Abstract: Lack of insight is a core feature of non-affective psychosis and has been associated with
poorer outcomes. Brain abnormalities underlying lack of insight have been suggested,
mostly in the frontal lobe, although previous research showed mixed results. We used a
voxel-based morphometry (VBM) analysis in 108 first-episode non-affective psychosis
patients to investigate the pattern of brain structural abnormalities related to lack of insight.
In addition, 77 healthy volunteers were compared with the patients classified as having poor
and good insight. The shortened version of the Scale to Assess Unawareness of Mental
Disorder was used to evaluate insight. Patients with poor insight (n = 68) compared with
patients with good insight (n = 40) showed a single significant cluster (kc = 5834; PcFWE =
0.001) of reduced grey matter volume (GMV) in the right occipital lobe extending to its lateral
and medial surfaces, the cuneus, and the middle temporal gyrus. In addition, GMV at this
cluster showed a negative correlation with the score of the SUMD (r = -0.305; p = 0.001).
When comparing patients with poor insight with healthy subjects overall reductions of GMV
were found, mainly in frontal and occipital lobes. Hence, poor insight in non-affective psychosis
seems to be associated with specific brain abnormalities in the right occipital and
temporal cortical regions. Dysfunction in any combination of these areas may contribute to
lack of insight in non-affective psychosis. Specifically, the `right' hemisphere dysfunction
underlying impaired insight in our sample is consistent with previously reported similarities
between lack of insight in psychosis and anosognosia in neurological disorders.
Fuente: PLoS One. 2018 Jun 1;13(6):e0197715
Editorial: Public Library of Science
Año de publicación: 2018
Nº de páginas: 16
Tipo de publicación: Artículo de Revista
Url de la publicación: https://doi.org/
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DIANA TORDESILLAS GUTIERREZ
MARIA ROSA AYESA ARRIOLA
MANUEL DELGADO ALVARADO
ROBINSON, JENNIFER L.
DAVID, ANTHONY S.
BENEDICTO CRESPO FACORRO