Effects of metacognitive training on the neurophysiological correlates of the jumping-to-conclusions bias in schizophrenia

在妄想产生理论中，跳跃结论偏差(JTC)，即倾向于基于有限的证据做出决定的倾向，占据着核心地位。由于妄想症是精神分裂症的核心症状之一，JTC偏向可能是治疗的理想靶点。虽然不受多巴胺能拮抗剂的影响，但JTC偏倚容易受到特定的心理治疗干预，这些干预已被证明在精神分裂症患者的抗精神病药物治疗的辅助下治疗妄想症状是有效的。然而，JTC在精神分裂症中的神经生物学基础到目前为止还没有引起多少兴趣。一些研究调查了健康受试者的数据收集，并表明它与大脑中不同于(或不同于)参与决策和奖励处理的区域的活动有关。然而，到目前为止，还没有关于精神分裂症患者数据收集障碍的神经生理学相关性的研究。本研究旨在为精神分裂症患者的JTC偏差和其他方面的数据收集异常提供一个生物标志物。这将通过比较24名未服用药物的精神分裂症患者和24名健康对照组(性别、年龄和教育程度匹配)在两项评估数据收集的不同任务中的大脑激活和功能连接模式来实现。此外，患者在元认知训练(MCT)课程后大脑激活/连接模式的变化，这是一种专门为解决推理偏见而设计的干预措施，如JTC。这项研究旨在为精神分裂症的病理生理学提供见解，这将进一步开发这种疾病的新治疗方案。

The jumping-to-conclusions (JTC) bias, i.e. the tendency to arrive on decisions based on limited evidence, occupies a central place among theories of delusion generation. Since delusions constitute one of the core symptoms of schizophrenia, the JTC bias might represent an ideal target for treatment. Although not affected by dopaminergic antagonists, the JTC bias is amenable to specific psychotherapeutic interventions, which have been shown to be efficient in treating delusional symptoms as an adjunct to antipsychotic medication treatment in patients with schizophrenia. However, the neurobiological bases of JTC in schizophrenia have received little interest so far. A few studies have investigated data gathering in healthy subjects and have shown it to be associated with activity in brain areas different than (or additional to) those involved in decision making and reward processing. However, so far there have been no studies on the neurophysiological correlates of disturbed data gathering in patients with schizophrenia. The present study aims to provide a biological marker for the JTC bias and other aspects of data gathering abnormalities in patients with schizophrenia. This will be achieved by comparing brain activation and functional connectivity patterns in 24 unmedicated patients with schizophrenia and 24 healthy control subjects (matched in gender, age and education) during two different tasks assessing data gathering. Moreover, changes in brain activation/connectivity patterns in patients following a course of metacognitive training (MCT), an intervention specifically designed to address reasoning biases such as the JTC. The study aims to provide insights into the pathophysiology of schizophrenia that will further the development of new treatment options for the disorder.