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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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LEFT: Whole brain analysis of correlation of haemodynamic activation in the visuomotor MC and ratings of passivity symptoms from the AMDP (A) and SAPS (B) (P = 0.001 uncorr. for display; k > 10 voxel) overlayed on parietal clusters of main effects (MC–CC) of the monitoring task in the parietal cortex (dark green, P = 0.05 FDR corr.) for illustration. RIGHT: Scatter plots of passivity and beta estimates of activation in CC and MC extracted from spheres (10 mm) centred in indicated IPL coordinates. Correlations (Pearson's; r) in MC and CC are indicated as well as P-values specifying the significance of differences between these correlations.
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Figure 3: LEFT: Whole brain analysis of correlation of haemodynamic activation in the visuomotor MC and ratings of passivity symptoms from the AMDP (A) and SAPS (B) (P = 0.001 uncorr. for display; k > 10 voxel) overlayed on parietal clusters of main effects (MC–CC) of the monitoring task in the parietal cortex (dark green, P = 0.05 FDR corr.) for illustration. RIGHT: Scatter plots of passivity and beta estimates of activation in CC and MC extracted from spheres (10 mm) centred in indicated IPL coordinates. Correlations (Pearson's; r) in MC and CC are indicated as well as P-values specifying the significance of differences between these correlations.

Mentions: SPM correlation analysis with small volume corrections in bilateral IPL defined by a mask for BA 40—a key component of the action monitoring network identified in the preceding study (Schnell et al., 2007)—revealed a significant positive correlation between AMDP passivity symptom scores and BOLD-signal in the MC bilaterally [right IPL (x, y, z = 51, –48, 48, z = 3.79), left IPL (x, y, z = –45, –51, 42, z = 3.73), P < 0.05, FWE corrected for BA 40, Table 5)]. There was also a significant correlation between AMPD passivity scores and individual beta values in the MC extracted from spheres (diameter = 10 mm) centred in the given correlation maxima in the right IPL (Pearson's r = 0.787, P = 0.0002) and in the left IPL (Pearson's r = 0.793, P = 0.0003) (Table 3, Fig. 3). Remarkably the beta values from the left IPL were also correlated with latency and the number of incongruence detections.Fig. 3


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)

LEFT: Whole brain analysis of correlation of haemodynamic activation in the visuomotor MC and ratings of passivity symptoms from the AMDP (A) and SAPS (B) (P = 0.001 uncorr. for display; k > 10 voxel) overlayed on parietal clusters of main effects (MC–CC) of the monitoring task in the parietal cortex (dark green, P = 0.05 FDR corr.) for illustration. RIGHT: Scatter plots of passivity and beta estimates of activation in CC and MC extracted from spheres (10 mm) centred in indicated IPL coordinates. Correlations (Pearson's; r) in MC and CC are indicated as well as P-values specifying the significance of differences between these correlations.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

Figure 3: LEFT: Whole brain analysis of correlation of haemodynamic activation in the visuomotor MC and ratings of passivity symptoms from the AMDP (A) and SAPS (B) (P = 0.001 uncorr. for display; k > 10 voxel) overlayed on parietal clusters of main effects (MC–CC) of the monitoring task in the parietal cortex (dark green, P = 0.05 FDR corr.) for illustration. RIGHT: Scatter plots of passivity and beta estimates of activation in CC and MC extracted from spheres (10 mm) centred in indicated IPL coordinates. Correlations (Pearson's; r) in MC and CC are indicated as well as P-values specifying the significance of differences between these correlations.
Mentions: SPM correlation analysis with small volume corrections in bilateral IPL defined by a mask for BA 40—a key component of the action monitoring network identified in the preceding study (Schnell et al., 2007)—revealed a significant positive correlation between AMDP passivity symptom scores and BOLD-signal in the MC bilaterally [right IPL (x, y, z = 51, –48, 48, z = 3.79), left IPL (x, y, z = –45, –51, 42, z = 3.73), P < 0.05, FWE corrected for BA 40, Table 5)]. There was also a significant correlation between AMPD passivity scores and individual beta values in the MC extracted from spheres (diameter = 10 mm) centred in the given correlation maxima in the right IPL (Pearson's r = 0.787, P = 0.0002) and in the left IPL (Pearson's r = 0.793, P = 0.0003) (Table 3, Fig. 3). Remarkably the beta values from the left IPL were also correlated with latency and the number of incongruence detections.Fig. 3

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