The neuroanatomical correlates of cognitive insight in schizophrenia

Maria Donata Orfei, Fabrizio Piras, Enrica Macci, Carlo Caltagirone, Gianfranco Spalletta

Research output: Contribution to journalArticlepeer-review


Insight has been mostly studied from a clinical perspective. Recently, attention moved to cognitive insight or the ability to monitor and correct one's erroneous convictions. Here, we investigated the neuroanatomical correlates of cognitive insight. We administered the Beck cognitive insight scale to 45 outpatients with a schizophrenia diagnosis and 45 age- and gender-matched healthy control subjects who underwent a MRI investigation, including high-resolution volumetric and diffusion tensor imaging sequences. Gray and white matter volume, mean diffusivity and fractional anisotropy were used as dependent variables and were analyzed on a voxel-by-voxel basis with reference to the cognitive insight indexes. Self-reflectiveness was positively related to gray matter volume of the right ventro-lateral prefrontal cortex (VLPFC). No statistically significant results emerged from the DTI analyses, and no significant relationships were found for self-certainty and global cognitive insight. Reduced self-reflectiveness is related to a reduced volume of the VLPFC, an area involved in generating and maintaining in working memory different hypotheses about the self. This line of research focusing on the metacognitive features of insight in schizophrenia can provide relevant information to identify patients who are most vulnerable to lack of insight and develop effective cognitive therapeutic strategies.

Original languageEnglish
Pages (from-to)418-423
Number of pages6
JournalSocial Cognitive and Affective Neuroscience
Issue number4
Publication statusPublished - Apr 2013


  • Awareness
  • Insight
  • Metacognitive
  • Neuroimaging
  • Schizophrenia

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Experimental and Cognitive Psychology


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