Toward integrated understanding of salience in psychosis

Attribution of abnormally heightened salience to daily-life stimuli is considered to underlie psychosis. Dopaminergic hyperactivity in the midbrain-striatum is thought to cause such aberrant salience attribution. A "salience network" comprising the bilateral insula and anterior cingulate cortex is related to the processing of stimulus salience. In addition, visual and auditory attention is well described by a "saliency map". However, so far there has been no attempt to clarify these different domains of salience in an integrated way. This article provides an overview of the literature related to four domains of salience, tries to unite them, and attempts to extend the understanding of the relationship between aberrant salience and psychosis.