TY - JOUR
T1 - Vestibular stimulation improves insight into illness in schizophrenia spectrum disorders
AU - Gerretsen, Philip
AU - Pothier, David D.
AU - Falls, Carolyn
AU - Armstrong, Maxine
AU - Balakumar, Thushanthi
AU - Uchida, Hiroyuki
AU - Mamo, David C.
AU - Pollock, Bruce G.
AU - Graff-Guerrero, Ariel
N1 - Publisher Copyright:
© 2017 Elsevier Ireland Ltd
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Impaired insight into illness (IMP-INS) is common among individuals with schizophrenia spectrum disorders (SSD), contributing to medication nonadherence and poor clinical outcomes. Caloric vestibular simulation (CVS) is typically used to assess peripheral vestibular system function. Left cold CVS is also a transiently effective treatment for IMP-INS and hemineglect secondary to right brain hemisphere stroke, and possibly for IMP-INS and mood stabilization in patients with SSD. Participants with SSD and moderate-to-severe IMP-INS participated in an exploratory double blind, crossover, randomized controlled study of the effects of CVS on IMP-INS. Participants sequentially received all experimental conditions—left cold (4 °C), right cold, and body temperature/sham CVS—in a random order. Repeated measures ANOVA were performed to compare changes in IMP-INS, mood and positive symptom severity pre and 30 min post CVS. A significant interaction was found between CVS condition, time, and body temperature nystagmus peak slow phase velocity (PSPV) for IMP-INS, indicating that single session left cold CVS transiently improved IMP-INS while right cold CVS may have worsened IMP-INS, particularly in participants with greater vestibular reactivity (i.e. higher PSPV) to body temperature CVS. The procedure's effectiveness is attributed to stimulation of underactive right hemisphere circuits via vestibular nuclei projections to the contralateral hemisphere.
AB - Impaired insight into illness (IMP-INS) is common among individuals with schizophrenia spectrum disorders (SSD), contributing to medication nonadherence and poor clinical outcomes. Caloric vestibular simulation (CVS) is typically used to assess peripheral vestibular system function. Left cold CVS is also a transiently effective treatment for IMP-INS and hemineglect secondary to right brain hemisphere stroke, and possibly for IMP-INS and mood stabilization in patients with SSD. Participants with SSD and moderate-to-severe IMP-INS participated in an exploratory double blind, crossover, randomized controlled study of the effects of CVS on IMP-INS. Participants sequentially received all experimental conditions—left cold (4 °C), right cold, and body temperature/sham CVS—in a random order. Repeated measures ANOVA were performed to compare changes in IMP-INS, mood and positive symptom severity pre and 30 min post CVS. A significant interaction was found between CVS condition, time, and body temperature nystagmus peak slow phase velocity (PSPV) for IMP-INS, indicating that single session left cold CVS transiently improved IMP-INS while right cold CVS may have worsened IMP-INS, particularly in participants with greater vestibular reactivity (i.e. higher PSPV) to body temperature CVS. The procedure's effectiveness is attributed to stimulation of underactive right hemisphere circuits via vestibular nuclei projections to the contralateral hemisphere.
KW - Anosognosia
KW - Illness denial
KW - Insight into illness
KW - Schizophrenia
KW - Vestibular stimulation
UR - http://www.scopus.com/inward/record.url?scp=85013857909&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85013857909&partnerID=8YFLogxK
U2 - 10.1016/j.psychres.2017.02.020
DO - 10.1016/j.psychres.2017.02.020
M3 - Article
C2 - 28237912
AN - SCOPUS:85013857909
SN - 0165-1781
VL - 251
SP - 333
EP - 341
JO - Psychiatry Research
JF - Psychiatry Research
ER -
