Conflict and error processing in an extended cingulo-opercular and cerebellar network in schizophrenia

The loss of cognitive control is a prominent feature of schizophrenia. Relevant for adaptive control, individuals with schizophrenia often show impairments in their ability to monitor their ongoing behavior, and to adjust their responses based on advance information or feedback. By conducting a systematic examination of the behavioral adjustments after error and conflict and of activity within and between brain regions sensitive to the need to increase control (i.e. error commission, conflict presentation) in individuals with schizophrenia (n = 38) compared to healthy controls, we aimed to 1) shed light on the role of diverse brain regions previously associated with adaptive cognitive control, and 2) contribute to our understanding of the nature of the cognitive deficits present in individuals with schizophrenia. Our results show that error- and conflict-related behavioral adjustments are relatively intact during the performance of a change-signal task. Similarly, individuals with schizophrenia demonstrated intact error- and conflict-related effects in the dorsal anterior cingulate cortex, as well as in a number of other key regions including the bilateral anterior prefrontal cortex (PFC), bilateral insula, right inferior parietal lobule during error processing, and bilateral inferior parietal lobule and thalamus, right anterior PFC, left insula, and left lateral and inferior cerebellum during conflict processing. Given that a critical characteristic of our experimental design was the use of tasks that explicitly provide information about errors and conflict, we interpret our results as suggesting that the error- and conflict-detection systems are still somewhat functional in individuals with schizophrenia, but that a compromise in the ability to represent task relevant information that allow for the generation of an error representation may lead to the alterations in error- and conflict-processing documented in the schizophrenia literature.