represent standard error. ACC = anterior cingulate cortex; PANSS = Positive and Negative Syndrome Scale; SZ/SZAF = schizophrenia/schizoaffective disorder.
Figure 4
Figure 4
Results of mediation analyses between PANSS negative symptoms, peak ACC activation to pleasant images, and QLS interpersonal relationships in SZ/SZAF participants. Coefficients are standardized regression weights. a = association between X and M; ab = indirect effect of X on Y; ACC = anterior cingulate cortex; b = association between M and Y; c = total effect of X on Y; c’ = direct effect of X on Y; M = mediator variable; PANSS = Positive and Negative Syndrome Scale; QLS = Quality of Life Scale; SZ/SZAF = schizophrenia/schizoaffective disorder; X = independent variable; Y = dependent variable. * p < .05, ** p < .01, *** p < .001
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