Large-scale networks underlie cognitive insight differs between untreated adolescents ongoing their first schizophrenic episode and their reference non-schizophrenic mates

OBJECTIVES: Cognitive insight (CI), the ability to perceive erroneous beliefs and correcting them based on safe experiences, is a common cognitive manifestation among schizophrenic individuals. Even though the functional morphology of the default mode network (DMN), the central executive network (CEN) and the salience network (SN) differs between non-schizophrenic and schizophrenic individuals, it is unclear whether such differences are already in place by the first schizophrenic episode. METHODS: Forty-two adolescents, including twenty-one AOS subjects was recruited, and performed independent component analysis (ICA) on resting-state fMRI data to explore alterations in the three networks in schizophrenia and the association of network changes with Beck Cognitive Insight Scale (BCIS) scores. RESULTS: Compared to the non-schizophrenic group, the AOS group showed hyper-connectivity in the left middle temporal gyrus (MTG) and hypo-connectivity in the right parahippocampal gyrus within the DMN; hypo-connectivity in the dorsal anterior cingulate (dACC) and supplementary motor area (SMA) within the SN were also detected in AOS individuals. CI subscores were positively correlated with functional connectivity (FC) in the right parahippocampal gyrus. CONCLUSIONS: The correlations reported here suggest that increased DMN connectivity in the right parahippocampal gyrus might be an early neural correlate of reduced cognitive insight in a number, but not all, adolescent untreated individuals ongoing their first schizophrenic episode.