Increased overlap between the brain areas involved in self-other distinction in schizophrenia

Self-awareness impairments are frequently mentioned as being responsible for the positive symptoms of schizophrenia spectrum disorders. However, the neural correlates of self-other distinction in this pathology are still poorly understood. In the present study, we developed an fMRI procedure in order to examine self-other distinction during speech exchange situations. Fifteen subjects with schizophrenia were compared to 15 matched controls. The results revealed an increased overlap between the self and non-self cortical maps in schizophrenia, in the medial frontal and medial parietal cortices, as well as in the right middle temporal cortex and the right inferior parietal lobule. Moreover, these neural structures showed less BOLD amplitude differences between the self and non-self conditions in the patients. These activation patterns were judged to be independent of mirror-like properties, familiarity or body-ownership processing. Significantly, the increase in the right IPL signal was found to correlate positively with the severity of first-rank symptoms, and thus could be considered a "state-marker" of schizophrenia, whereas temporal and medial parieto-frontal differences appear to be "trait-markers" of the disease. Such an increased overlap between self and non-self cortical maps might be considered a neuro-physiological signature of the well established self-awareness impairment in people suffering from schizophrenia.