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Neural correlates of referential/persecutory delusions in schizophrenia: examination using fMRI and a virtual reality underground travel paradigm

Published online by Cambridge University Press:  22 June 2022

Paola Fuentes-Claramonte
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
Pilar Salgado-Pineda
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
Isabel Argila-Plaza
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
María Ángeles García-León
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
Núria Ramiro
Affiliation:
Psychiatry Department, Hospital Sant Rafael, Barcelona, Spain
Joan Soler-Vidal
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
Auria Albacete
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
Nicolas Delgado
Affiliation:
Qmenta, Barcelona, Spain
Paulo Tavares
Affiliation:
Qmenta, Barcelona, Spain
María Llanos Torres
Affiliation:
Hospital Mare de Dèu de la Mercé, Unitat Polivalent, Barcelona, Spain
Amalia Guerrero-Pedraza
Affiliation:
Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
Francisco Portillo
Affiliation:
Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
Ester Boix
Affiliation:
Mental Health Department, Hospital de Mataró, Mataró, Spain
Josep Munuera
Affiliation:
Diagnostic Imaging Department, Hospital Sant Joan de Déu, Barcelona, Spain
Antonio Arévalo
Affiliation:
Hospital Sagrat Cor, Martorell, Barcelona, Spain
Salvador Sarró
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
Raymond Salvador
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
Peter J. McKenna*
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
Edith Pomarol-Clotet
Affiliation:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
*
Author for correspondence: Peter J. McKenna, E-mail: mckennapeter1@gmail.com

Abstract

Background

The brain functional correlates of delusions have been relatively little studied. However, a virtual reality paradigm simulating travel on the London Underground has been found to evoke referential ideation in both healthy subjects and patients with schizophrenia, making brain activations in response to such experiences potentially identifiable.

Method

Ninety patients with schizophrenia/schizoaffective disorder and 28 healthy controls underwent functional magnetic resonance imaging while they viewed virtual reality versions of full and empty Barcelona Metro carriages.

Results

Compared to the empty condition, viewing the full carriage was associated with activations in the visual cortex, the cuneus and precuneus/posterior cingulate cortex, the inferior parietal cortex, the angular gyrus and parts of the middle and superior temporal cortex including the temporoparietal junction bilaterally. There were no significant differences in activation between groups. Nor were there activations associated with referentiality or presence of delusions generally in the patient group. However, patients with persecutory delusions showed a cluster of reduced activation compared to those without delusions in a region in the right temporal/occipital cortex.

Conclusions

Performance of the metro task is associated with a widespread pattern of activations, which does not distinguish schizophrenic patients and controls, or show an association with referentiality or delusions in general. However, the finding of a cluster of reduced activation close to the right temporoparietal junction in patients with persecutory delusions specifically is of potential interest, as this region is believed to play a role in social cognition.

Type
Original Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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