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Correlation of passivity symptoms and dysfunctional visuomotor action monitoring in psychosis.

Schnell K, Heekeren K, Daumann J, Schnell T, Schnitker R, Möller-Hartmann W, Gouzoulis-Mayfrank E - Brain (2008)

Bottom Line: In the patient group we found the expected correlation of passivity symptoms and visuomotor monitoring performance.A correlation of passivity symptoms with the main experimental effect (actions with -- actions without monitoring) was found in the posterior cingulate cortex (PCC) and in the left IPL.No group differences or group by task interactions were found within the visuomotor-action-monitoring network.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Psychotherapy, Division of Medical Psychology, University Hospital of Bonn, Bonn, Germany. knut.schnell@ukb.uni-bonn.de

ABSTRACT
Passivity experiences are hallmark symptoms of schizophrenia that can be characterized by the belief that one's thoughts or actions are controlled by an external agent. It has recently been suggested that these psychotic experiences result from defective monitoring of one's own actions, i.e. disturbed comparison of actions and perceived outcomes. In this study, we examined the function of the previously characterized action monitoring network of the inferior parietal lobule (IPL), medial (mPFC) and lateral prefrontal cortices in patients with different levels of passivity symptoms with an fMRI task. The visuomotor fMRI task demanded control of visually perceived object movements by alternating button presses with the left and the right index finger. In the monitoring condition of this task subjects stopped their actions whenever they detected visuomotor incongruence. fMRI and behavioural data from 15 patients were tested for correlation with passivity symptoms using standardized Scale for Assessment of Positive Symptoms (SAPS)- and AMDP- passivity symptom ratings. Both types of data were tested for differences between the patients group and 15 healthy controls. In the patient group we found the expected correlation of passivity symptoms and visuomotor monitoring performance. There was a significant positive correlation of passivity symptoms with increased latency of incongruence detection and a negative correlation of SAPS-passivity with the number of detected events. fMRI data revealed correlations of passivity symptoms with activation in bilateral IPL, primary motor and sensory cortices in the action monitoring condition. A correlation of passivity symptoms with the main experimental effect (actions with -- actions without monitoring) was found in the posterior cingulate cortex (PCC) and in the left IPL. No group differences or group by task interactions were found within the visuomotor-action-monitoring network. Our results demonstrate the association between passivity symptoms and the dysfunction of visuomotor action monitoring and support the idea that psychotic passivity experiences result from dysfunctions of central action monitoring mechanisms: According to pre-existing concepts of parietal cortex function, IPL-hyperactivation may represent an increase in false detections of visuomotor incongruence while the correlation between passivity and the differential effect of monitoring on PCC-activation assumedly represents greater self-monitoring effort in passivity experiences.

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The pattern of differential activation for action monitoring (MC–CC) in the patient group (A, P < 0.05 FDR-corrected, k > 10 voxel, AMDP passivity as covariate of no interest) was not statistically different from the pattern in the control group (B, P < 0.001 uncorr. for display). Both patterns reassembled the network found in the previous study with the same design but higher visuomotor load in healthy subjects (C, P < 0.05 FDR-corrected, k > 10 voxel).
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Figure 2: The pattern of differential activation for action monitoring (MC–CC) in the patient group (A, P < 0.05 FDR-corrected, k > 10 voxel, AMDP passivity as covariate of no interest) was not statistically different from the pattern in the control group (B, P < 0.001 uncorr. for display). Both patterns reassembled the network found in the previous study with the same design but higher visuomotor load in healthy subjects (C, P < 0.05 FDR-corrected, k > 10 voxel).

Mentions: In the patient group the differential activation pattern in the action monitoring condition (MC–CC) resembled the pattern found in the previous study in healthy subjects after passivity was controlled for as a covariate of no interest. This pattern included bilateral IPL, the temporoparietal junction, the anterior cingulate cortex and dorsolateral PFC as well as right inferior PFC (P < 0.05, FDR-corrected, voxel level, k = 10, Table 4, Fig. 2). The control group displayed a similar pattern however at a lower significance level than expected in comparison to the healthy subjects in the previous experiment (P < 0.001 uncorr., voxel level, k = 10, Fig. 2).Fig. 2


Correlation of passivity symptoms and dysfunctional visuomotor action monitoring in psychosis.

Schnell K, Heekeren K, Daumann J, Schnell T, Schnitker R, Möller-Hartmann W, Gouzoulis-Mayfrank E - Brain (2008)

The pattern of differential activation for action monitoring (MC–CC) in the patient group (A, P < 0.05 FDR-corrected, k > 10 voxel, AMDP passivity as covariate of no interest) was not statistically different from the pattern in the control group (B, P < 0.001 uncorr. for display). Both patterns reassembled the network found in the previous study with the same design but higher visuomotor load in healthy subjects (C, P < 0.05 FDR-corrected, k > 10 voxel).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2570714&req=5

Figure 2: The pattern of differential activation for action monitoring (MC–CC) in the patient group (A, P < 0.05 FDR-corrected, k > 10 voxel, AMDP passivity as covariate of no interest) was not statistically different from the pattern in the control group (B, P < 0.001 uncorr. for display). Both patterns reassembled the network found in the previous study with the same design but higher visuomotor load in healthy subjects (C, P < 0.05 FDR-corrected, k > 10 voxel).
Mentions: In the patient group the differential activation pattern in the action monitoring condition (MC–CC) resembled the pattern found in the previous study in healthy subjects after passivity was controlled for as a covariate of no interest. This pattern included bilateral IPL, the temporoparietal junction, the anterior cingulate cortex and dorsolateral PFC as well as right inferior PFC (P < 0.05, FDR-corrected, voxel level, k = 10, Table 4, Fig. 2). The control group displayed a similar pattern however at a lower significance level than expected in comparison to the healthy subjects in the previous experiment (P < 0.001 uncorr., voxel level, k = 10, Fig. 2).Fig. 2

Bottom Line: In the patient group we found the expected correlation of passivity symptoms and visuomotor monitoring performance.A correlation of passivity symptoms with the main experimental effect (actions with -- actions without monitoring) was found in the posterior cingulate cortex (PCC) and in the left IPL.No group differences or group by task interactions were found within the visuomotor-action-monitoring network.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Psychotherapy, Division of Medical Psychology, University Hospital of Bonn, Bonn, Germany. knut.schnell@ukb.uni-bonn.de

ABSTRACT
Passivity experiences are hallmark symptoms of schizophrenia that can be characterized by the belief that one's thoughts or actions are controlled by an external agent. It has recently been suggested that these psychotic experiences result from defective monitoring of one's own actions, i.e. disturbed comparison of actions and perceived outcomes. In this study, we examined the function of the previously characterized action monitoring network of the inferior parietal lobule (IPL), medial (mPFC) and lateral prefrontal cortices in patients with different levels of passivity symptoms with an fMRI task. The visuomotor fMRI task demanded control of visually perceived object movements by alternating button presses with the left and the right index finger. In the monitoring condition of this task subjects stopped their actions whenever they detected visuomotor incongruence. fMRI and behavioural data from 15 patients were tested for correlation with passivity symptoms using standardized Scale for Assessment of Positive Symptoms (SAPS)- and AMDP- passivity symptom ratings. Both types of data were tested for differences between the patients group and 15 healthy controls. In the patient group we found the expected correlation of passivity symptoms and visuomotor monitoring performance. There was a significant positive correlation of passivity symptoms with increased latency of incongruence detection and a negative correlation of SAPS-passivity with the number of detected events. fMRI data revealed correlations of passivity symptoms with activation in bilateral IPL, primary motor and sensory cortices in the action monitoring condition. A correlation of passivity symptoms with the main experimental effect (actions with -- actions without monitoring) was found in the posterior cingulate cortex (PCC) and in the left IPL. No group differences or group by task interactions were found within the visuomotor-action-monitoring network. Our results demonstrate the association between passivity symptoms and the dysfunction of visuomotor action monitoring and support the idea that psychotic passivity experiences result from dysfunctions of central action monitoring mechanisms: According to pre-existing concepts of parietal cortex function, IPL-hyperactivation may represent an increase in false detections of visuomotor incongruence while the correlation between passivity and the differential effect of monitoring on PCC-activation assumedly represents greater self-monitoring effort in passivity experiences.

Show MeSH
Related in: MedlinePlus