Social Processing Systems in Veterans with Schizophrenia: Identifying Deficits in Brain Activation and Network Organization

精神分裂症是一种严重的、使人衰弱的精神疾病，影响着世界上近1%的人口。 在退伍军人健康管理局内，2014财年患有精神障碍的退伍军人的总费用( 哪种精神分裂症最严重)超过60亿美元。认知缺陷--包括非社会性和 社交--是精神分裂症的核心特征。社会认知缺陷指的是 参与感知、编码、存储、检索和调节关于其他人的信息以及 我们自己。社会认知方面的问题是这种疾病的社会残疾和功能减退的基础。 对社会认知障碍的更好理解将为定向康复提供机会- 有针对性的干预。该提案将解决一个悬而未决的问题：具体地说，如何以及在 精神分裂症患者的大脑社交处理出现问题。 我们知道哪些社会处理大脑系统与理解精神分裂症有关。然而，我们有 不知道社交处理障碍是否出现在特定的大脑系统内或系统之间 当它们一起工作时(即，集成在一起)。精神分裂症患者中只有一些系统受损。为 例如，接受他人观点的意念化在精神分裂症患者中明显受损。影响 分享，这是当我们看到别人的情绪表现时，我们自己的情绪自动激活，这是 相对完好无损。移情(即分享、理解和回应他人的情感体验 Person)是一种高级社交处理能力，需要处理系统之间的集成，包括 影响分享和心灵化。我们对社会加工障碍和社会认知障碍的神经基础的了解 精神分裂症严重缺乏残疾，这项提案的目标是解决这一知识差距。 这项研究将使用功能磁共振成像(FMRI)来检查大脑的局部活动，SEED- 72例退伍军人精神分裂症患者和72例配对患者的基于连接性和脑网络组织的研究 控制。临床评估和社会认知方面的绩效任务也将包括在内。这个 AIMS将使用三种社交处理范式来解决：1)参与者 查看痛苦和非痛苦的图像。它激活了情感分享系统。2)在以下情况下的董事任务 参与者采取与另一个人相同或不同的视角。它激活了思考化 系统。3)同理心精确度任务，受试者在一项任务中监控社交目标的情绪。 录像。它依赖于多个社交处理系统，包括情感分享和心灵化。 对社会加工脑的激活、连接和脑网络组织的密切评估 系统将识别精神分裂症中神经脆弱的特定点。这样，我们就可以开始 了解神经过程中的特定干扰如何导致社会功能受损。

Schizophrenia is a serious and debilitating psychiatric disorder that affects nearly 1% of the world's population. Within the Veterans Health Administration, total costs in FY 2014 for Veterans with psychotic disorders (of which schizophrenia is the most severe) was over 6 billion dollars. Deficits in cognition – both non-social and social -- are core features of schizophrenia. The deficits in social cognition refer to the processes that are involved in the perception, encoding, storage, retrieval and regulation of information about other people and ourselves. The problems in social cognition underlie the social disability and reduced functioning of the illness. A greater understanding of social cognitive impairments would provide opportunities for targeted recovery- focused interventions. This proposal will address an unanswered question: specifically how and where in the brain social processing goes awry in schizophrenia. We know which social processing brain systems are relevant to understanding schizophrenia. However, we do not know whether social processing impairments emerge within a particular brain system or between systems when they work together (i.e., are integrated). Only some systems are impaired in schizophrenia. For example, mentalizing, which involves taking others' viewpoints, is clearly impaired in schizophrenia. Affect sharing, which is the automatic activation of emotion in ourselves when we see emotional displays in others, is relatively intact. Empathy (i.e. sharing, understanding, and responding to emotional experiences of another person) is a high-level social processing ability that requires integration among processing systems, including affect sharing and mentalizing. Our knowledge of the neural basis of social processing impairments and social disability in schizophrenia is severely lacking, and the goal of this proposal is to address this knowledge gap. The study will use functional magnetic resonance imaging (fMRI) to examine regional brain activity, seed- based connectivity, and brain network organization in 72 Veterans with schizophrenia and 72 group-matched controls. Clinical assessments and performance-based tasks in social cognition will also be included. The aims will be addressed using three social processing paradigms: 1) A Pain Rating Task in which participants view painful and non-painful images. It activates the affect sharing system. 2) A Director's Task in which participants take the same or different viewing perspective as another person. It activates the mentalizing system. And 3) An Empathic Accuracy Task in which participants monitor the mood of a social “target” on a video. It relies on multiple social processing systems, including affect sharing and mentalizing. A close evaluation of activation, connectivity, and brain network organization in social processing brain systems will identify specific points of neural vulnerability in schizophrenia. In that way, we can begin to understand how specific disruptions in neural processes lead to impaired social functioning.