Images of psychopathology

doi:10.1016/S0959-4388(98)80149-9

Current Opinion in Neurobiology

Volume 8, Issue 2, April 1998, Pages 259-262

https://doi.org/10.1016/S0959-4388(98)80149-9 Get rights and content

Abstract

Brain imaging continues to provide important data about brain structure, neurotransmitter function and the physiological basis of cognitive processes, as these relate to schizophrenia and mood disorders. A unifying theoretical perspective, however, that can clarify the precise nature of the biological basis of these diverse psychiatric conditions is lacking. It is becoming increasingly evident that a lesion model is inappropriate and that a more relevant characterisation will be found in terms of disorders of functional interconnections between brain regions.

References (36)

DA Yurgelun-Todd et al.
Proton magnetic resonance spectroscopy of the temporal lobes in schizophrenics and normal
Schizophr Res
(1996)
T Shioiri et al.
Proton magnetic resonance spectroscopy of the basal ganglia in patients with schizophrenia: a preliminary report
Schizophr Res
(1996)
EV Sullivan et al.
Cognitive and motor impairments are related to gray matter volume deficits in schizophrenia
Biol Psychiatry
(1996)
IC Wright et al.
A voxel-based method for the statistical analysis of gray and white matter density applied to schizophrenia
Neuroimage
(1995)
WG Honer et al.
Cingulate cortex synaptic terminal proteins and neural cell adhesion molecule in schizophrenia
Neuroscience
(1997)
PF Liddle
Functional imaging — schizophrenia
Br Med Bull
(1996)
R Elliott et al.
Prefrontal dysfunction in depressed patients performing a complex planning task: a study using positron emission tomography
Psychol Med
(1997)
LE DeLisi et al.
Schizophrenia as a chronic active brain process: a study of progressive brain structural change subsequent to the onset of schizophrenia
Psychiatry Res
(1996)
FM Benes et al.
Differential distribution of tyrosine hydrolase fibers on small and large neurons in layer II of anterior cingulate cortex of schizophrenic brain
Synapse
(1997)
B Bogerts
The temporolimbic system theory of positive schizophrenic symptoms
Schizophr Bull
(1997)

Y Okubo et al.

Decreased prefrontal dopamine D1 receptors in schizophrenia revealed by PET

Nature

(1997)

RJ Dolan et al.

Dopaminergic modulation of an impaired cognitive activation in the anterior cingulate cortex in schizophrenia

Nature

(1995)

A Breier et al.

Schizophrenia is associated with elevated amphetamine-induced synaptic dopamine concentration: evidence from a novel positron emission tomography method

Proc Natl Acad Sci USA

(1997)

DR Weinberger et al.

Prefrontal function in schizophrenia: confounds and controversies

Philos Trans R Soc Lond

(1996)

DA Yurgelun-Todd et al.

Functional magnetic resonance imaging of schizophrenic patients and comparison subjects during word production

Am J Psychiatry

(1996)

TJ Crawford et al.

Abnormal saccadic distractibility in patients with schizophrenia: a 99mTc-HMPAO SPET study

Psychol Med

(1996)

SF Taylor

Cerebral blood flow activation and functional lesions in schizophrenia

Schizophr Res

(1996)

CD Frith

The role of the prefrontal cortex in self-consciousness: the case of auditory hallucinations

Philos Trans R Soc Lond [Biol]

(1996)

Cited by (30)

FMRI at 20: Has it changed the world?
2012, NeuroImage
Citation Excerpt :
Pausing briefly, he then followed by saying that this will change in the next few years, and the change will revolve around a new definition of psychiatric diseases as disorders of brain circuitry—that this evolving understanding will change our definition of mental illnesses and our understanding of their causes, treatments, and preventions. In a review published more than 10 years ago, Frith and Dolan (1998), said “It is becoming increasingly evident that a lesion model is inappropriate and that a more relevant characterization will be found in terms of disorders of functional interconnections between brain regions.” An important example of this “circuit-based” understanding of mental disorders, and how to treat them, is the work of Helen Mayberg.
The prevalence of fMRI in cognitive neuroscience research is clear, but the overall impact of the associated research in the broader scope of our scientific community, and of society, is less obvious. The first reports of fMRI garnered huge interest in many areas, giving rise to a wide range of applications and technical developments over the past 20 years. Using five primary areas, i.e. scientific impact, clinical practice, cognitive neuroscience, mental illness, and society–this essay examines the question: Has fMRI changed the world?
Cerebral white matter deficiencies in pedophilic men
2008, Journal of Psychiatric Research
Citation Excerpt :
The present white matter findings, however, suggest that the neuroanatomic component to pedophilia may instead be an insufficiency of connectivity among a set of topographically disparate brain regions. This would suggest for pedophilia what has previously been suggested for schizophrenia and mood disorders: “It is becoming increasingly evident that a lesion model is inappropriate and that a more relevant characterisation will be found in terms of disorders of functional interconnections between brain regions” (Frith and Dolan, 1998, p. 259). Functional imaging studies of healthy (nonpedophilic) men have repeatedly identified a set of grey matter regions that consistently respond to sexual stimuli; of these, the cortical regions include (a) medial and middle frontal cortex (Ferretti et al., 2005; Garavan et al., 2000; Gizewski et al., 2006; Karama et al., 2002; Montorsi et al., 2003; Rauch et al., 1999), (b) insula (Garavan et al., 2000; Gizewski et al., 2006; Karama et al., 2002; Moulier et al., 2006; Park et al., 2001; Stoléru et al., 1999), (c) superior and inferior parietal lobules (Beauregard et al., 2001; Bocher et al., 2001; Ferretti et al., 2005; Moulier et al., 2006; Mouras et al., 2003; Ponseti et al., 2006; Rauch et al., 1999; Redouté et al., 2000; Stoléru et al., 2003), (d) visual cortex (Beauregard et al., 2001; Bocher et al., 2001; Moulier et al., 2006; Mouras et al., 2003; Park et al., 2001; Ponseti et al., 2006), (e) inferior temporal cortex (Beauregard et al., 2001; Ferretti et al., 2005; Karama et al., 2002; Montorsi et al., 2003; Moulier et al., 2006; Park et al., 2001; Stoléru et al., 1999, 2003; Yang, 2004), and (f) the fusiform gyrus (Bocher et al., 2001; Ferretti et al., 2005; Gizewski et al., 2006; Karama et al., 2002; Moulier et al., 2006; Rauch et al., 1999; Stoléru et al., 2003).
The present investigation sought to identify which brain regions distinguish pedophilic from nonpedophilic men, using unbiased, automated analyses of the whole brain. T1-weighted magnetic resonance images (MRIs) were acquired from men who demonstrated illegal or clinically significant sexual behaviors or interests (n = 65) and from men who had histories of nonsexual offenses but no sexual offenses (n = 62). Sexual interest in children was assessed by participants’ admissions of pedophilic interest, histories of committing sexual offenses against children, and psychophysiological responses in the laboratory to erotic stimuli depicting children or adults. Automated parcellation of the MRIs revealed significant negative associations between pedophilia and white matter volumes of the temporal and parietal lobes bilaterally. Voxel-based morphometry corroborated the associations and indicated that the regions of lower white matter volumes followed, and were limited to, two major fiber bundles: the superior fronto-occipital fasciculus and the right arcuate fasciculus. No significant differences were found in grey matter or in cerebrospinal fluid (CSF). Because the superior fronto-occipital and arcuate fasciculi connect the cortical regions that respond to sexual cues, these results suggest (1) that those cortical regions operate as a network for recognizing sexually relevant stimuli and (2) that pedophilia results from a partial disconnection within that network.
Mental rotation in schizophrenia
2006, Consciousness and Cognition
Motor imagery provides a direct insight into action representations. The aim of the present study was to investigate the level of impairment of action monitoring in schizophrenia by evaluating the performance of schizophrenic patients on mental rotation tasks. We raised the following questions: (1) Are schizophrenic patients impaired in motor imagery both at the explicit and at the implicit level? (2) Are body parts more difficult for them to mentally rotate than objects? (3) Is there any link between the performance and the hallucinating symptom profile? The schizophrenic patients (n = 13) displayed the same pattern of performance as the control subjects (n = 13). More particularly, schizophrenic patients’ reaction time varied as a function of the angular disparity of the stimuli. On the other hand, they were significantly slower and less accurate. Interestingly, patients suffering from hallucinations made significantly more errors than non-hallucinatory patients. We discussed these latter results in terms of deficit of the forward model. We emphasized the necessity to distinguish different levels of action, more or less impaired in schizophrenia.
Hysterical conversion and brain function
2005, Progress in Brain Research
Citation Excerpt :
Over the past 10 years, functional brain imaging has literally exploded into innumerable paths of new research on the cerebral bases of various behavioral functions in humans, including not only perceptual and motor processes accessible to external objective assessment, but also much more complex mental operations related to internal affective states (Damasio et al., 2000), perceptual or motor imagery (Kosslyn et al., 1995; Ehrsson et al., 2003), and even unconscious processing or preferences (Elliott and Dolan, 1998). This functional brain mapping approach has also been successfully extended to a variety of psychiatric conditions such as depression, obsessive-compulsive disorders, phobia, post-traumatic stress disorders, schizophrenia, or hallucinations (e.g., Frith and Dolan, 1998; Parsey and Mann, 2003; Kircher, this volume). Surprisingly, however, very few neuroimaging studies have been performed in patients with conversion symptoms, despite the fact that such symptoms might often be very well suited to neuroimaging investigations.
Hysterical conversion disorders represent “functional” or unexplained neurological deficits such as paralysis or somatosensory losses that are not explained by organic lesions in the nervous system, but arise in the context of “psychogenic” stress or emotional conflicts. After more than a century of both clinical and theoretical interest, the exact nature of such emotional disorders responsible for hysterical symptoms, and their functional consequences on neural systems in the brain, still remain largely unknown. However, several recent studies have used functional brain imaging techniques (such as EEG, fMRI, PET, or SPECT) in the attempt to identify specific neural correlates associated with hysterical conversion symptoms. This article presents a general overview of these findings and of previous neuropsychologically based accounts of hysteria. Functional neuroimaging has revealed selective decreases in the activity of frontal and subcortical circuits involved in motor control during hysterical paralysis, decreases in somatosensory cortices during hysterical anesthesia, or decreases in visual cortex during hysterical blindness. Such changes are usually not accompanied by any significant changes in elementary stages of sensory or motor processing as measured by evoked potentials, although some changes in later stages of integration (such as P300 responses) have been reported. On the other hand, several neuroimaging results have shown increased activation in limbic regions, such as cingulate or orbitofrontal cortex during conversion symptoms affecting different sensory or motor modalities. Taken together, these data generally do not support previous proposals that hysteria might involve an exclusion of sensorimotor representations from awareness through attentional processes. They rather seem to point to a modulation of such representations by primary affective or stress-related factors, perhaps involving primitive reflexive mechanisms of protection and alertness that are partly independent of conscious control, and mediated by dynamic modulatory interactions between limbic and sensorimotor networks. A better understanding of the neuropsychobiological bases of hysterical conversion disorder might therefore be obtained by future imaging studies that compare different conversion symptoms and employ functional connectivity analyses. This should not only lead to improve clinical management of these patients, but also provide new insights on the brain mechanisms of self-awareness.
Regional frontal abnormalities in schizophrenia: A quantitative gray matter volume and cortical surface size study
2000, Biological Psychiatry
Citation Excerpt :
Second, because of the number of subregions of interest considered, a large number of comparisons were conducted, and therefore the risk of a type I error in the interpretation of the results increases; however, regions of abnormality had been identified as candidate ROIs a priori, based on previous findings in PET studies. Further, the “regions of interest” approach for searching structural brain abnormalities in schizophrenia, which implicitly assumes a regional deficit in a single brain structure, has been criticized (Frith and Dolan 1998). To address this problem, we parceled the entire frontal cortex into 10 subregions of interest; however, this approach inevitably leads to an increase in the number of comparisons.
Background: Previous structural studies of the frontal lobe in schizophrenia have had somewhat inconsistent results, but most of them have measured the frontal lobe as a single brain structure. To investigate more specific abnormalities in frontal subregions, we measured gray matter volume and cortical surface size in 10 subregions in drug-naive patients during the early stages of the illness.
Methods: Magnetic resonance imaging was used to measure frontal subregions in 34 healthy male volunteers, and 26 male, drug-naive schizophrenia patients at early stages of the illness. Frontal subregions were manually traced using our locally developed parcellation method.
Results: Patients with schizophrenia had a significant deficit in cortical surface size in the right straight gyrus and left orbitofrontal cortex. No differences were found in gray matter volumes.
Conclusions: Frontal structural abnormalities found in drug-naive schizophrenic patients appear to be subtle and circumscribed to ventral portions. Anomalies in the cortical surface size suggest neurodevelopmental abnormalities might occur during the early stages of the gyrogenesis. Further investigations are needed to explore the implications of paralimbic ventral frontal regions (i.e., straight gyrus and orbitofrontal cortex) in the pathophysiology of schizophrenia.
Neural science: A century of progress and the mysteries that remain
2000, Cell

View all citing articles on Scopus

View full text

Images of psychopathology

Abstract

Schizophr Res

Schizophr Res

Biol Psychiatry

Neuroimage

Neuroscience

Br Med Bull

Psychol Med

Schizophrenia as a chronic active brain process: a study of progressive brain structural change subsequent to the onset of schizophrenia

Psychiatry Res

Differential distribution of tyrosine hydrolase fibers on small and large neurons in layer II of anterior cingulate cortex of schizophrenic brain

Synapse

The temporolimbic system theory of positive schizophrenic symptoms

Schizophr Bull

Decreased prefrontal dopamine D1 receptors in schizophrenia revealed by PET

Nature

Dopaminergic modulation of an impaired cognitive activation in the anterior cingulate cortex in schizophrenia

Nature

Schizophrenia is associated with elevated amphetamine-induced synaptic dopamine concentration: evidence from a novel positron emission tomography method

Proc Natl Acad Sci USA

Prefrontal function in schizophrenia: confounds and controversies

Philos Trans R Soc Lond

Functional magnetic resonance imaging of schizophrenic patients and comparison subjects during word production

Am J Psychiatry

Abnormal saccadic distractibility in patients with schizophrenia: a 99mTc-HMPAO SPET study

Psychol Med

Cerebral blood flow activation and functional lesions in schizophrenia

Schizophr Res

The role of the prefrontal cortex in self-consciousness: the case of auditory hallucinations

Philos Trans R Soc Lond [Biol]