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Cerebral Cortex Advance Access originally published online on March 4, 2008
Cerebral Cortex 2008 18(11):2532-2539; doi:10.1093/cercor/bhn028
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Published by Oxford University Press 2008.

Deficit in a Neural Correlate of Reality Monitoring in Schizophrenia Patients

Sophia Vinogradov1,2, Tracy L. Luks3, Brian J. Schulman1,2,3 and Gregory V. Simpson3

1 Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94121, USA, 2 San Francisco Department of Veterans Affairs Medical Center, 116C, 4150 Clement Street, San Francisco, CA 94121, USA, 3 Dynamic Neuroimaging Laboratory, Department of Radiology, University of California, San Francisco, Suite 350, 185 Berry Street, San Francisco, CA 94143, USA

Address correspondence to Sophia Vinogradov. Email: Sophia.vinogradov{at}ucsf.edu.

Patients who suffer from the devastating psychiatric illness schizophrenia are plagued by hallucinations, bizarre behavior, and delusional ideas, such as believing that they are controlled by malevolent outside forces. A fundamental human cognitive operation that may contribute to these hallmark symptoms is the ability to maintain accurate and coherent self-referential processing over time, such as occurs during reality monitoring (distinguishing self-generated from externally perceived information). However, the neural bases for a disturbance in this operation in schizophrenia have not been fully explored. Using functional magnetic resonance imaging, we asked clinically stable schizophrenia patients to remember whether or not they had generated a target word during an earlier sentence completion task. We found that, during accurate performance of this self-referential source memory task, the schizophrenia subjects manifest a deficit in rostral medial prefrontal cortex (mPFC) activity—a brain region critically implicated in both the instantiation and the retrieval of self-referential information in healthy subjects. Impairment in rostral mPFC function likely plays a key role in the profound subjective disturbances that characterize schizophrenia and that are the aspect of the disorder most troubling to patients and to society at large.

Key Words: agency • cognition • fMRI • medial prefrontal cortex • self-referential processes • source memory


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