Differential aberrant connectivity of precuneus and anterior insula may underpin the diagnosis of schizophrenia and mood disorders

World J Psychiatry. 2021 Dec 19;11(12):1274-1287. doi: 10.5498/wjp.v11.i12.1274.

Abstract

Background: Over the past decade, resting-state functional magnetic resonance imaging (rs-fMRI) has concentrated on brain networks such as the default mode network (DMN), the salience network (SN), and the central executive network (CEN), allowing for a better understanding of cognitive deficits observed in mental disorders, as well as other characteristic psychopathological phenomena such as thought and behavior disorganization.

Aim: To investigate differential patterns of effective connectivity across distributed brain networks involved in schizophrenia (SCH) and mood disorders.

Methods: The sample comprised 58 patients with either paranoid syndrome in the context of SCH (n = 26) or depressive syndrome (Ds) (n = 32), in the context of major depressive disorder or bipolar disorder. The methods used include rs-fMRI and subsequent dynamic causal modeling to determine the direction and strength of connections to and from various nodes in the DMN, SN and CEN.

Results: A significant excitatory connection from the dorsal anterior cingulate cortex to the anterior insula (aI) was observed in the SCH patient group, whereas inhibitory connections from the precuneus to the ventrolateral prefrontal cortex and from the aI to the precuneus were observed in the Ds group.

Conclusion: The results delineate specific patterns associated with SCH and Ds and offer a better explanation of the underlying mechanisms of these disorders, and inform differential diagnosis and precise treatment targeting.

Keywords: Bipolar disorder; Major depressive disorder; Resting-state functional magnetic resonance imaging; Schizophrenia; default mode network; effective connectivity; insula; precuneus; salience network.