Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies

Pau Soldevila-Matías; Anton Albajes-Eizagirre; Joaquim Radua; Gracián García-Martí; José M Rubio; Diana Tordesillas-Gutierrez; Inmaculada Fuentes-Durá; Aleix Solanes; Lydia Fortea; Dominic Oliver; Julio Sanjuán

doi:10.1016/j.rpsm.2020.08.001

Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies

Rev Psiquiatr Salud Ment (Engl Ed). 2020 Sep 25:S1888-9891(20)30100-2. doi: 10.1016/j.rpsm.2020.08.001. Online ahead of print.

[Article in English, Spanish]

Affiliations

¹ Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain.
² Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain.
³ Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Electronic address: [email protected].
⁴ Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Spain.
⁵ Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Feinstein Institute, Northwell Health Hospital, New York, USA.
⁶ Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; University Hospital Marqués de Valdecilla (IDIVAL), Department of Psychiatry, School of Medicine, University of Cantabria, Spain; Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain.
⁷ Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.
⁸ Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain.
⁹ Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK.
¹⁰ Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain.

PMID: 32988773
DOI: 10.1016/j.rpsm.2020.08.001

Abstract

Introduction: The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP.

Methods: Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines.

Results: Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum.

Conclusions: While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.

Keywords: Cognitive tasks; First-episode psychosis; Frontal lobe; Functional MRI; Insula; Lóbulo frontal; Primer episodio psicótico; Resonancia magnética funcional; Tareas cognitivas; Ínsula.

Publication types

Review