Theory of mind and schizophrenia: A positron emission tomography study of medication-free patients
Theory of mind and schizophrenia: A positron emission tomography study of medication-free patients
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DOI：
10.1093/schbul/sbn034
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发表时间：
2008-07-01
影响因子：
6.6
通讯作者：
O'Leary, Daniel S.
中科院分区：
文献类型：
--
作者：
Andreasen, Nancy C.;Calage, Chadi A.;O'Leary, Daniel S.
背景：“心理理论”（TOM）是指将心理状态（即信念和目标）归因于自己和他人的能力，并认识到行为是由这些心理状态引导的。这种对社交能力至关重要的能力在精神分裂症中受到损害。我们对一组精神分裂症患者和健康对照者进行了一项 TOM 研究。方法：我们使用正电子发射断层扫描来识别在口头任务中招募的神经回路，该任务要求参与者将心理状态归因于他们创作的故事中的角色。比较任务包括大声朗读一个中性故事，控制任务的言语部分。结果：患者和对照组产生相同百分比的 TOM 话语。然而，两组人的大脑激活模式明显不同。与对照组相比，患者左半球多个区域的血流量较低，包括额叶和视觉关联皮质、后海马和岛叶。小脑外侧、蚓部、丘脑和后岛叶的对侧区域的流量也较低。另一方面，主要位于右半球的患者血流较高，包括多个额叶和顶叶区域、岛叶、视觉关联皮层和枕丘。讨论：血流较低的区域与先前的研究一致，表明精神分裂症中皮质-小脑回路的募集受损。流量较高的区域可能反映出需要利用右半球来补偿左半球网络的缺陷，包括额叶皮层、前扣带回、小脑和丘脑。
Background: "Theory of mind" (TOM) refers to the ability to attribute mental states (ie, beliefs and goals) to one's self and others and to recognize that behaviors are guided by these mental states. This capacity, critical for social competence, is impaired in schizophrenia. We undertook a study of TOM in a group of patients with schizophrenia and healthy controls. Method: We used positron emission tomography to identify the neural circuits recruited during a verbal task that required participants to attribute mental states to a character in a story of their creation. The comparison task consisted of reading aloud a neutral story, controlling for the speech component of the task. Results: Patients and controls generated the same percentage of TOM utterances. However, the two groups had markedly different patterns of brain activation. Compared with controls, patients had a lower blood flow in multiple regions in the left hemisphere including the frontal and visual association cortices, posterior hippocampus, and insula. The flow was also lower in contralateral areas in the lateral cerebellum and vermis, thalamus, and posterior insula. On the other hand, the flow was higher in the patients predominantly in the right hemisphere, including multiple frontal and parietal regions, insula, visual association cortex, and pulvinar. Discussion: The areas of lower flow are consistent with previous studies indicating impairment in recruiting cortical-cerebellar circuitry in schizophrenia. The areas of higher flow may reflect a need to draw on the right hemisphere to compensate for deficits in left hemisphere networks that include frontal cortex, anterior cingulate, cerebellum, and thalamus.